Ask any person who has struggled with acne and they’ll tell you, it is one of the most difficult health conditions to get under control and it can lead to unwanted stress that often compounds the problem. Not only does acne cause significant physical problems such as altered appearance and permanent scarring, it also causes psychological problems as well. People are often self-conscious about the appearance of their skin, and acne has been linked to poor self-image, depression and anxiety.
According to the American Academy of Dermatology, acne is the most common skin condition in the United States, affecting up to 50 million Americans annually and the costs associated with the treatment of acne exceed $3 billion per year.
But what is acne and why is it so prevalent in our society?
Acne, also known as acne vulgaris, is a chronic inflammatory skin condition that occurs when overactive oil glands (sebaceous glands) produce too much oil and combine with skin cells to plug pores. When the pores in the skin become plugged, bacteria on the skin multiply, which causes skin lesions.
The condition is characterized by blackheads, whiteheads, pimples and deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and upper arms. It usually begins in puberty and affects many adolescents and young adults, but it can occur at any stage of life. Approximately 85% of people between the ages of 12 and 24 experience at least minor acne.
Caused by many factors, acne can be linked to genetics, hormones, menstruation, emotional stress, medication, and some foods.
Prevention through a cleansing regimen is often the first line of defense. For mild to moderate acne, current treatment today generally consists of topical therapies and oral antibiotics. For more severe cases, a dermatologist may prescribe isotretinoin which is a retinoid or a vitamin A derivative used as a treatment for severe cystic acne.
However more recently, scientists have discovered that the endocannabinoid system may play a major role in the development of acne vulgaris as well. Furthermore, they feel that novel therapeutic approaches that target the endocannabinoid system could become the next breakthrough in specialized acne treatment.
The endocannabinoid system of the skin
The endocannabinoid system (ECS) consists of the cannabinoid receptors CB1 and CB2, the endocannabinoid ligands anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and their metabolic enzymes. The ECS has been implicated in a growing number of physiological functions in the central and peripheral nervous systems and in peripheral organs. Also, researchers have found evidence that modulating the activity of the ECS holds therapeutic promise for the treatment of a wide variety of diseases.
Of course, skin is considered the body’s largest organ. Therefore, it was not a surprise when researchers discovered that there was indeed the existence of a functional ECS in the skin.
Since its discovery, the ECS has been implicated in various biological processes in the skin. These include proliferation, growth, differentiation, apoptosis, and cytokine production, mediator production or hormone production of various cell types of the skin.
In a 2009 study published in Trends in Pharmacological Sciences, researchers found that, “the main physiological function of the cutaneous ECS is to constitutively control the proper and well-balanced proliferation, differentiation and survival, as well as immune competence and/or tolerance, of skin cells. The disruption of this delicate balance might facilitate the development of multiple pathological conditions and diseases of the skin (e.g. acne, seborrhea, allergic dermatitis, itch and pain, psoriasis, hair growth disorders, systemic sclerosis and cancer).”
In another study published in 2008 in the FASEB journal, Hungarian researchers from the Department of Physiology, University of Debrecen, Medical and Health Science Center, found that the endocannabinoids AEA and 2-AG enhanced lipid (fat) synthesis and apoptosis (programmed cell death) of human sebocytes through CB2 signaling.
Sebocytes are specialized skin cells that are grouped in clusters of oil glands called sebaceous glands. These cells are responsible for the synthesis and secretion of sebum, which is a blend of fatty acids, waxes, lipids and other molecules that are normally responsible for moisturizing, lubricating and protecting the skin. However, overactive glands can lead to the overproduction of sebum, which in turn can facilitate the growth of bacteria that contributes to acne problems. Excess sebum can also cause clogged pores which block the follicle and spur the development of inflammatory lesions.
The discovery that endocannabinoids can enhance lipid synthesis and apoptosis of sebocytes through CB2 signaling is huge. This discovery has made the ECS a prime target for novel pharmacological approaches. In the study, the researchers concluded that CB2 antagonists or agonists could play a major role in the management of a skin disorders like acne and others – which are characterized by sebaceous gland dysfunctions.
Finally, in a 2014 study published in the Journal of Clinical Investigation, a team of researchers investigated the effects of CBD on human sebaceous gland function.
The researchers observed that CBD exerted a “trinity of cellular anti-acne actions.” In other words, their results showed that CBD normalized the pathologically elevated lipogenesis induced by “pro-acne” agents, suppressed cell proliferation, and prevented the actions of “pro-acne” agents to elevate pro-inflammatory cytokine levels.
In conclusion, the authors found CBD to be a potent “universal” anti-acne agent that possesses a unique “triple anti-acne” profile, and that it as a promising, cost-effective, and, likely, well-tolerated new strategy for treating acne vulgaris. They suggested that a topical application of CBD could be used as a potent, novel class of anti-acne treatment in the near future.
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