Cannabis has been a popular topic recently, with a clear consensus that there are wide health benefits to the plant, and evolving laws that are increasing its availability. Recognized commonly for its use in chronic pain and inflammation, its benefits in treating a variety of skin conditions is a less familiar topic. This article will focus on cannabidiol (CBD) only, i.e. the part of the plant not containing tetrahydrocannabinol (THC), which is the psychoactive part that gets you high.

CBD's effect on skin goes beyond its anti-inflammatory effects, and is not only helpful in treatment but prevention as well.

Dr. Phillip Blair, MD, Ret. COL spoke on this topic at the recent Cannabis World Conference and Business Exposition in Los Angeles. An international consultant on medical uses of CBD, Dr. Blair geared this presentation to the effects CBD can have on such conditions as acne, psoriasis, and even skin cancer. This was the inspiration for this article.

• Neuro-regulation
• Immune modulation—includes decreasing pro-inflammatory cytokines TNF, IL1 and IL6 and increasing anti-inflammatory cytokines IL4 and IL10
• Effects on hunger, stress, and sex hormones
• Ability to restore balance to the Endocannabinoid System (ECS)

What is Cannabidiol?
Cannabidiol (pronounced Can’na-bi-die’-ol) is a derivative of the cannabis or hemp plant that contains a number of beneficial natural chemicals such as cannabinoids and terpenes, providing a synergistic or "entourage effect." This means that when added together, the effects are not simply additive, but create a more potent effect overall.

Over-the-counter cannabidiol, legal in all 50 states, contains less than .3 percent tetrahydrocannabinol (THC). In states where licensed, plants and their derivatives that contain more than .3 percent THC require a medical license and are purchased at a dispensary. That is a changing requirement, though, beyond the scope of this article. THC is the chemical in the plant that has direct mind- and mood-altering effects; i.e., it gets you high. Non-THC CBD also can have positive effects on mind and mood, but without the "high" effect.

Cannabidiol and the Skin
Cannabidiol (CBD) has been shown to have positive effects on a variety of skin conditions, its mechanism of action going beyond the commonly accepted anti-inflammatory properties of CBD. The most common modes of administration for skin care are orally and topically. Conditions treated include acne, eczema, psoriasis, skin cancer, wound healing, and aging skin.

The Endocannabinoid System and Acne
Acne is generally a result of overactive sebaceous glands. The body's endocannabinoid system (ECS) which plays a key role in the regulation of sebum production¹ responds to both endocannabinoids (made naturally in our body) and phytocannabinoids (found in the cannabis plant). Balancing the ECS is key here.

CBD works three different ways to regulate a sebaceous cell:

• Stops inflammatory lipids like arachidonic acid
• Stops the extra production of the cell types in sebaceous cells that lead to overproduction of sebaceous material
• Provides an anti-inflammatory effect²

There are other factors, too, which facilitate acne beyond the sebocyte factor. One is the over-production of testosterone which induces lipid synthesis, with excessive secretion and cell growth. CBD was shown to inhibit this lipid syntheses.2 Another factor is the overgrowth of bacteria called Propionibacterium. CBD has been shown to exhibit antibacterial properties and potentially inhibit its growth.^2,3

Eczema
Eczema is a common skin condition characterized by a red, itchy rash, most commonly appearing on the face, back of the knees, wrists, hands, or feet, but may affect other areas as well. Eczema affects about 10 percent to 20 percent of infants and about 3 percent of adults and children in the US.

Newer research indicates that that skin conditions like eczema and acne develop when there is an imbalance in the ECS,⁴ and suggests that the cannabinoids can help repair this imbalance by interacting with cannabinoid receptors. One study of 2500 patients with eczema experienced significant reductions in redness, scaling, itching, chafing, and thickening after regular topical use of a cannabinoid-containing cream. This study also resulted in 38.3 percent of the patients experiencing a complete resolution of itching symptoms.⁵

Psoriasis
Psoriasis is an autoimmune disorder which includes pathological overproduction of skin cells. The cytokine, Interleukin-17 (IL-17) is known to be largely responsible for psoriasis. CBD reduces the production of inflammatory cytokines IL-17 and IL-6 and increases the production of an anti-inflammatory cytokine, IL-10.⁶ This is a great boon to psoriasis sufferers, who have had to cover up with clothing, or take strong and expensive medications. They can now use a product that not only treats their unsightly rash, but has side benefits instead of side effects.

