Can CBD Help With Rosacea?

  • Rosacea is a common skin condition that causes visible blood vessels and redness on the face. Rosacea can also cause acne due to sebum buildup (1).
  • A study shared in The Journal of Clinical Investigation mentioned cannabidiol (CBD) might possess anti-inflammatory properties that might reduce redness on skin conditions (2).
  • The study also mentioned that CBD might reduce sebum buildup and prevent the prevalence of acne rosacea (3)
  • A study from La Clinica Terapeutic acknowledged that topical CBD is a safe and effective alternative for inflammatory skin conditions (4).
  • Anxiety has also been known to cause rosacea flare-ups. A study posted by The Permanente Journal demonstrated that CBD might help reduce anxiety (5).

Why People Are Turning to CBD for Rosacea

Rosacea is a chronic skin inflammatory condition that causes visible blood vessels and redness on the face. 

There are no definitive studies that answer what causes rosacea. However, it is believed that the cause can be a combination of environmental factors and heredity (6)

Rosacea risk factors include eating spicy food, alcohol consumption, extreme climate temperatures, exercise, and stress.

Symptoms of rosacea are triggered by the body’s immune response to stimuli. This response is called a “flare-up.”

Prescription creams or gels can reduce redness. However, topical drugs, such as azelaic acid (7), metronidazole (8), and ivermectin (9), may cause allergic reactions, burning, or itching sensation. 

Oral antibiotics may also be prescribed to treat rosacea(10). However, rosacea is a relapsing inflammatory condition. Continuous antibiotic treatments may result in antibiotic resistance (11)

These factors may be why individuals are turning to alternative medicine to treat rosacea.

Some studies acknowledged that CBD might have therapeutic properties on several skin conditions (12)

An in vitro study shared by the Journal of Clinical Investigation mentioned that CBD exerted anti-inflammatory actions (13).   

CBD’s anti-inflammatory properties were demonstrated by another study posted in La Clinica Terapeutica. The study found that CBD-enriched ointment significantly reduced swelling of atopic dermatitis and psoriasis in human subjects (14)

The study’s results were supported by skin evaluations and photographic data involving 20 individuals. The authors also observed that topical CBD did not produce any side effects or allergic reactions (15).

Although the study results were considered anecdotal evidence, the authors mentioned that topical CBD might theoretically be a promising alternative for improving the quality of life for individuals with inflammatory skin conditions (16)

Studies also demonstrated that CBD might be an effective agent against acne rosacea (17).

Acne rosacea is caused by sebum buildup in the pores due to blockage brought by inflammation (18)

Researchers learned that CBD inhibited pro-acne agents. This activity means CBD might reduce excessive lipid synthesis in human sebaceous glands (19).

Additionally, the study concluded that CBD reduced lipogenesis (metabolic formation of fat). This lipostatic action might help prevent acne rosacea (20).

Anecdotal and in vitro study conclusions suggested that CBD might have promising therapeutic properties for rosacea.

Still, more human studies are needed to show how CBD might act as lipostatic agent against acne rosacea. Our scientific understanding of CBD use in the setting of rosacea is in its infancy. 

How CBD Oil Works to Help With Rosacea

The endocannabinoid system (ECS) is a complex signaling network that maintains homeostasis in the body. 

The ECS is composed of receptors (CB1 and CB2 cannabinoid receptors), anandamides (fatty acid neurotransmitter), and complex enzymes (21)

These receptors can be found in the immune system, central nervous system, peripheral nervous system, and organs (22).

The receptors, anandamides, and enzymes are specific targets for activities triggered by cannabinoids in hemp, such as tetrahydrocannabinol (THC), cannabidiol (CBD) (23), and cannabigerol (CBG) (24)

Several researchers studied cannabinoids for their ability to modulate the ECS and influence the production of proinflammatory cytokines (25)

Cytokines are composed of signaling proteins that modulate individual cells’ function in the immune system (26).

A study published in Future Medicinal Chemistry mentioned that the mechanism behind cannabinoids’ immune control is through the dysregulation of cytokine production (27)

The inhibition of cytokines enables the ECS to provide therapeutic applications in several inflammatory conditions.

