Do CBD Topicals Work? We Asked Doctors

Since CBD has begun to explode on the wellness scene, tons of products have emerged. From tinctures, oils, and capsules to bath bombs, skin serums, and cleansers, it seems like this miracle compound can do a little of everything. One of the most popular ways of harnessing the plant power has been through creams and salves applied topically — but how does that work?

These are topical solutions, not transdermal, meaning that the compound doesn't have the ability to penetrate the skin's protective layers in order to get to the blood stream. But can a cream directly treat a targeted area of muscle or epidermal tissue? There's not a ton of scientific information out there specifically about CBD (in the US, at least), thanks to lack of federal regulation and legal stipulations of the past.

In fact, many doctors aren't very familiar with the endocannabinoid system at all — yes, there's a system that exists in your body that has cannabis receptors. "In the medical education field, out of 144 medical schools in the country, [only] one gives a course on the endocannabinoid system," said Perry Solomon, MD, chief medical officer at HelloMD and a board-certified anesthesiologist. "Something like 16 percent of the other 143 touch on it in some way, shape, or form — either not at all or they brush by it. There was just a study from the University of Michigan, and 92 percent of them said they were completely unqualified to talk about cannabis."

He also noted that there are nearly 20,000 scientific studies on cannabis and the endocannabinoid system on PubMed, but "doctors in the US think that if a study doesn't come from the United States, it doesn't exist."

According to Dr. Solomon, topical CBD creams and salves are "a great idea." He told POPSUGAR, "I've heard lots of different things [about the ointments and the cream] — doctors will say, 'There's no way it'll get absorbed,' but when I talk to my patients, they say they put it on their knee, and 20 minutes later it felt great." So in this case, the success stories have been mostly anecdotal.

Shivani Amin, MD, of Green Health Docs in Frederick, MD, also suggested using topicals, as she prescribes some to her patients. "For back pain and neck pain and muscle spasms, I like the topicals, and Sagely produces a really good cream for that." Though her preferred delivery of CBD is tinctures, she did say that the creams are great for localized pain.

How it works is still unclear. "On the skin, there's individual reactions to topicals," said Dr Solomon. "For some people it does work. But if someone scientifically was to ask, 'What's the blood level of CBD to THC from just a skin ointment?' I'd say it's not very high."

While there's no scientific study examining exactly how it works, neurophysiologist Gregory Gerdeman, PhD, told Shape that, in theory, topical CBD could work by "increasing your natural endocannabinoids, decreasing your inflammatory response and desensitizing your pain receptors."

All that said, would Dr. Solomon recommend it? "It depends what the problem is," he told POPSUGAR. "If someone had joint pain and their knee was bothering them, I think a topical would be great to try, or for skin conditions like eczema."

He left a disclaimer and said, "I have to use a word of caution: everything may work. Whether or not it will work is a different story . . . but there's no part of cannabis that is toxic at all." So it can't hurt to try! POPSUGAR also spoke with Harvard-trained physician Jordan Tishler, MD, who said that when it comes to CBD topicals (or otherwise), "Placebo gives you a real benefit . . . just not biological." Whatever works, right?