Topical use of Cannabis cream for healing and antipruritic actionABSTRACT
Healing cutaneous lesions and the management of pruritus are common challenges in veterinary practice, significantly impacting animal welfare. The application of Cannabis-based products has emerged as an innovative alternative in the treatment of these conditions. This case report describes the positive outcome of the topical use of a product containing phytocannabinoids for the management of pruritus and wound healing in a dog. The endocannabinoid system (ECS), present in the skin, plays a crucial role in modulating inflammation and tissue regeneration, acting well beyond the CB1 and CB2 receptors. These receptors are responsible for regulating physiological processes such as pruritus control and the promotion of healing. In cases of intense pruritus, self-trauma caused by the animal presents a major challenge to therapeutic management, exacerbating lesions and delaying recovery. Self-trauma, common in dermatitis and other pruritic conditions, can lead to secondary complications such as infections and compromise the patient’s well-being. The use of cannabidiol, due to its anti-inflammatory and antipruritic properties, has shown efficacy in controlling self-trauma and accelerating healing, offering a promising alternative to conventional treatment, in addition to contributing to the improvement of the animal’s physical and psychological well-being.
Keywords:
Cannabis; endocannabinoid system; healing; pruritus e self-trauma
RESUMO
A cicatrização de lesões cutâneas e o controle do prurido são desafios comuns na prática veterinária, impactando significativamente o bem-estar dos animais. A aplicação de produtos à base de Cannabis emergiu como uma alternativa inovadora no tratamento dessas condições. Este relato de caso descreve o resultado positivo do uso tópico de um produto contendo fitocanabinoides para o manejo de prurido e cicatrização de feridas em um animal. O sistema endocanabinoide (SEC), presente na pele, exerce um papel crucial na modulação da inflamação e regeneração tecidual, atuando muito além de receptores CB1 e CB2. Esses receptores são responsáveis pela regulação de processos fisiológicos, como o controle do prurido e a promoção da cicatrização. Em casos de prurido intenso, o autotrauma causado pelo animal representa um grande desafio no manejo terapêutico, exacerbando as lesões e retardando a recuperação. O autotrauma, frequente em dermatites e outras condições pruriginosas, pode resultar em complicações secundárias, como infecções, e comprometer o bem-estar do paciente. O uso do canabidiol, com suas propriedades anti-inflamatórias e antipruriginosas, demonstrou ser eficaz no controle do autotrauma e na aceleração da cicatrização, oferecendo uma alternativa promissora ao tratamento convencional, além de contribuir para a melhora do bem-estar físico e psicológico do animal.
Palavras-chave:
autotrauma; cicatrização; Cannabis; prurido; sistema endocanabinoide
INTRODUCTION
The healing of cutaneous lesions and the control of pruritus are frequent challenges in veterinary practice, significantly impacting animal welfare and quality of life (Smith et al., 2020). Proper management of these conditions is essential to promote recovery and prevent complications associated with infections and prolonged discomfort. Recently, the use of Cannabis-based products has gained prominence as an innovative alternative for treating various dermatological conditions, including wound healing and pruritus relief (Feng et al., 2022; Aran et al., 2023).
Cannabis contains a variety of bioactive compounds, known as phytocannabinoids, which have been studied for their therapeutic properties. The two main cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is well known for its psychoactive effects, but it also possesses anti-inflammatory and analgesic properties that may be beneficial in clinical contexts (Grotenhermen and Müller-Vahl, 2012). CBD, on the other hand, has shown significant potential in modulating inflammation and reducing pruritus (Russo, 2016; Sativex, 2020). Studies have demonstrated that CBD can act as a potent anti-inflammatory agent, which is particularly relevant for wound healing and the treatment of inflammatory skin conditions. The mechanism by which CBD reduces inflammation involves interaction with receptors of the endocannabinoid system, which regulate various physiological and immune functions (Hargreaves and Stöhr, 2018; Burke et al., 2023). Furthermore, CBD may help control pruritus by modulating the activity of nerve cells responsible for the sensation of itching, providing relief for conditions such as dermatitis and allergies (Feng et al., 2022).
Thus, Cannabis-based therapies, particularly those involving CBD, have demonstrated significant potential in helping to control inflammation and reduce pruritus, providing an alternative or acting as an adjuvant to conventional treatments (Aran et al., 2023; Scharf et al., 2021).
The topical application of phytocannabinoids allows for direct administration to the affected area, which is advantageous for minimizing systemic side effects and increasing the local concentration of active compounds. This approach can be particularly useful for treating localized skin lesions and relieving pruritus without compromising the animal’s overall systemic condition (Scharf et al., 2021).