Moreover, an in vitro study mentioned that CBD exerted complex anti-inflammatory actions by modulating adenosine receptors. This action also decreased lipogenesis in sebaceous glands, which means less sebum buildup (28)

The authors credited CBD as a potent anti-acne and stebostatis compound that can serve as a promising cost-effective alternative to skin conditions (29)

Aside from skin conditions, the ECS has been credited for having therapeutic benefits for other health problems, such as chronic pain, neurodegenerative diseases (30), anxiety (31), depression (32), and epilepsy (33)

However, clinical studies are essential to determine if these hypotheses have clinical value. 

The Pros and Cons of CBD Oil for Rosacea

The Pros

  • A study mentioned CBD might possess anti-inflammatory properties. CBD might help reduce redness and inflammation brought by rosacea (34).
  • A study credited CBD as a potentially potent anti-acne and stebostatis compound that can serve as a promising cost-effective alternative to rosacea acne breakouts and other inflammatory skin conditions (35)
  • A study also noted that CBD might theoretically improve the quality of life of individuals with inflammatory skin disorders, such as psoriasis or atopic dermatitis (36). A study declared topical CBD as a safe and effective alternative solution (37)
  • Anxiety has also been known to cause rosacea flare-ups. A study posted by The Permanente Journal demonstrated that CBD might reduce anxiety (38).

The Cons

  • The CBD industry lacks regulation. Individuals are encouraged to do extensive research before choosing a CBD brand. 
  • There currently are no high quality, prospective clinical studies evaluating CBD use in the setting of rosacea.
  • If taken orally, CBD may cause side effects, such as dry mouth, diarrhea, and loss of appetite (39).
  • According to the US Food and Drug Administration (FDA), extremely high doses of CBD may cause liver injury (40).

How CBD Oil Compares to Alternative Treatments for Rosacea

A common alternative treatment for rosacea is aloe vera. Abundant with polysaccharides, the aloe vera plant is a natural herb used for dermatological conditions (41).

Polysaccharides are long-chain carbohydrates that supply energy for cellular structure (new skin cells) (42)

Several reports acknowledge aloe vera’s therapeutic benefits on skin disorders, like psoriasis, atopic dermatitis, hives, burn injuries, oral mucositis, and surgical wounds (43)

No studies mention if components in aloe vera influence the ECS. Still, some manufacturers take advantage of aloe vera’s and CBD’s health benefits by combining them in skincare products. 

Aloe vera infused with CBD oil is marketed towards sunburn, dry skin, itchiness, redness, and inflammation. 

Safflower seed oil is another alternative option for treating skin inflammation. The oil is known to be rich in monounsaturated oleic acid and polyunsaturated linoleic acid. 

Safflower seed oil is believed to have analgesic and antipyretic properties (44).

Like aloe vera, safflower seed oil may also be added to CBD products to maximize the health benefits they might provide for the skin. 

Moreover, some individuals like to use safflower seed oil as a base for CBD isolate powders.

How to Choose the Best CBD Oil for Rosacea

Full-spectrum CBD oil is composed of all the cannabinoids present in hemp (a cannabis plant), such as cannabidiol (CBD), cannabinol (CBN), cannabigerol (CBG), and tetrahydrocannabinol (THC). 

Broad-spectrum CBD also contains all the cannabinoids in hemp plants, except for THC. Some CBD consumers prefer not to have any THC in their system due to work and school situations.

The “entourage effect” is provided by both full-spectrum and broad-spectrum. The term entourage effect means all the supposed health benefits of all the cannabinoids are consumed in one dosing. 

If full-spectrum and broad-spectrum create an intolerance, individuals may opt for CBD isolate (pure CBD). 

CBD Dosage for Rosacea

There are no studies that can recommend a universal dosage for CBD. Experts advise that first-time CBD users start with a low dose. 

Once the body gets used to the cannabinoid, the user may gradually increase the dose. 