Skin Cancer
Many studies show promising results of cannabis on cancer cells. One study found that activating the cannabinoid receptors induced cell death in tumorigenic epidermal cells, while the non-cancerous epidermal cells remained unaffected.⁷ Dr. Blair discussed his experience with a 50-year-old man with recurring basal cell cancer. He had the cancer removed and covered the area with CBD under a band-aid. The patient experienced complete healing at two months with no signs of recurrence.

Wound Healing
There is considerable anecdotal evidence related to cannabis and wound healing. A few studies suggest that activation of the endocannabinoid system plays a role in this process.⁸ Dr. Blair showed some before and after photos of a patient with a wound on his arm, showing significant healing within 12 weeks.

Anti-aging Skin Care
There are an increasing number of CBD-containing skin care products, owing largely to its anti-inflammatory effects, which can counter the effects of aging.

Dosing and Application
For skin conditions, CBD can be taken orally, in capsules, gel caps or tinctures, or topically, as a cream or oil. Dosing should start at 15 mg of CBD twice a day orally, adjusting the dose upward as needed. It not unusual to go up to 60 mg. For a location-specific condition like eczema or skin cancer, you can apply the topical cannabis directly on the affected area. For nonspecific topical application, CBD oil can be applied to the back and covered with a band-aid as protection. Any improvements are typically seen in about two weeks after the first dose.

A number of troublesome and heretofore difficult to treat skin conditions have been resolved successfully with its use. And this is just one of a growing wave of uses of CBD.

We thank Dr. Phillip Blair for supplying both the inspiration and a portion of the material for this article.

References:

1. Dobrosi N, et al. Endocannabinoids enhance lipid synthesis and apoptosis of human sebocytes via cannabinoid receptor-2-mediated signaling. FASEB J. 2008;22(10):3685¡V95.
2. Olah A, et al. Cannabidiol exerts sebostatic and anti-inflammatory effects on human sebocytes. The Journal of Clinical Investigation. 2014;124(9): 3713¡V24
3. Kozela E, et al. Cannabinoids Decrease the Th17 Inflammatory Autoimmune Phenotype. Journal of Neuroimmune Pharmacology. 2013;8(5): 1265¡V76
4. Appendino G, et al. Antibacterial cannabinoids from Cannabis sativa: a structure-activity study. J Nat Prod. 2008;71(8):1427¡V30.
5. Eberlein, B., Eicke, C., Reinhardt, H.W., and Ring, J. (2008, January). Adjuvant treatment of atopic eczema: assessment of an emollient containing Npalmitoylethanolamine (ATOPA study). Journal of the European Academy of Dermatology and Venereology: JEADV, 22(1), 73¡V82.
6. Biro, T., Toth, B.I., Hasko, G., Paus, R., and Pacher, P. (2009). The endocannabinoid system of the skin in health and disease: novel perspectives and therapeutic opportunities. Trends in Pharmacological Sciences, 30(8), 411¡V20.
7. M. Llanos Casanova, et al. Inhibition of Skin Tumor Growth and Angiogenesis in Vivo by Activation of Cannabinoid receptors. JCI. 2003;111(1): 43¡V50.
8. Ramot Y, Sugawara K, Zakany N, Toth BI, Biro T, Paus R. (2013) A novel control of human keratin expression: cannabinoid receptor 1-mediated signaling down-regulates the expression of keratins K6 and K16 in human keratinocytes in vitro and in situ. PeerJ 1:e40 https://peerj.com/articles/40/

EWG's 2015 Sunscreen Report

What exactly does it mean when you see sunscreen or sunblock on a product label? The store shelves offer so many to choose from, no wonder it can get a bit frustrating. Federal Food and Drug Administration (FDA) has not updated their sunscreen safety standards since 1978. In June of 2011, FDA posted new rules for sunscreen products to help clear up some of the confusion. The new stricter guidelines mandate products to describe how well the product protects your skin.

