Inflammation of the Skin

One reason that eczema can be so troublesome is simply that we have SO much skin! Learn more about natural ways to reduce inflammation and the best CBD cream for eczema. The skin is considered the largest organ in the body, covering a total area of around 20 square feet. While eczema preferentially covers certain parts of the body (such as inside the elbows, behind the knees, and on the neck), pretty much anywhere is fair game. 

The skin has three layers.

Epidermis

The outer layer of the skin is the epidermis, which provides protection against injury, maintains hydration, and contains melanin which creates skin color. The epidermal skin barrier is waterproof, preventing water from coming in from outside but also keeping the water inside from moving out.

Dermis

The middle layer of the skin is the dermis, which contains nerve endings, sweat glands, hair follicles, and connective tissue like collagen and elastin. It also contains a high concentration of immune cells, which are important because the skin provides protection against invading pathogens. The dermis is the thickest layer of the skin.

Hypodermis

The innermost layer of the skin is the hypodermis, also known as subcutaneous tissue. The hypodermis contains fat and connective tissue that provides insulation, shock absorption, and energy storage. 

Eczema affects both the epidermis and dermis of the skin. The outermost layer of the dermis, called the corneal layer, is damaged, resulting in a loss of moisture. Consequently, the outer skin barrier becomes rough, cracked, and inflamed. Eczema skin conditions are regularly described as itchy skin and dry skin.

The damaged skin barrier also reduces protection from outer irritants and allergens, which can worsen the situation. In eczema, both the dermis and the epidermis are inflamed, so treatment often focuses on reducing inflammation. 

Eczema and The Endocannabinoid System

The endocannabinoid system (ECS) is a system of receptors, enzymes, and molecules that is distributed throughout our entire body. The ECS is often referred to as the body’s “master regulator” because of its role in regulating and coordinating our most important functions. There are three components of the classical ECS, including two endocannabinoids, two cannabinoid receptors, and several enzymes that both synthesize and break down the endocannabinoids. The two endocannabinoids are anandamide (AEA) and 2-arachidonylglycerol (2-AG), which bind to cannabinoid receptors 1 (CB1) and 2 (CB2). 

The Endocannabinoid System is widely distributed through all the systems of the body, including in the skin, or integumentary system. In the skin, it is heavily concentrated in the dermis, where it is involved in regulating several functions including hair growth, inflammation, and sebum production. These latter two functions provide an important link between the ECS and eczema.

Two of the defining characteristics of eczema are skin dryness and inflammation. The ECS regulates the production of sebum, an oil found in the skin which is produced by sebaceous glands in the dermis. Sebocytes have been found to contain CB1 receptors and are involved in both acne (too much sebum production), as well as eczema (too little sebum production).

In addition to sebaceous glands, the dermis also contains many immune cells. Immune cells are also present in the epidermis, and the immune cells in both layers coordinate to provide protection against invading pathogens. These immune cells also regulate inflammation and are involved in eczema, especially allergic eczema. 

In addition to eczema, the ECS has been implicated in a wide range of dermatologic conditions, including allergic dermatitis, psoriasis, fibrotic disorders such as scleroderma, conditions that cause itching, keratin diseases such as epidermolysis bullosa, and hair growth disorders. The extensive implication of the ECS in dermatologic disorders is interesting because this system can be targeted with both topical applications of ECS modulators as well as systemic approaches such as taking by mouth. 

The most used ECS modulators are cannabidiol (CBD) and delta-9-tetrahydrocannabinol. THC is a Schedule 1 drug at the federal level, although it is legalized for recreational and/or medical use in some US states. Unlike THC products, CBD products in the US are made from hemp, a sub-species of cannabis that was made federally legal in the US with the passing of the 2018 Farm Bill.

Also unlike THC, CBD is not psychoactive, meaning it doesn’t cause users to feel impaired. CBD has been found to have many health benefits, most of which are mediated through effects on the ECS, including regulating immune function and inflammation. CBD products come in many forms, including oral and topical, which are applied to the skin. Oral CBD is used to treat a range of issues including chronic pain, sleep, and stress, while topical CBD is used in the treatment of pain and dermatological conditions, including eczema.

Topical Eczema Cream

Topical creams are used commonly to treat eczema, and there are many different formulations. Topical treatments are applied directly to the skin, which unless formulated with special ingredients, will be absorbed into the skin but will not pass into the bloodstream. Some of the most popular topical eczema creams are as follows:

CBD

CBD topicals usually contain CBD derived from hemp, which is available without a prescription in countries in which hemp extract is legal. There are different types of CBD creams, including isolate, full-spectrum, and broad-spectrum. 

CBD isolate products only contain isolated CBD and are THC-free.

Broad-spectrum CBD products will contain CBD along with other cannabinoids (and usually other compounds like terpenes) but are THC free.