The British Journal of Pharmacology shared a review that recommended a starting dose of less than 1 to 50 milligrams per kilogram a day. This dosing may only be applied to oral CBD administration (45)

Currently, there are no existing studies that can recommend dosage amounts in vape and transdermal administration. 

A 2015 study shared in Pharmacology and Pharmacy demonstrated that CBD has a bell-shaped curve response. The authors mentioned that CBD’s therapeutic effects were only observed when given within a limited dose range (46).

Another study posted in the Brazilian Journal of Psychiatry experimented with doses using healthy volunteers. The authors aimed to find the correct dosing on treating anxiety caused by public speaking (47)

The authors learned that a dose of 300mg was able to reduce anxiety. Meanwhile, no improvements were observed in individuals with 150mg and 600mg dosings (48)

Individuals must always use caution when experimenting with CBD dosage. Another recent study has discovered that extreme CBD dosages may lead to liver damage (49)

How to Take CBD Oil for Rosacea

When taking CBD oil for rosacea symptoms, the best method is through topical administration. Some brands have a wide range of CBD skincare products, such as moisturizers, creams, ointments, and serums. 

Aside from treating the face, CBD oil can also be applied to other parts of the body. 

CBD creams, lotions, and salves may be used on dry skin, pimples, and other skin problems. Some CBD brands may also add extra ingredients, such as hempseed oil and hyaluronic acid. 

Individuals with other skin diseases, such as herpes zoster (shingles), psoriasis, eczema, and cellulitis, need to consult a dermatologist before using CBD

Individuals who want to take CBD through oral and sublingual administration (under the tongue) may opt for tinctures and capsules. 

However, this method is not ideal because CBD potency may be broken down when absorbed by the gastrointestinal tract. 

Another available method is through vaping, a quick CBD delivery method. A study mentioned that CBD inhaled through vapors can deliver plasma concentrations into the body in 10 minutes or less (50)

However, vaping may also come with a few side effects, such as chemical irritation, chest pains, and shortness of breath (51)

FAQ

Do Demodex Mites Cause Rosacea

Demodex folliculorum are microscopic organisms that are found in human hair follicles. Most of the time, these mites are harmless. 

However, healthy rosacea patients have been observed to host Demodex on their skin. Studies also suggested that Demodex might also promote inflammatory duration during rosacea flare-ups (52)

More studies are needed to explain how CBD might affect the presence of Demodex mites. The common treatment to reduce the Demodex population is the antiparasitic drug, 1% ivermectin (53)

The 2018 United States Farm Bill legalized the production of hemp derivatives, such as hemp oil, hempseed oil, and CBD. These products can be sold and consumed as long as the THC content is 0.3% or below (54)

Although CBD is legal, it remains highly unregulated. Thus, many CBD companies present the certificate of analysis (COA) to guarantee that their products are high-quality and safe to use.  

Individuals must always look for COAs that come from third-party ISO-certified laboratories. 

These third-party laboratories test the product for cannabinoid concentrations and contaminants, such as heavy metals, pesticides, and fungicides. 

Are CBD Oil and Medical Marijuana the Same?

CBD is abundant in hemp, a plant that belongs to the Cannabis sativa species. Manufacturers derive CBD from the hemp plants to create a concentrated version without the psychoactive effects one may get from marijuana.

THC is the active component of marijuana, also called cannabis. Although CBD and THC are the two major components used in medical cannabis (medical marijuana), THC is what makes users high.

The THC content in CBD oil is 0.3% or less, while medical marijuana (depending on the cannabis strain used) may contain up to 17-28% THC (55)

Conclusion

While there is no cure for rosacea, individuals may still find CBD useful in improving their quality of life and self-esteem (56)

Findings suggest that CBD’s antioxidant, analgesic, and anti-inflammatory effects may reduce redness in inflammatory skin conditions, such as rosacea (57)

Moreover, studies also show that CBD has a combination of lipostatic activities that may prevent sebum buildup. This activity may help prevent rosacea acne (58)

The best way to avoid rosacea flare-ups is to avoid environmental factors, like sun exposure, stress, and spicy foods (59)

More importantly, individuals suffering from rosacea must consult with a dermatologist before taking CBD