Ultraviolet B testing is currently the only one required from manufacturers. UVB rays are the ones that cause sunburn. The new regulations also require sunscreens that don’t protect against both UVA and UVB rays or offer SPF under 15, to carry a warning label: “This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”

Other new regulations include requirements to prohibit claims like “waterproof ” and “sweatproof.” FDA has said these claims are exaggerations. If a product has proof of “water & sweat proofing,” they also need to show how much time you can expect to get SPF protection before having to reapply.

What is the SPF?
“Sun protection factor” lets you know the amount of sun exposure needed to cause sunburn on sunscreen-protected skin compared to unprotected skin. For example, an SPF of 30, allows you to get sun exposure thirty times longer than without any sunscreen, before sunburn. Over the years, the definition of just how high the factor needs to be has changed and gone up and down many times.

The reason for the yo-yo reports on SPF needed is that studies have not proven what amount is effective. The FDA is now proposing to set a high SPF value to 50 and a low of 15. Companies that want to set SPF levels of 75 and 100 on their labels must show testing to back up their claims. As of now, there are no studies substantiating any SPF higher than 50 is more effective or beneficial. In fact, the higher SPFs contain more chemicals, which could cause more harm than good.

Another problem with high SPF such as 100, is it falsely indicates you can stay in the sun a hundred times longer before causing the skin to burn. However, studies report users of high- SPF sunscreens have similar or higher exposures to harmful UV rays. One reason could be they trust the product and do not reapply as needed, while extending sun exposure.

FDA is also banning the term “sunblock” under the new rules, because it does not exist. You can’t block the sun with creams or lotions. The only real way to block the sun is with a hat, umbrella or whatever physical means of not exposing your skin to direct sun.

Ultraviolet A Rays and Cancer
UVB rays only penetrate the outer skin layer, which results in sunburn or in some cases, non-melanoma skin cancer such as squamous cell carcinoma. Although current regulations require testing for UVB rays, it is the UVA rays that are of concern. These rays are far more dangerous. They penetrate deeper into the skin, where it can cause DNA damage. They are linked to wrinkles, skin cancer and can even penetrate glass.

The new FDA ruling mandates products have “broad spectrum” protection, which means sunscreen for both UVA and UVB rays.

Sun worshipers should not, however, get too secure, even with this new “broad spectrum” rule. Skin cancer has been on the rise since the early 1990s. The FDA 2007 draft of sunscreen safety regulations reported: “FDA is not aware of data demonstrating that sunscreen use alone helps prevent skin cancer.”

Truth be told, clothing, hats, and shade are the only true barriers to UV radiation and prevention of skin cancer. This fact is echoed by the International Agency for Research on Cancer (IARC).

Some reports have found an increase in melanoma (the deadliest form of skin cancer) among sunscreen users. The reason could be these individuals feel they are being protected and that the product they are using is blocking dangerous UV radiation. We know now this is not true.

1. Frequent sunscreen users do show a lower incidence of squamous cell carcinoma, which is a slow-growing tumor that is treatable by surgery.
2. Sunscreen use has no demonstrated influence on basal cell carcinoma.
3. Long-term exposure to the sun, may increase the risk of melanoma.

Physicians are more concerned about malignant melanoma. Children who are exposed to intermittent, severe sunburns are at greatest risk.

Ingredients to Avoid in Sunscreen
Dermatologists recommend sunscreen should only be used on exposed skin areas, like the hands and face. There is concern that problems of potential hormonal toxicity of sunscreen active ingredients with frequent applications on the whole body. This could lead to increase systemic absorption of these ingredients with resulting risk of adverse health effects.

Vitamin A, retinyl palmitate, in some sunscreens, has been recently shown in FDA studies to speed development of skin cancer and lesions. Currently, 30 percent of sunscreens, according to Environmental Working Group (EWG), contain retinyl palmitate. This ingredient is effective for anti-aging when used in creams or lotions for indoor use, but when exposed to sunlight, free radicals can form, that can damage DNA.

