Results from a medical study published at the beginning of January 2023 suggest the topical application of CBD to affected areas can be beneficial in the treatment of skin ulcers, and can help to mitigate pain in people living with a condition known as scleroderma.
Scleroderma is an autoimmune connective tissue condition that affects the skin, tendons and sometimes blood vessels and internal organs. As with arthritis, scleroderma is classed as a rheumatic disease.
The condition is thought to occur when the body’s immune system attacks what it believes to be an injury, wound or infection. This triggers a response where the production of collagen is increased in the body’s attempt to help heal the area.
Scleroderma is a rare condition thought to affect around 1 in 10,000, which equates to approximately 2.5 million people around the world living with symptoms.
Symptoms from scleroderma can differ from person to person, and can depend on which parts of the body are afflicted. However, many people who have the condition experience hardening or tightening of the skin, and sometimes of the blood vessels and connective tissue.
In cases of localised scleroderma, which is often found in children, only the skin is affected and patients may experience discoloured oval patches that can occur anywhere on the body. These can become itchy and may go on their own, or require treatment.
Systemic scleroderma can affect the organs as well as skin, and mostly affects women between the ages of 30 and 50, but rarely affects children.
There are two types of the condition, the milder variety primarily impacts the skin of the hands, lower arms, feet, lower legs, and face but can later spread to the lungs and digestive system. Milder types can cause something called digital ulcers, these can begin with Raynauds, a condition where fingers turn white in the cold.
The more severe type of systemic scleroderma can affect internal organs, can change the skin over the whole body, and can lead to other symptoms such as weight loss, fatigue, and joint pain and stiffness.
Systemic sclerosis digital ulcers are extremely painful, can be very hard to heal, and are frequently responsible for what patients describe as “an unsatisfying quality of life”. They are conventionally treated with anti-inflammatory drugs, and opioids such as tramadol.
Doctors and scientists are still not able to say for sure what causes scleroderma, although it is thought that the immune system has become damaged or overactive through a combination of factors including genetics, and environmental triggers.
Conducted in Modena, Italy, and published in the journal Advances in Skin and Wound Care, the study was designed with the aim of establishing whether topical CBD oil would be effective in the treatment of digital ulcers in people living with systemic scleroderma.
The randomised trial involved 45 participants who were selected to be in either the group that received CBD oil topically, or the control group receiving a standard scleroderma treatment.
Standardised tests were performed on the participants to assess their pain and general health before and after the application of treatment in both groups. Participants were also supplied with a diary where they were asked to record their symptoms on a daily basis.
Participants in the group receiving CBD treatment reported test scores which indicated they felt lower pain and more improved healing of their wounds than the group treated conventionally.
The study reports, “Although mean wound-related pain NRS [numeric rating scale] scores did not differ between CBD-treated patients and control patients at baseline, their mean scores differed significantly after 1 month.”.
It added, “In terms of DU [digital ulcer] healing, 18 of the 25 patients in the CBD-treated group (72 percent) experienced complete healing by the end of the study. In contrast, complete healing was observed in (only) 6 of the 20 control group participants (30 percent).”
The science of how cannabis, its cannabinoids and other therapeutic compounds can be beneficial in treating conditions such as scleroderma is still in its infancy due to years of prohibition and restrictions placed on the scientific community. However, the scientists involved in this study said “The complex interactions between the ECS members in the skin, even if not yet fully clarified, seem to play a key function in controlling local immune responses. Interestingly, the ECS seems to play a role in epigenetic modification, resulting in tissue proliferation and modulation of wound-related pain. Moreover, the ECS could regulate pathways involved in keratinocyte differentiation, skin development, and epidermal cell differentiation.”.
No participants in the study reported any adverse reactions, and further investigations are required to fully assess the efficacy of CBD as a treatment for digital ulcers in people living with systemic scleroderma. However this study has produced positive results that can be used to better understand how CBD and cannabis in general can help patients.
The researchers concluded “The present study is the first to report the effectiveness of local CBD treatment in the management of SSc-DUs [systemic sclerosis digital ulcers].
“Topical administration of CBD is a safe, effective, noninvasive tool that is associated with improved wound-related pain, DU healing, and QoL [quality of life] of patients with SSc.”