  1. The Mayo Clinic. Rosacea Overview. Retrieved from https://www.mayoclinic.org/diseases-conditions/rosacea/symptoms-causes/syc-20353815 
  2. Oláh, A., Tóth, B. I., Borbíró, I., Sugawara, K., Szöllõsi, A. G., Czifra, G., Pál, B., Ambrus, L., Kloepper, J., Camera, E., Ludovici, M., Picardo, M., Voets, T., Zouboulis, C. C., Paus, R., & Bíró, T. (2014). Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The Journal of clinical investigation, 124(9), 3713–3724. https://doi.org/10.1172/JCI64628
  3. Ibid.
  4. Palmieri B, Laurino C, Vadalà M. A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. Clin Ter. 2019;170(2):e93-e99. doi:10.7417/CT.2019.2116
  5. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
  6. The Mayo Clinic. Rosacea Overview. Op cit.
  7. The Mayo Clinic. Azelaic acid overview. Retrieved from https://www.mayoclinic.org/drugs-supplements/azelaic-acid-topical-route/side-effects/drg-20062084
  8. The Mayo Clinic. Metronidazole Overview. Retrieved from https://www.mayoclinic.org/drugs-supplements/metronidazole-oral-route/description/drg-20064745
  9. The Mayo Clinic. Ivermectin Overview. Retrieved from https://www.mayoclinic.org/drugs-supplements/ivermectin-topical-application-route/side-effects/drg-20075441?p=1
  10. Rivero, A. L., & Whitfeld, M. (2018). An update on the treatment of rosacea. Australian prescriber, 41(1), 20–24. https://doi.org/10.18773/austprescr.2018.004
  11. Ventola C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T : a peer-reviewed journal for formulary management, 40(4), 277–283.
  12. Tóth, K. F., Ádám, D., Bíró, T., & Oláh, A. (2019). Cannabinoid Signaling in the Skin: Therapeutic Potential of the “C(ut)annabinoid” System. Molecules (Basel, Switzerland), 24(5), 918. https://doi.org/10.3390/molecules24050918
  13. Oláh, A., (2014). Op cit.
  14. Palmieri, B., (2019). Op cit.
  15. Ibid.
  16. Ibid.
  17. Oláh, A., (2014). Op cit.
  18. The Mayo Clinic. Rosacea Overview. Op cit.
  19. Oláh, A., (2014). Op cit.
  20. Ibid.
  21. Tóth, K. F., Ádám, D., Bíró, T., & Oláh, A. (2019). Cannabinoid Signaling in the Skin: Therapeutic Potential of the “C(ut)annabinoid” System. Molecules (Basel, Switzerland), 24(5), 918. https://doi.org/10.3390/molecules24050918
  22. Zou, S., & Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International journal of molecular sciences, 19(3), 833. https://doi.org/10.3390/ijms19030833
  23. Ibid.
  24. Navarro, G., Varani, K., Reyes-Resina, I., Sánchez de Medina, V., Rivas-Santisteban, R., Sánchez-Carnerero Callado, C., Vincenzi, F., Casano, S., Ferreiro-Vera, C., Canela, E. I., Borea, P. A., Nadal, X., & Franco, R. (2018). Cannabigerol Action at Cannabinoid CB1 and CB2 Receptors and at CB1-CB2 Heteroreceptor Complexes. Frontiers in pharmacology, 9, 632. https://doi.org/10.3389/fphar.2018.00632
  25. Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93
  26. Foster J. R. (2001). The functions of cytokines and their uses in toxicology. International journal of experimental pathology, 82(3), 171–192. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517710/
  27. Nagarkatti, P., (2009).Op cit.
  28. Oláh, A., (2014). Op cit.
  29. Ibid.
  30. Fernández-Ruiz, J., Sagredo, O., Pazos, M. R., García, C., Pertwee, R., Mechoulam, R., & Martínez-Orgado, J. (2013). Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid?. British journal of clinical pharmacology, 75(2), 323–333. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579248/
  31. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