Topical products containing THC and CBD have shown promising results in preclinical trials and early clinical studies. These products have suggested a viable alternative to conventional therapies such as corticosteroids, other topical anti-inflammatory agents, and analgesics (Hargreaves and Stöhr, 2018; Mackie, 2008; Smith et al., 2020).
ETHICAL ASPECTS
This research was not submitted to the Ethics Committee on Animal Use.
CASE REPORT
A nine-year-old female mixed-breed dog was seen at the Veterinary Teaching Hospital of the Federal University of Santa Maria (HVU-UFSM). The guardian sought care reporting that the animal was experiencing itching on the right lateral side of the abdomen, accompanied by skin lesions. The dog showed no other clinical issues or changes in daily behavior. Following an initial veterinary medical evaluation, the diagnosis was pyotraumatic dermatitis. The affected area presented with alopecia, erythema, skin flaking, and multiple lesions resulting from self-trauma (Fig. 1).
Treatment was initiated with a mango-based cream containing full-spectrum CBD, with a concentration of 500 mg/mL of Cannabis extract (MuV® Organics), prescribed for topical application twice daily. As the animal was community-owned, the caregiver experienced difficulties in adhering to the prescribed regimen during the first two days of treatment-applying the cream once on the first day, not at all on the second, and correctly on the third day. After just one day of proper application, the animal already showed a reduction in pruritus and local discomfort. Consequently, the guardian chose to continue the treatment with once-daily application for the remainder of the course. The product was administered for seven days, at which point a complete reduction of local cellular debris was observed. One week later, the animal returned to the hospital for re-evaluation, where therapeutic effectiveness was confirmed, with a marked decrease in pruritus and lesions, as well as hair regrowth in the affected area (Fig. 2). The total duration of treatment with the cream was ten days.
Image of the right lateral thoracic region of a mixed-breed female dog, aged 9 years, presenting with alopecia and secondary lesions caused by self-trauma due to pruritus. Image captured before the Cannabis treatment.
Image of the same right lateral thoracic region of the same dog, taken on day 7 of treatment with topical application of a Cannabis-based cream. At this stage, the absence of lesions and reduction of desquamation are evident, associated with the resolution of pruritus and self-trauma. Note the onset of hair regrowth in the previously alopecic area.
The attending veterinarian advised continuing the therapy; however, after observing significant improvement, the guardian decided to discontinue the treatment on her own. Consequently, the animal returned several weeks later presenting with the same clinical signs. The veterinarian on duty at the time prescribed a repellent collar along with oral administration of prednisone at a dose of 2 mg/kg body weight, once daily for five days, in an attempt to resolve the issue. Unfortunately, the patient did not return for further follow-up.
DISCUSSION
Cutaneous lesions such as pyotraumatic dermatitis are common in the clinical routine of small animals and present significant therapeutic challenges, mainly due to intense pruritus and consequent self-trauma. In the reported case, the topical application of a cream containing phytocannabinoids-particularly CBD-resulted in notable clinical improvement, evidenced by the reduction of pruritus and tissue regeneration. These findings reinforce the therapeutic relevance of cannabinoids in the management of inflammatory skin diseases, especially in cases of atopic dermatitis, psoriasis, wounds, and persistent pruritus (Aran et al., 2023; Feng et al., 2022; Filipiuc et al., 2023; Mariga et al., 2024).
Phytocannabinoids such as CBD act on the endocannabinoid system (ECS), which is present in the skin and regulates functions such as inflammation, pain, and homeostasis. Interaction with CB1, CB2, and TRPV1 receptors contributes to the control of inflammatory processes and the perception of pruritus, as observed in this case. Studies indicate that CBD reduces the expression of pro-inflammatory cytokines through the modulation of these receptors, which may have contributed to the rapid clinical response observed in the animal (Aran et al., 2023; Filipiuc et al., 2023; Hargreaves and Stöhr, 2018).
One of the advantages of topical use is its localized action, which reduces the risk of systemic side effects and increases the concentration of the active compound at the affected site. The transdermal route bypasses first-pass hepatic metabolism, which is common in oral administration, and enhances the bioavailability of CBD (Filipiuc et al., 2023). In the present case, this approach appears to have been crucial for the observed therapeutic effectiveness. Furthermore, topical application is not limited to cream formulations but may also include direct application of Cannabis oil to the lesion, as reported by Mariga and colleagues (2024) in a case of post-surgical suture dehiscence in a Great Dane, where significant improvements in pain and pruritus were observed as early as the first day of treatment.
