Dr.G Dhadwal et al. in a review article”The Risks and Benefits of Cannabis in the Dermatology Clinic” have outlined Benefits and Risks of Cannabis in Dermatology.The same has been published in Journal of Cutaneous Medicine and Surgery.
Cannabis (cannabis sativa/indica), also known as marijuana, has been used for medicinal and recreational purposes for millennia.
There has been a recent trend to legalize the use of cannabis, as illustrated by the recent legalization votes in numerous states in the US and legislation in Canada to allow recreational cannabis use. With this increasing consumption of cannabis, dermatologists will see increased pressure to prescribe cannabis and will observe the side effects of cannabis use with greater frequency. There are several approved medical indications for cannabis use and very preliminary studies have suggested cannabis and its derivatives might have use in acne, dermatitis, pruritus, wound healing, and skin cancer.Perhaps the most promising role for cannabinoids is in the treatment of itch. In a study of patients with uremic pruritus on maintenance hemodialysis, topical application of a cream with structured physiologic lipids (derma membrane structure) and endogenous cannabinoids applied twice daily for 3 weeks completely eliminated pruritus in 8 of 21 patients (38%).
Conversely, the side effects of cannabis use are relatively well documented, and dermatologists should be aware of these presentations. Side effects of cannabis use include cannabis allergy manifesting as urticaria and pruritus, cannabis arteritis presenting with necrosis and ulcers, and oral cancers from cannabis smoke.
Many of the dermatoses including acne, atopic dermatitis, and psoriasis, have inflammation as a major pathogenic factor which also plays a role in the evolution of skin cancers in wound healing and pruritus. The use of cannabis which has anti-inflammatory properties, could theoretically be used to improve these conditions. Some patients themselves may request the treatment therefore properties and mechanisms of action of cannabis need to be studied by treating Dermatologists.
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Dr. Kamal Kant Kohli
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