  32. de Mello Schier, A. R., de Oliveira Ribeiro, N. P., Coutinho, D. S., Machado, S., Arias-Carrión, O., Crippa, J. A., Zuardi, A. W., Nardi, A. E., & Silva, A. C. (2014). Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS & neurological disorders drug targets, 13(6), 953–960. https://doi.org/10.2174/1871527313666140612114838
  33. Silvestro, S., Mammana, S., Cavalli, E., Bramanti, P., & Mazzon, E. (2019). Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials. Molecules (Basel, Switzerland), 24(8), 1459. https://doi.org/10.3390/molecules24081459
  34. Oláh, A., (2014). Op cit.
  35. Ibid.
  36. Palmieri B, Laurino C, Vadalà M. A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. Clin Ter. 2019;170(2):e93-e99. doi:10.7417/CT.2019.2116
  37. Ibid.
  38. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
  39. Bauer, B. (2018, Dec 20). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
  40. FDA. What You Need to Know (And What We’re Working to Find Out). Retrieved from https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
  41. Lovegrove, A., Edwards, C. H., De Noni, I., Patel, H., El, S. N., Grassby, T., Zielke, C., Ulmius, M., Nilsson, L., Butterworth, P. J., Ellis, P. R., & Shewry, P. R. (2017). Role of polysaccharides in food, digestion, and health. Critical reviews in food science and nutrition, 57(2), 237–253. https://doi.org/10.1080/10408398.2014.939263
  42. Ibid.
  43. Foster M, Hunter D, Samman S. Evaluation of the Nutritional and Metabolic Effects of Aloe vera. In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. Chapter 3. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92765/
  44. Lin, T. K., Zhong, L., & Santiago, J. L. (2017). Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils. International journal of molecular sciences, 19(1), 70. https://doi.org/10.3390/ijms19010070
  45. Millar SA, Stone NL, Bellman ZD, Yates AS, England TJ, O’Sullivan SE. A systematic review of cannabidiol dosing in clinical populations. Br J Clin Pharmacol. 2019;85(9):1888-1900. doi:10.1111/bcp.14038
  46. Gallily, R., Yekhtin, Z., Hanuš, L.O., (2015) Pharmacology & Pharmacy, 2015, 6, 75‐85. SciRes. https://www.scirp.org/journal/pp. https://dx.doi.org/10.4236/pp.2015.62010
  47. Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Braz J Psychiatry. 2019;41(1):9-14. doi:10.1590/1516-4446-2017-0015
  48. Ibid.
  49. Ewing, L. E., Skinner, C. M., Quick, C. M., Kennon-McGill, S., McGill, M. R., Walker, L. A., ElSohly, M. A., Gurley, B. J., & Koturbash, I. (2019). Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model. Molecules (Basel, Switzerland), 24(9), 1694. https://doi.org/10.3390/molecules24091694
  50. Devinsky, O., Cilio, M. R., Cross, H., Fernandez-Ruiz, J., French, J., Hill, C., Katz, R., Di Marzo, V., Jutras-Aswad, D., Notcutt, W. G., Martinez-Orgado, J., Robson, P. J., Rohrback, B. G., Thiele, E., Whalley, B., & Friedman, D. (2014). Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia, 55(6), 791–802. https://doi.org/10.1111/epi.12631
  51. Shmerling, R.H., Can Vaping Damage Your Lungs? (2019)., Retrieved from https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734
  52. Kubanov, A., Gallyamova, Y., & Kravchenko, A. (2019). Clinical picture, diagnosis and treatment of rosacea, complicated by Demodex mites. Dermatology reports, 11(1), 7675. https://doi.org/10.4081/dr.2019.7675
  53. Ibid.
  54. The 2018 United States Farm Bill. Retrieved from https://www.usda.gov/farmbill
  55. Stuyt E. (2018). The Problem with the Current High Potency THC Marijuana from the Perspective of an Addiction Psychiatrist. Missouri medicine, 115(6), 482–486.
  56. Palmieri, B., (2019). Op cit.
  57. Ibid.
  58. Oláh, A., (2014). Op cit.
  59. The Mayo Clinic. Rosacea overview. Op cit.
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