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Ask A Doctor CBD Health

Ask A Doctor – CBD & Psoriasis

How & Why Does CBD Work?
Written by Dr. Leah Zachar

CBD, whether in Oil, softgel or tincture form, has helped thousands of patients suffering from different ailments and skin conditions. Let’s take a closer look at how CBD could help those with Psoriasis, and even deal with it completely for some…

Question: I have psoriasis – inverse, plaque and guttate. My skin changes have “exploded”. They now involve areas on my body where the skin is thin and impossible to control with steroids. I have recently developed aches in my deep joints. After a thorough examination my doctor told me that I am developing psoriatic arthritis and we are now discussing methotrexate. Because of the skin lesions & the aches and pains in all my joints, I have difficulty sleeping, constant fatigue, and depression. Can CBD help?

CBC can help. It can address each one of your concerns. First, let me explain the pathophysiology of psoriasis, and then it will become clear why CBD is the best agent to treat you.

In psoriasis, the skin cells are replaced every 3 to 5 days rather than the normal 30 days. The excessive and rapid growth of the epidermal layer of the skin results in itchy & scaly patches.

The condition may be localized or completely cover the body. In 30% of people the disease starts to involve the cartilaginous areas followed by the bone and finally the visceral organs. Psoriasis is not contagious and there is no cure for it, however, various treatments can control the symptoms.
Due to the skin lesions, many people become self-conscious and often their social life is affected.

Once the joints and cartilage become involved, sleep becomes difficult and there is often resulting insomnia. Pain, insomnia, and social isolation may give way to depression.
Prior to explaining how CBD can treat you, allow me to give you a simple instruction:

Do not smoke. Do not smoke cigarettes. Do not smoke “weed”. Do not smoke period.
The smoke creates via combustion a release of carcinogens and other skin-damaging radicals into the air – and these carcinogens and skin-damaging radicals will aggravate your psoriasis.

Question: How & why does CBD work?

CBD controls psoriasis by balancing the immune system’s response.
Here are the details:

  • Inflammation – CBD decreases the release of cytokines from immune cells and thus decreases the inflammatory changes resulting from the rapid growth of the epidermal skin cells.
  • Skin lesions – CBD decreases tumor necrosis factor-α which decreases the skin maturation and constant flaking.
  • Pain – CBD stimulates the vanilloid pain receptors (TRPV-1) and reduces the aches and pains you have resulting from the psoriatic arthritis.
  • Depression – CBD activates the 5-HT1A serotonin receptors which act as an anti-depressant.
  • Sleep – CBD increases the release of serotonin and will grant you a deeper and more restful sleep.
  • Bliss – CBD blocks fatty acid amide hydrolase which degrades anandamide. And, CBD also inhibits the uptake of anandamide.

You can use CBD lotion, CBD tinctures, or CBD soft-gels

All will work because there are cannabinoid receptors in the skin cells and in the bones & internal organs. I would suggest starting with CBD oil rather than CBD cream, because your psoriasis is diffuse and has already progressed to involve your bones & cartilaginous joints.
Begin with 5-mg twice a day and slowly taper it up. You will initially feel a “lightening” of your depression. It will feel as if a cloud has lifted.
Following than, as you increase the dose a little further, you’ll then notice a “tingly” sensation on your skin, and the patches will begin to fade. After a few weeks – or less – the achiness will lessen.
By the way, it is generally safe to use CBD with methotrexate (MTX) – certainly, you should discuss this with your doctor first.

MTX is an antineoplastic antimetabolite with immunosuppressant properties. It selectively affects the most rapidly dividing cells (neoplastic and psoriatic cells). Renal excretion is the primary route of MTX elimination. Less than 10% of MTX undergoes hepatic elimination.
The dose of methotrexate in some cases can be lowered because MTX is a substrate of CYP450 3A4, where CBD is an inhibitor.

1. “Cannabidiol exerts sebostatic and anti-inflammatory effects on human sebocytes” J Clin Invest. 2014 Sep 2; 124(9): 3713–3724.
2. Cannabinoid system in the skin – a possible target for future therapies in dermatology. Exp Dermatol. 2009;18(8):669–679.
3.“In vitro-in vivo correlation for intrinsic clearance for drugs metabolized by human aldehyde oxidase.” Drug Metab Dispos. 2010 Aug;38(8):1322-1327
4. “Herbal cannabis (THC) not recommended for rheumatology patients.” ScienceDaily. ScienceDaily, 3 March 2014.

As per your request, we are moving the weekly In-house doctor session from Thursday at 1 pm EST, to Thursday at 3 pm EST (That’s UK’s 20:00, NYC’s 15:00 and LA’s 12:00)

If you want to read more from Dr Zachar, check out: ‘Ask A Doctor CBD For Pets: Delivery Systems, Health Issues And Dosing’

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About the author

Dr. Leah Zachar

Dr. Leah Zachar, M.D. is a physician who worked for nearly thirty years in Internal Medicine.
She currently is a scientific adviser to CBD Testers. Dr. Zachar believes that there is much that medical cannabis, and cannabidiol in particular can offer to traditional medicine.