The skin contains all elements of the endocannabinoid system, receptors, endocannabinoids and enzymes needed for synthesis and metabolism of cannabis (endocannabinoids AEA, 2-AG and receptors CB1, CB2 TRPV-1). These factors are important for skin regulation, epidermal growth control, cell survival, immune responses and inflammatory responses, sensory stimulation of the nervous system, itch and pain, and lipid synthesis.
There is little evidence of cannabinoids and the skin system, but there is growing evidence of potential cannabis therapy for skin diseases characterized by infections and fibrosis such as psoriasis, scleroderma and atopic dermatitis.
Psoriasis is a skin disease in which there is an overgrowth of keratinocytes caused by over-infiltration of T cells and neutrophils from the immune system. Excessive activation of dendritic and macrophage cells occurs. Pathogenesis is not fully understood, but it is known that there is a problem regulating the skin cells, especially the TH1 and TH17 cells. The therapeutic options of cannabinoids acting with CB2 receptors and mechanisms independent of classic cannabinoid receptors are very broad considering their role in regulating Th1 and TH17 lymphocytes.
Psoriasis is a heavy burden for patients with this disease. Medical treatment is now very limited in efficacy, and effective treatments are accompanied by known side effects. In addition, the economic burden on patients is enormous as life expectancy increases. Patients have decreased body image resulting in symptoms such as mood loss, depression and a decline in social activities. The rationale for using cannabis and / or cannabinoids based on psoriasis is based on empirical evidence collected over recent years. There was a significant improvement in the severity of the disease in the treated areas (upper and lower extremities and scalp). CBD is an effective substance without psychotropic effects and is effective for treating skin problems such as psoriasis, combined with small percentages of THC and other substances in cannabis rash (the entourage effect). It is important to integrate cannabis as a systemic and local treatment – in the form of smearing areas affected by Cannabis butter based on coconut oil, for example.
In the following picture: After 9 days of cannabis oil treatment compared to treatment with MTX as a treatment for cannabis without side effects and under chemotherapy in MTX there were many adverse events, fever, diarrhea, impaired liver function and risk of infections acquired due to decrease in the body’s immune system.
 Derakhshan, N. Kazemi, M. Cannabis for Refractory Psoriasis—High Hopes for a Novel Treatment and a Literature Review. Current Clinical Pharmacology, Vol. 11, Number 2, May 2016, pp. 146-147(2).