In 2009, a study by the Center for Disease Control found the common UVA blocker oxybenzone in the urine of 2,500 people who regularly used sunscreens. Oxybenzone has been reported to have hormone-like activity and is not recommended by EWG.

After testing 1,000 brands of sunscreen, EWG found many with potentially toxic ingredients, including oxybenzone.

FDA Allowable Ingredients in Sunscreens, and Results for Safety

• Padimate O—not supported by European Union (EU), may be delisted by FDA
• p-Aminobenzoic Acid (PABA)—shown to increase DNA defects
• Cinoxate—not tested for safety
• Dioxybenzone—not tested for safety
• Oxybenzone—not tested for safety
• Homosalate—not tested for safety
• Menthyl Anthranilate—not tested for safety
• Octocrylene—increases reactive oxygen in skin, advancing aging
• Octyl Salicylate—not tested for safety
• Trolamine Salicylate—not tested for safety
• Zinc Oxide—protects skin against tumors in mice

How to Protect Yourself in Summer or Winter
Sunshine is vital to our health and well-being. The main source of vitamin D in the body is sunshine. Vitamin D strengthens bones and our immune system, reduces the risk of certain cancers and is important in regulation of genes involved in many tissues of the body.

Vitamin D supplements are the alternative to maintaining needed levels, however, how much is needed is still debated by scientists. Dermatologists and researchers do agree on the following:

1. Keep sunscreen and lip balm with you at all time, in your car and purse.
2. Use a natural sunscreen, preferably with zinc oxide and titanium dioxide.
3. Keep a broad-rimmed hat in your car and wear it during sun exposure, especially between the hours of 10 a.m. and 4p.m., when ultraviolet rays are strongest.
4. Children have sensitive, delicate skin and should especially be protected with proper clothing to cover sun-exposed areas. Sunscreens with zinc oxide and titanium dioxide are the best recommended for babies and children.
5. Wear sunglasses to help prevent damage like cataracts or vision loss at older age.
6. Your lips also need sun cream. Protect your lips with natural lip balm with shea butter, which has natural sunscreen properties.
7. Apply sunscreen approximately 30 minutes before exposure. Re-apply often.
8. Make sure to apply to face, hands, neck, ears, hands and arms.

Best Sunscreens to Buy
Consumer watchdog groups like the Environmental Working Group, offer education and health and eco-friendly sun protection recommendations. They also recommend not giving up on sunscreens altogether. But they do summarize that the best first line of defense against harmful radiation should be shade, protective clothing and avoiding the noontime sun.

When skin is exposed to the sun, the body's protective mechanism against oxidative damage is an increase in skin pigmentation (i.e. increase in melanin production)—also known as getting a tan. In addition to the tan, however, a localized hyperpigmented lesion, also known as age spot, solar, or senile lentigo, may occur, especially in Asian and Caucasian populations.¹ These benign-pigmented lesions are not only considered unattractive on visible areas of the skin, such as the face, hands, upper back and forearms, but they are also a marker for skin photo-damage (i.e. damage caused by the sun, leading to wrinkles, etc.).^2,3

EWG's 2015 Sunscreen Report is online.

There is no clear consensus on whether sunscreens actually prevent cancer; in fact, there’s some evidence that sunscreens might increase the risk of the deadliest form of skin cancer in some people.

The U.S. lags far behind Europe, Japan and Australia in providing consumers with safe, high quality sunscreens. Why you might ask? Because the FDA is slow in evaluating and approving better sunscreen ingredients and new combinations – making it impossible for U.S. formulators to achieve the highest level of UVA protection in their products (Osterwalder, 2009).

Tomatoes and natural tomato complex may be the ultimate women’s health food

Heart disease, breast cancer, ovarian cancer, skin cancer, endometrial cancer and osteoporosis— what do they have in common? They are all caused by oxidative stress, they attack women and they can all be prevented by tomatoes. The tomato may very well be one of nature’s most perfect foods, containing phytonutrients that help prevent oxidative damage which serves to protect against the leading health problems of women.