No pain, no gain? To your patients, no pain is absolutely gain!
Pain requires immediate attention … and relief. Topical hemp products are increasingly popular among patients to target localized aches and pains. But not just any topical hemp product will get the job done well.
The CBD (cannabidiol) topical market is crowded with products, complicating the selection process.
Here are 4 key considerations as you review options to find the most effective one for your patients.
1. What is the cannabinoid content and potency of the product?
You will see many products vaguely labeled as “hemp” that populate the marketplace. Unfortunately, “hemp” is an expansive term that seems to have varying definitions, including being made only from hemp seed oil, which may not contain cannabinoids. Look specifically for content of CBD and/or CBG (cannabigerol) which are active phytocannabinoids.
Discerning potency is where it may get a bit tricky. Most are labeled for total bottle content, so consider the size of the container which directly impacts the true potency per serving. A 5-ounce bottle labeled with 800 mg total CBD is much less potent than a 2-ounce bottle labeled with 800 mg total CBD, as an example.
The potency per serving that will typically provide your patients with optimal relief is a concentration of about 10 mg cannabinoids per application.
2. Has the product been formulated to penetrate the skin?
CBD topicals exert their effects by interacting with cannabinoid receptors in the skin. The skin, an active organ with several layers, is by nature and necessity, not easily permeable, so it is challenging for the active phytocannabinoids and supportive ingredients to breach its protective barrier and reach the deeper layers.
The skin contains a widespread distribution of cannabinoid receptor type 1(CB1) and cannabinoid receptor type 2(CB2). [Also see related blog on the Skin’s ECS]. As noted above, CBD topicals produce their effects by interacting with these cannabinoid receptors in the skin, which then starts a cascade of events that may lead to decreased inflammation, pain relief, enhanced healing, and more.
Most cannabinoid topicals typically act on only the outermost, epidermal layer of the skin. Products formulated with natural and organic carrier oils will be most readily absorbed and may assist in transporting the phytocannabinoids and any supporting ingredients into the skin. Formulas including ingredients that help carry the cannabidiol content through the epidermis to penetrate into deeper layers can provide additional desired benefits.
When included in a topical, non-synthetic ingredients like squalane are proven carriers, penetrating the skin and escorting the phytocannabinoids to where they work.
Squalane, a naturally occurring lipid in the skin and sebum, is an exceptional delivery mechanism for efficiently delivering cannabidiol in topical products into the skin. It can also prevent trans-epidermal water loss and dryness, promoting hydration and restoring the supple texture to skin.1
One squalane source has clinical research quantifying its abilities to improve bioavailability. Neossance® Squalane is made from sustainable, renewable sugarcane. A penetration study showed that Neossance squalane, when combined with CBD, can have a more impactful effect on the desired area, more immediately.
In a 24-hour test, 1% CBD in five oils — squalane, sunflower, hemp seed, caprylic, and jojoba — were compared for their ability to deliver the active ingredient through the skin using EpiSkin™. Samples were collected at 1, 3, 6 and 24 hours post application to measure the amount of CBD.
The results showed that Neossance Squalane provided faster and greater penetration and delivery of CBD into the skin through the duration of the experiment. In contrast, the other four carrier oils had much lower rates of CBD penetration. In 24 hours, Neossance Squalane delivered 100% of CBD, compared to 4.8% sunflower oil, 5.3% hemp seed oil, 2.2% caprylic, and 8.3% jojoba oil.
Figure 1. CBD measured in EpiSkin
3. Does the product include synergistic ingredients that contribute to its effects?
While the cannabinoids are “the star of the show,” a formula that includes complementary ingredients can make an important contribution in overall effectiveness. Supporting ingredients can intensify the desired effects.
A product that contains synergistic ingredients can add to the soothing properties and overall efficacy of topical products, whether used for pain or a variety of skin conditions.
A New Use for an Old Favorite
You may be familiar with palmitoylethanolamide (PEA) and its anti-inflammatory and other clinical effects, as this dietary supplement has been in use for decades. However, what’s new is that more recent research has demonstrated its benefits when used topically.
PEA is categorized as part of the extended endocannabinoid family, and like CBD, it interacts with the body’s endocannabinoid receptors. PEA is a simple fatty acid amide that closely resembles anandamide, a key endocannabinoid transmitter (known as the “bliss” molecule) that is directly associated with pain regulation. It is produced by the body to begin to repair inflammation. There are many studies showing how PEA acts as a cannabimimetic, helping to reduce inflammation and pain.
As an endogenous lipid in the N-acylethanolamine family, PEA resembles stratum corneum components and functions as peroxisome proliferators-activated receptor α (PPAR- α) agonist, lending it analgesic and anti-inflammatory properties. Research has also demonstrated that PEA helps to restore healthy skin barrier function and minimize trans-epidermal water loss.2
A large multinational, multicenter study involving 2,456 individuals with mild to moderate atopic dermatitis demonstrated that the use of PEA-containing moisturizers could improve itch severity, skin dryness and eczema. At the study’s conclusion, 56% of participants discontinued their use of topical corticosteroids.3
The unique combination of PEA with CBD offers complementary clinical effects.
There are a variety of plants that produce terpenes, aromatic oils that emit unique odors and flavors to protect the plant from various predators or environmental insults. The hemp plant is one of these (think of that familiar aroma of hemp). Different beneficial effects are attributed to different plant terpenes. Two botanicals producing terpenes that may work synergistically with phytocannabinoids are lavender (Lavandula angustifolia) and peppermint (Mentha piperata). They contribute supplemental effects – from augmenting the relief and soothing properties, to exerting astringent, anti-bacterial and anti-inflammatory activities.
Peppermint promotes skin healing, as it provides astringent, anti-inflammatory and antiseptic properties. Peppermint’s high content of menthol was found to have a robust antimicrobial activity.5 Many enjoy relief from the cooling sensation and soothing effects of menthol as well.
While commonly recognized as a calming agent and analgesic, one study demonstrated that topical application of lavender oil accelerated wound healing by stimulating collagen synthesis and fibroblast differentiation along with upregulating the cytokine TGF-beta, which expedites repair of skin cells.4
4. Is the product made with clean ingredients?
In a prior blog, we’ve reviewed the importance of ensuring that the product does not contain potentially harmful ingredients such as phthalates, parabens and sulfates. It’s also important to ensure that products are tested for — and do not contain — heavy metals, pesticides and other contaminants. This is especially important for CBD products as hemp plants are phyto-accumulators, exhibiting a high tendency to also absorb unwanted compounds in soil. Choose products that are third-party tested for a range of purity measures.
When sourcing CBD topicals for your patients’ relief of aches and pains or skin issues, look for products that are potent, clean, contain synergistic ingredients and can deliver the cannabinoids through the epidermis. Your patients will thank you for doing the research and providing them with high-quality and effective hemp formulas.
- Purnamawati, Clinical Medicine & Research 2017 15(3-4):75-87
- Kircik, J Drugs Dermatol. 2010 Apri;9(4):334-338
- Eberlein, J Euro Acad Dermatol Venereol 2008 Jan;22(1):73-82
- Mori, BMC Complement Altern Med 2016 16:144
- Orchard Evid Based Complement Alternat Med 2017; 4717971