Full-spectrum CBD products will contain CBD along with other cannabinoids (along with other compounds like terpenes), and they can contain up to 0.3% THC. In addition to CBD creams or lotions, topical CBD is also available as a salve.

Topical CBD has been shown to improve eczema symptoms within two weeks of treatment. CBD for eczema can also be taken orally, and oral CBD has been shown to reduce pain and inflammation.

Cbd also acts as an immune system modulator. Oral and topical CBD may be combined in the treatment of eczema, although research has focused only on topical application. According to the World Health Organization, CBD is “generally well tolerated with a good safety profile”. 

Steroids

Steroid creams contain topical corticosteroids, which are considered a first-line therapy for treating eczema. Topical steroid creams containing up to 1% steroids are available over the counter, in contrast to prescription eczema steroid creams, which contain up to 2.5%.

The creams come in a variety of different types (like betamethasone and hydrocortisone) and dosing instructions vary. Steroid creams, especially at stronger concentrations, can have side effects including thinning of the skin, bruising, and premature aging.

A recent analysis found that although clinical trial evidence suggests that steroid cream can be used safely when used as required to treat eczema flares, the short duration of most studies limits our knowledge of long-term side effects. Steroids work by reducing inflammation, healing lesions, and decreasing relapse rates.

Aloe Vera

Aloe vera is a plant that grows in dry, hot regions that have been widely used to treat skin problems. Aloe vera contains many chemical compounds that have a pharmacological activity that provides skin protection, including aloesin, aloin, and emodin.

Topical aloe vera has antioxidant and anti-inflammatory activity. Usually, aloe vera gel and extracts are applied to the skin. However, a recent study found that oral aloe vera improved markers of skin health in mice with atopic dermatitis.

Clinical research using aloe vera to treat eczema is limited, although there are many anecdotal reports on the internet that support its use. Aloe vera cream is available without a prescription.

Coconut Oil

Coconut oil is derived from the meat of the coconut. It contains high levels of fatty acid lauric acid, which has antimicrobial and anti-inflammatory activity. Although there is limited research using coconut oil to treat eczema, it has been shown to be helpful in both children and adults. Coconut oil and creams containing coconut oil do not require a prescription.

What is the Best CBD Cream for Eczema?

Which is the best eczema cream?

Most doctors would agree that before trying a prescription eczema cream, that over-the-counter eczema creams should be explored. All the creams reviewed here have been shown to be effective in the treatment of eczema. Unfortunately, no study has compared different creams to see which works the best. A few considerations that may help you decide what to use are as follows: 

What part of my body am I treating? Eczema cream for the face should be “non-comedogenic”, which means that it is specially formulated not to block pores. This means that coconut oil, which is highly comedogenic, is not an option for use on the face.

Aloe vera is non-comedogenic and is face friendly. CBD in an oil form should not be used on the face, but when formulated as a cream, will work depending on what other are ingredients present. Some steroid creams are non-comedogenic. For most people, eczema cream for the hands does not need to be non-comedogenic.  

What are the other ingredients in the cream? Aloe vera gel and coconut oil are available as pure extract, but usually, these ingredients are mixed with others to make a cream. Similarly, CBD and steroid creams also contain other ingredients.

You should look carefully at what these ingredients are when choosing a product. It is generally accepted that products applied to the skin should be free from parabens, artificial fragrances, sodium lauryl/laureth sulfate, toluene, phthalates, formaldehyde, diethanolamine, and triclosan.

Almost all steroid creams contain some of these ingredients, although there are a few that are formulated with natural ingredients. Some creams may contain more than one of the ingredients described in this article. For example, Fringe’s Mysa cream contains both CBD and aloe vera, as well as other skin-soothing ingredients like jojoba seed oil and shea butter.

Is it a high-quality product? People have different ideas of what constitutes quality, but when it comes to skincare, many consumers are looking for products that contain natural, organic ingredients. In the US, products can be USDA-certified organic if they follow organic regulations.

Quality assurance also comes from verification that a product contains the listed ingredients in the specified amounts. This is evidenced by a Certificate of Analysis (COA), which displays the results of a chemical composition analysis, preferably done by a third-party lab. The CBD and aloe vera in Mysa are certified organic, and the CBD levels are verified on a COA.

The COA also ensures that the product does not contain any residual pesticides, microbes, heavy metals, and solvents. Some people may also prefer products that are not tested on animals. 

As we say at Fringe, “It’s Personal!” You may need to try a few products, but if you focus on choosing high-quality products that contain ingredients proven to work you will find the one that works best for you.

The content on this site is for informational and educational purposes only and has not been evaluated by the Food and Drug Administration. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions or before beginning any nutrition, supplement, or lifestyle program.

Dr. Genevieve Newton, publishers of this content, or Fringe, Inc. takes no responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.