The reduction in pruritus observed after the first few applications highlights CBD’s ability to modulate neuronal pathways related to itching, through TRPV1 and TRPA1 channels and GPR55 receptors. This reinforces its applicability as an alternative or adjuvant to corticosteroids, whose prolonged use may lead to undesirable side effects (Filipiuc et al., 2023; Hargreaves and Stöhr, 2018). CBD’s neuromodulatory effect includes the inhibition of glutamate release, which reduces pain transmission, positioning it as a promising alternative or adjuvant to conventional analgesics (Hargreaves and Stöhr, 2018). Its topical application presents a high safety profile, being suitable even for geriatric patients and those with comorbidities (Scharf et al., 2021). Furthermore, it is notable for the short duration of treatment required-on average seven days-with positive clinical outcomes, as observed both in this case and in previous studies (Mariga et al., 2024; Scharf et al., 2021).
In addition to its anti-inflammatory properties, CBD also has antioxidant action, which contributes to the protection of skin cells and supports tissue regeneration. In conditions such as pyotraumatic dermatitis, this is particularly relevant given the increased risk of infections and secondary oxidative damage. The combination of these properties creates a favorable environment for wound healing and the restoration of the skin barrier (Filipiuc et al., 2023). Mariga et al. (2024) reported a reduction in wound healing time following topical application of Cannabis oil rich in CBD. This outcome reinforces the therapeutic potential of the phytocompound, which may act through multiple pathways, promoting analgesic, anti-inflammatory, and antipruritic effects. These effects, in turn, directly contribute to clinical improvement and accelerate the healing process.
Although the literature highlights challenges related to skin absorption and the stability of phytocannabinoid-based products-due to their high lipophilicity-advances in delivery technologies, such as nanoparticles and microemulsions, have shown potential to overcome these limitations. While such technologies were not employed in the present case, they represent a promising avenue for future therapeutic enhancement (Aran et al., 2023; Filipiuc et al., 2023). In the meantime, the application of Cannabis oil, as reported by Mariga et al. (2024), and the use of cream formulations, as demonstrated in this study, are convenient alternatives until a broader range of phytocannabinoid-based products becomes available on the market.
Finally, the recurrence of clinical signs following the premature discontinuation of treatment by the guardian reinforces the importance of adherence to the therapeutic protocol. Continuation of the therapy could have prevented the recurrence of the clinical condition, highlighting the need to educate guardians about the appropriate duration of treatment with cannabinoid-based products. The comfort provided by the properties of phytocannabinoids, combined with the acceleration of the healing process, are valuable allies in small animal clinical practice, aiming to improve quality of life during recovery and to minimize healing time, while preventing potential complications-particularly those related to self-trauma.
Although this is a case study with inherent limitations-such as a short observation period and the absence of a control group-the results obtained are promising. This report illustrates the potential of topical cannabinoid use in the treatment of inflammatory dermatoses in dogs and highlights the need for further clinical studies, involving larger case series and long-term follow-up, to consolidate its use in veterinary practice in a safe, effective, and evidence-based manner.
CONCLUSION
This case report demonstrated that the topical use of a cream containing phytocannabinoids may represent a promising option for the treatment of skin lesions and pruritus in dogs. The application of the product resulted in significant improvement of the patient’s clinical signs, including reduced pruritus, diminished lesions, and stimulation of hair regrowth in the affected area. Although the treatment was prematurely discontinued by the guardian, the initial positive response underscores the potential of Cannabis as a beneficial tool in the management of dermatological conditions in animals.
The effectiveness observed during the initial days of treatment suggests that phytocannabinoids have a beneficial impact on wound healing and pruritus relief, likely due to their ability to modulate inflammation and interact with ECS receptors present in the skin. The use of topical Cannabis-based products offers the advantage of direct application to the affected site, minimizing systemic side effects and maximizing local efficacy.
In summary, the integration of Cannabis-based products in the management of dermatitis and other inflammatory conditions in veterinary practice represents a significant advancement and warrants further investigation to validate their use and therapeutic potential.
ACKNOWLEDGMENTS
We would like to thank MuV® Organics for their partnership. We also extend our gratitude to the Coordination for the Improvement of Higher Education Personnel (CAPES) and the National Council for Scientific and Technological Development (CNPq) for funding this study.
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Data-in-article - the research data are available within the article itself.
