Cannabinoids for the Treatment of Dermatologic Conditions
Cannabinoids, found in Cannabis sativa and Cannabis indica, encompass various compounds, with delta-9-tetrahydrocannabinol (THC) as the main psychoactive component.  Cannabidiol is known for its pain-relief and anti-inflammatory qualities without causing a high.
Clarification on Psychoactive Components
It’s essential to distinguish between the various compounds found within Cannabis sativa and Cannabis indica, primarily THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol).
THC is the primary psychoactive component of the cannabis plant. In other words, it’s the compound responsible for producing the “high” associated with marijuana use. This psychoactive property can lead to alterations in thought, perception, and mood, often manifesting as euphoria, heightened sensory perception, and relaxation, but also sometimes resulting in anxiety or paranoia.
On the other hand, CBD, while also a significant compound found in cannabis, does not have psychoactive properties. This means that when CBD is consumed or applied, it doesn’t produce the “high” or any psychoactive effects that THC does. Instead, CBD is primarily recognized for its potential therapeutic benefits, including anti-inflammatory, analgesic (pain-relieving), and anxiolytic (anxiety-reducing) effects.
The Evolution of Cannabinoid Use in Dermatology
In the not-so-distant past, cannabinoids were primarily associated with recreational or medicinal use, far removed from the realm of dermatology. However, the scientific community’s growing interest in the potential therapeutic effects of cannabinoids has initiated a paradigm shift. This shift is underpinned by a deeper understanding of each three main classes of cannabinoids: phytocannabinoids, endocannabinoids, and synthetic cannabinoids.
Exploring the Different Classes of Cannabinoids and Their Sources
I. Phytocannabinoids: Derived from Cannabis sativa 
Phytocannabinoids, extracted from the Cannabis sativa plant, are perhaps the most well-known class. Among them, two stand out: cannabidiol (CBD) and delta-9-tetrahydrocannabinol (Δ9-THC). These compounds have gained notoriety for their potential therapeutic applications in various dermatologic conditions.
II. Endocannabinoids: Naturally produced within the human body
Endocannabinoids are endogenous compounds produced by our own bodies. Notable examples include anandamide and 2-arachidonoylglycerol (2-AG). They serve as crucial players in regulating skin homeostasis and the body’s response to external stressors.
III. Synthetic CBs: Produced under controlled lab conditions
Synthetic cannabinoids, synthesized in controlled laboratory conditions, are pivotal in research and experimental treatment settings.  They provide an avenue for scientists to better understand the effects of cannabinoids on dermatologic conditions, unencumbered by the complexities of natural sources.
Unlocking the Potential: How Cannabinoids Transform Dermatologic Care
In the realm of dermatology, cannabinoids have emerged as a beacon of hope, offering innovative solutions for a spectrum of skin conditions. Each condition presents a unique narrative of discovery and progress, as researchers explore the therapeutic power of these compounds.
1. Systemic Sclerosis
Systemic sclerosis, a rare autoimmune condition, once stood as an insurmountable challenge. But the advent of Lenabasum, a synthetic cannabinoid currently undergoing the crucible of a phase III trial, has sparked optimism. The research narrative unfolds, revealing the potential of Lenabasum to quell inflammation and fibrosis, offering renewed hope to those affected by systemic sclerosis. The paper also mentions the potential of both inhaled cannabis and oral formulations of CBD oil in the treatment of systemic sclerosis symptoms.
2. Dermatomyositis (DM)
Dermatomyositis (DM), a condition marked by severe skin disease, has presented challenges in treatment. Lenabasum, a synthetic cannabinoid, emerges as a potent contender in managing DM. Research has highlighted its ability to modulate the immune system, particularly by reducing the production of proinflammatory cytokines such as TNF-α, IFN-α, and IFN-β. This immunomodulatory effect holds promise for enhancing the quality of life for those affected by DM.
Research on trichotillomania has shown that Dronabinol, a synthetic cannabinoid, provides significant relief from hair-pulling behaviors.
4. Epidermolysis Bullosa
Epidermolysis bullosa, characterized by fragile skin causing severe pain and pruritus, has seen therapeutic benefits from Δ9-THC and CBD. These compounds have demonstrated potential in alleviating symptoms and improving the quality of life for patients.
Persistent itching, known as pruritus, has found relief through the therapeutic potential of cannabinoids. Both oral and topical cannabinoid treatments have shown promise, providing a much-needed respite to those affected and adding a hopeful chapter to the narrative of skin care.
6. Atopic Dermatitis
Atopic dermatitis, a canvas often marred by itching and inflammation, has witnessed a renaissance. N-PEA and CBD have emerged as the brushes, artfully restoring harmony and bringing respite to those affected by this common skin condition.
7. Psoriasis Vulgaris
In the world of psoriasis vulgaris, where fiery red plaques mar the skin’s landscape, CBD and Δ9-THC have emerged as enigmatic problem solvers.  With each application, they cast a spell of transformation, dissolving the plaques and quelling inflammation, painting a picture of healing.
Cannabinoids are being explored for potential treatments in conditions such as calciphylaxis, pyoderma gangrenosum, lichen simplex chronicus, and prurigo nodularis. In dermatology, the potential of cannabinoids indicates that our understanding of skin health continues to evolve, presenting new treatment possibilities.
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Dr. Raquel Molina Martinez is a board-certified dermatologist from Barcelona with over a decade of experience. Trained at Gothenburg’s University Hospital, she now practices at Centre Medic in Catalonia.