Jennifer Aniston uses CBD to calm her nerves, Dakota Johnson keeps it in her carry-on to get good sleep on long flights and Mandy Moore rubs it on her feet before walking a red carpet. It’s the three little letters that have disrupted the skin-care and wellness arenas with no sign of slowing down—the market is projected to reach $22 billion in 2022. “We are on the cutting-edge of a whole new science, biochemistry and industry,” says San Diego dermatologist Jeanette Jacknin, MD. “This is just the beginning.
The Cannabis Connection
CBD (or cannabidiol) comes from the cannabis plant (sativa or indica), which contains more than 130 different compounds known as cannabinoids. To break it down, we like to think of the cannabis plant as a parent company, and within that company there are two separate brands: hemp, which contains less than 0.3 percent THC, and marijuana, which contains more than 0.3 percent. The hemp brand creates CBD and hemp seed oil, which are two distinct compounds, but both are non-intoxicating. The marijuana brand creates THC—the psychoactive element associated with getting high—but also CBD, although it isn’t as potent.
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“First isolated from cannabis in 1940 by Roger Adams, the structure of CBD was not completely understood until 1963,” says Dr. Jacknin. “Early studies resulted in the accepted view that THC was the ‘active’ principle of cannabis, and research then focused primarily on it, to the virtual exclusion of CBD. This was no doubt due to the belief that activity meant psychoactivity that was shown by THC and not CBD. In retrospect, this was unfortunate because a number of actions of CBD with potential therapeutic benefit—largely the ease of joint and muscle pain, but also anxiety relief and sleep support, among others—were downplayed for many years.”
However, as David S. Younger, MD, New York neurologist and author of The Science of Medical Cannabis, notes, the study of THC has led to many groundbreaking discoveries, including that of the human endocannabinoid system, which “has emerged as one of the key regulatory mechanisms in the brain, controlling things like mood, pain perception, learning and memory.”
Our bodies actually make our very own receptors for cannabinoids, known as CB1 and CB2, and when we ingest CBD or THC, it targets one or the other. “CB1 receptors are present throughout the central nervous system, which is why THC does its thing when smoked or eaten, but CBD selectively targets CB2 receptors, which inhabit the immune system, making it a favorable option for wound healing and managing inflammation,” explains Adam Friedman, MD, professor and chair of dermatology at George Washington School of Medicine and Health Sciences.
It’s these benefits that first caught the attention of doctors and wellness aficionados, and eventually, skin-care experts, too. But, as the experts interviewed for this story unanimously stressed, not all CBD is created equal.
The CBD Controversy
Given the popularity of CBD, it seems like everyone wants a piece of the plant-based pie. Whether we’re at Ulta, a SoulCycle class, a spa, or even some doctors’ offices, CBD-infused products are most likely within reach—or will be in the near future. As a result, there’s abundant confusion as to which products actually contain the ingredient and which don’t.
“Many skin-care brands are formulating products with hemp seed oil—aka cannabis sativa seed oil—which contains zero CBD and comes from the seeds of the plant versus the flowers, stems and stalk, where CBD is sourced. Many people are confused and think it’s the same thing as CBD or contains CBD, but there’s a significant difference,” says Lord Jones cofounder and president Cindy Capobianco. Although hemp seed oil is high in antioxidants and fatty acids that plump and protect skin, CBD trumps it on both fronts, and is also touted as an acne fighter—it helps reduce sebum production in the skin—and an over-the-counter solution for eczema, rosacea and psoriasis (clinical trials for these uses are pending).
“Multiple OTC hemp brands have received warning letters from the FDA because their products had little to no CBD in them,” says Dr. Friedman. “Furthermore, these companies have to be very cautious with their claims—if anything sounds remotely medical, meaning intended for use in the diagnosis, mitigation, cure, treatment, or prevention of disease, then their product would be considered a drug, and that is a big infraction.”
Another hurdle for many topical CBD pain relievers, Dr. Friedman notes, is that they contain other scientifically proven analgesic compounds, such as menthol, camphor and capsaicin, so it’s tough to determine which ingredient is doing the heavy lifting.
Topicals Vs. Ingestibles
Topicals
What they are: Oils, lotions, serums, creams, salves and sprays that are applied to the skin
What they’re best for: Providing “targeted, fastacting relief for aches, pains and skin inflammation,” says Bumgarner, “and treating localized issues like sore muscles.”
Other benefits: CBD potions are being used in dozens of ways: on joints and muscles to ease stiffness, the temples to address pain associated with migraines, the abdomen to soothe menstrual cramps, and the feet before a long night in stilettos. “We’ve also heard cases where it’s been applied prior to in-office aesthetic treatments like fillers and lasers to help minimize discomfort during the procedure and any bruising or swelling afterward,” adds Capobianco. Dr. Friedman says there is definitely potential for this use to become mainstream, but more clinical evidence and regulation is needed first.
Good to know: Most CBD topicals can’t penetrate into the bloodstream, unless they are designed to be transdermal or are applied to areas of the body that are more porous (such as mucous membranes).
Ingestibles
What they are: Tinctures, capsules, gummies, powders, drinks, etc. that, like other dietary supplements, are not regulated by the FDA. Tinctures—CBD-infused liquids (mainly oils) that get dispensed via dropper under the tongue—are the most common and quickly absorb into the bloodstream. Candies and capsules need to be processed through the digestive tract, so their effects may take longer to manifest.
What they’re best for: Promoting restful sleep, as well as easing stress and anxiety issues, and symptoms associated with autoimmune disorders like multiple sclerosis and rheumatoid arthritis
Other benefits: CBD ingestibles may also offer a natural treatment for some types of chronic pain. “In preclinical trials, CBD was found to reduce the body’s inflammatory response in those with autoimmune conditions,” says Dr. Younger. Researchers are also studying its effects on depression, type 1 diabetes, Parkinson’s, Huntington’s, Alzheimer’s, and schizophrenia, among other disorders.
