Wellness and Research

Cannabis Topicals for Wound Care

Loren DeVito, PhD
Written by Loren DeVito, PhD

Evidence from a patient case series

When thinking about cannabis and pain, you may imagine relief after smoking/vaporizing flower, taking edibles, or using sublingual oils or tinctures. These methods can be very effective for acute or chronic pain, whether using full-spectrum cannabis with different cannabinoid formulations (cannabidiol or CBD, or tetrahydrocannabinol or THC) or using CBD isolate alone. But you may not have considered topical cannabis—a popular method used by many patients.

They key benefit of topicals is that they allow for targeted treatment. For example, if you are experiencing pain in your right hand (something many experience due to daily computer and keyboard use), opting for a topical could direct cannabis treatment to the source of the problem for a quicker reprieve. And, unlike ingestible methods, topical cannabis is absorbed directly into the skin, which gets around first-pass metabolism in the gastrointestinal tract.

Research has indicated that local cannabis treatment may be effective for inflammatory conditions like arthritis. [1] And a recent study based on patient case reports has indicated that it may also be effective for wound pain. [2]

Opioids remain standard treatment for wound pain. In light of the current opioid epidemic, alternative options are urgently needed, especially in the case of wounds since there is some evidence that opioids could block healing. [2] Therefore, identifying a treatment that can be applied topically without significant side effects that works rapidly is an important unmet need.

In this patient case series, researchers investigated the effects of a topical medical cannabis formulation on pyoderma gangrenosum, a rare inflammatory skin condition. Skin lesions (or areas of damage) from this condition are very painful and significantly impact quality of life. [2]

This report included three patient cases as follows: [2]

Case 1

  • Patient: 50-year-old woman taking steroids and opioids for pain
  • Topical treatment: 1mL of 5mg/mL THC/6mg/mL CBD
  • Dose frequency: daily for 33 weeks

Case 2

  • Patient: 76-year-old man taking steroids and opioids for pain
  • Topical treatment: 0.5-1mL of 7mg/mL THC/9mg/mL CBD
  • Dose frequency: twice daily for 9 weeks; 1-3 times daily for breakthrough pain

Case 3

  • Patient: 60-year-old woman taking steroids and acetaminophen for pain (she refused opioids after experiencing side effects)
  • Topical treatment: 0.5-1mL of 7mg/mL THC/9mg/mL CBD
  • Dose frequency: twice daily for 21 weeks; 1-3 times daily for breakthrough pain

Patients reported that the onset of pain-relieving effects occurred within 3-5 minutes of application. And all reported reductions in average daily pain scores (results were significant for two out of three patients). In addition, topical application also was associated with a reduction in opioid use. [2]

 

While these data are limited in their application, as they reflect the experiences of only three patients, they add to the growing data on the effectiveness of topical cannabis for skin conditions.

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References

  1. Philpott, H.T., OʼBrien, M., McDougall, J.J. “Attenuation of Early Phase Inflammation by Cannabidiol Prevents Pain and Nerve Damage in Rat Osteoarthritis.” Pain. vol.158, no.12, 2017, pp. 2442-2451.
  2. Maida, V., & Corban, J. “Topical Medical Cannabis: A New Treatment for Wound Pain-Three Cases of Pyoderma Gangrenosum.” J Pain Symptom Manage. vol.54, no.5, 2017, pp. 732-736.

About the author

Loren DeVito, PhD

Loren DeVito, PhD

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