Modern science is investigating the science behind cannabis’ ability to treat injuries and wounds, and is discovering what role the endocannabinoid system plays in the maintenance of healthy skin and wound healing.
Pain from these wounds, ranging from moderate to severe, is common. Unfortunately, appropriate treatment is often unavailable, so painkillers such as opioids are a common treatment. Given the serious side effects of opioids, a safer treatment for the management of chronic wound pain is needed.
Cannabis and Wound Closure
Research conducted thus far has provided ample evidence that cannabis has a strong analgesic, anti-inflammatory and antiseptic effect. Indeed, it appears that the endocannabinoid system is fundamentally involved with the process of healing itself, and has a vital role to play in the formation of scar tissue.
Cannabis and wound healing in history
The historical medical texts of various different cultures mention the use of cannabis in topical preparations to treat cuts, scrapes and burns. Egyptian papyri note the use of topical antiseptic preparations thought to be made from cannabis mixed with fat; Greek writers from the 1st century BCE record the use of cannabis to treat horses suffering from wounds and sores, as well as to treat nosebleed in humans.
The medieval French herbalist Ruellius recorded in his 1536 treatise De Natura Stirpium that cannabis extract could be used to treat wounds and ulcers; a few decades later, the renowned German botanist Tabernaemontanus recommended a mixture of butter and cannabis leaves to be applied to burns.
In 1649, the eminent British herbalist Nicholas Culpeper recorded that cannabis could be used to treat burns and bleeding, due to its antiseptic properties. In 1751, British herbalist Thomas Short wrote in his Medicina Britannica that a preparation of cannabis could be used to treat burns, wounds, insect bites and ulcers.
In the modern era, researchers have investigated the ability of cannabis and cannabis preparations to reduce pain, swelling and bleeding associated with cuts and burns, and to aid in the repair of epidermal tissue.
A 2010 study conducted at the University of California found that if a synthetic compound known as URB937 was administered to rats and mice with peripheral injuries, levels of anandamide increased and the analgesic effect became stronger. URB937 exerts this effect by inhibiting the fatty acid amide hydrolase (FAAH) enzyme, which is responsible for the degradation of anandamide.
Another 2010 study conducted at the China Medical University found that in mice inflicted with skin incisions, the number of cells expressing CB1-receptors increased at the injury site. The increase in CB1-expressing cells began six hours after injury occurred, peaked at five days post-injury, and reduced to baseline levels by fourteen days post-injury.
One 2017 study published in Journal of Pain and Symptom Management looked to solve the problem of pain management for wound patients. Researchers turned to cannabis for possible answers.
With plenty of anecdotal and historical evidence of the application of various cannabis products to open wounds, as well as some pre-clinical studies, the researchers of this study investigated the effect of topical medical cannabis on open wounds. Participants all received wounds through biopsies that were necessary to rule out other possible diseases. There were three participants, or cases, in this study. They self-reported pain levels daily on a scale from zero to ten. Patients were then given wound treatment with topical medical cannabis and again asked to report daily pain scores. Patients also had their opioid use recorded.
The study lasted for seventeen, twenty-one, and twelve weeks before the topical cannabis treatment for patients one, two, and three. Then thirty-three, nine, and twenty-one weeks after the topical cannabis treatment. The results showed that all three patients found that the topical medical cannabis induced a pain-relieving effect within three to five minutes of application. There was also a significant reduction in daily pain scores for the first two patients after the introduction of the topical cannabis treatment. Impressively, all patients reported clinically significant reductions in pain. A pain reduction of 30 percent or more is the clinical standard bar to meet for pain reduction, and all of the patients saw a pain reduction greater than 30 percent. Patient one saw a 66.5 percent reduction, patient two a 73.4 percent reduction, and patient three a 65 percent reduction.
The researchers concluded that these cases demonstrate that topical medical cannabis treatments may provide effective pain relief for wound patients. Moreover, this pain relief may occur through THC and CBD absorption.
One study from 2016 looked into how a combination of plant-derived traditional medicines might help such burn wounds. Made with a combination of oils from sesame, wild pistachio, walnut, and the cannabis sativa (hemp) plant, this formula was used to treat burn wounds on mice. Patients applied the treatment topically twice a day for twenty-one days, with a control group left untreated.
The results showed that the hemp-containing product significantly improved the closure of burn wounds from treatment day ten. While researchers didn’t look at the mechanisms of the treatment, and there were other plant oils included, it is an indication that cannabis may help to close and heal wounds.
Another study from 2018 reviewed the effects of cannabidiol (CBD), an active cannabinoid, on oral wound healing. Using rat models, the study injected rats with varying doses of CBD after induced mouth ulcers. The results showed that although the injection treatment didn’t result in clinical improvement levels, CBD seemed to have an anti-inflammatory effect on early wound healing.
Cannabinoids for Healing
The endocannabinoid system plays a major role throughout the entire process of wound healing. Immediately after an injury occurs, levels of anandamide in the affected tissues rise, and provide an analgesic effect by acting on the CB1-receptors present in the peripheral nerves.
Cannabis can be applied to the skin, where it improves the health of this huge organ. THC and CBD interact with the endocannabinoid system, where they have a modulating effect of physiological systems. Research suggests that the endocannabinoid system exists within the skin, where it is heavily implicated in proliferation, growth, differentiation, apoptosis, and hormone production.
What’s interesting is that cannabis is now showing promise for the treatment of burns and wounds when applied as a topical. Cannabinoids exhibit anti-inflammatory properties, potentially assisting in the healing process and pain management of these conditions. Some cannabinoids have also been found to possess antibacterial properties, making them a potential first aid treatment when such injuries arise.
Several cannabinoids could offer aid to those dealing with chronic or painful wounds. Primarily, cannabidiol (CBD) is known for anti inflammatory benefits and has been recognized widely. However, it also offers several other benefits including analgesic effects, particularly useful in wound care.
How to Promote Rapid Healing on Wounds
To aid in the healing process, several actions should be taken to provide an efficient recovery. Wounds require cleansing as well as inspection for surgical necessity. Once the wound has received stitches or dressing, it should remain clean and wrapped as exposure to open air can delay the healing process. Dietary habits will affect the rate of healing as well. Including foods rich in vitamin C in your diet will encourage collagen production. Fresh fruits and vegetables eaten daily will also supply your body with other nutrients essential to wound healing such as vitamin A, copper and zinc.