Can cannabinoids help skin conditions like eczema, psoriasis, or acne?

The skin has a fully functional ECS — keratinocytes, sebocytes, hair follicle cells, and immune cells all express CB1, CB2, TRPV1, and TRPV4 receptors. This makes the skin a legitimate target for topical cannabinoid therapy. Evidence by condition: Acne: CBD inhibits sebocyte lipid synthesis and has anti-inflammatory effects on sebaceous glands — a 2014 cell study (Oláh et al.) found CBD reduced sebum production. No human RCTs. Eczema/atopic dermatitis: a 2019 RCT found a topical cannabinoid cream significantly reduced itch and sleep disturbance vs. placebo. Psoriasis: cannabinoids inhibit keratinocyte proliferation in vitro; no RCTs. Pruritus (itch): the strongest evidence — a 2005 study found topical endocannabinoid cream reduced chronic itch in dialysis patients. Wound healing: CB2 activation promotes keratinocyte migration. Key advantage of topical application: avoids systemic effects and psychoactivity. Key limitation: most commercial CBD skincare products contain concentrations far below those used in research, and skin penetration of cannabinoids is limited.