CBD (cannabidiol) oil may provide relief for people managing psoriatic arthritis. Learn how CBD soothes joint pain, swelling, and inflammation. [email protected] CBD is growing in popularity, and there are many over-the-counter skin products infused with CBD. While CBD can provide some pain relief to psoriasis and psoriatic arthritis, experts say there needs to be more research.
How Does CBD Oil Work for Psoriatic Arthritis?
Lindsay Curtis is a health writer with over 20 years of experience in writing health, science & wellness-focused articles.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles, California.
CBD (cannabidiol) has exploded in popularity in recent years, in large part because it has shown promise in reducing pain, alleviating anxiety, and reducing symptoms of certain health conditions.
One such condition that may benefit from CBD oil is psoriatic arthritis (PsA), a chronic (long-term) disease affecting the joints. While there is no cure for the condition, some people are turning to CBD to manage the symptoms of the disease.
Here are a few things to know if you want to try using CBD to treat the symptoms of psoriatic arthritis.
What Is CBD Oil?
Cannabis plants contain chemicals called cannabinoids. The two major cannabinoids are:
- Tetrahydrocannabinol (THC), which makes a person feel “high”
- Cannabidiol (CBD), which has no psychoactive effects but can provide a number of therapeutic benefits
Both CBD and THC act on a communication system in the body known as the endocannabinoid system (ECS). The ECS is a complex biological system that affects appetite, fertility, sleep, mood, and memory. The ECS is active in the body even if you do not use cannabis.
CBD isolate is the purest form on the market. It contains 99% CBD, with no other additives or chemicals from the cannabis plant from which it is derived.
CBD binds to and activates receptors in the brain that create a therapeutic effect in the body, which allows users to get relief from symptoms without feeling impaired.
Types of Arthritis
Arthritis is a term to describe conditions that affect the joints and surrounding tissues. Though there are over 100 types of arthritis, they all cause inflammation and swelling in one or more joints.
Psoriatic arthritis (PsA) is an autoimmune disease that causes an overactive immune system to attack normal cells and tissues in the joints. PsA affects some people who have psoriasis—a skin condition that causes the formation of itchy red patches topped with silvery scales.
PsA typically is diagnosed after psoriasis. PsA can cause pain, stiffness, and swelling in the joints and surrounding tissues. An estimated 2.25 million Americans have psoriatic arthritis.
PsA most commonly affects joints in the arms and legs, including the elbows, wrists, hands, and feet. It can also impact the spine, hips, and shoulders, though this is less common.
There are several types of psoriatic arthritis, which are categorized by the joints they affect.
The five types of psoriatic arthritis are:
- Distal interphalangeal predominant, which affects the end joints of the fingers and toes and can cause nail changes (such as pitting, spotting, and separation from the nail bed)
- Asymmetric oligoarticular, which affects fewer than five joints in the body and typically occurs on one side of the body
- Symmetric polyarthritis, the most common type of PsA, affecting five or more joints on both sides of the body
- Spondylitis, which involves inflammation of the spinal column and can cause neck pain, stiffness in the lower back, and limited mobility
- Arthritis mutilans, a severe type of PsA that can wear down, destroy, and deform joints in the fingers, hands, wrists, and feet
CBD and PsA Symptoms
Stress can cause psoriasis and psoriatic arthritis to flare up. People with PsA may find CBD helps reduce anxiety and prevent flares in addition to decreasing pain and inflammation in the joints.
CBD for Psoriasis Symptoms
Approximately one in four people with psoriasis will develop psoriatic arthritis. Some will develop symptoms of PsA slowly over time, and others will experience the onset of severe symptoms quickly.
Some common symptoms of PsA include:
- Swollen fingers and toes
- Stiffness, pain, throbbing, swelling, and tenderness in affected joints
- Pain, tenderness, and swelling in tendons (flexible fibrous tissue connecting muscle to bone)
- Nail changes (like pitting and separation from nail bed)
- Redness and pain in one or both eyes
- Limited range of motion
- Morning stiffness
- Anxiety and depression
CBD is being studied as a treatment for many conditions, including psoriatic arthritis, but research supporting its effectiveness is still limited. There is research demonstrating that CBD can effectively manage and reduce pain, however, so it might help some people with PsA.
CBD cannot cure conditions like psoriasis and psoriatic arthritis, but research has shown that it might help some people cope with their symptoms by decreasing pain sensation, inflammation, and the anxiety that a person might experience related to the condition.
A review of 49 studies found that CBD may help with generalized anxiety disorder and social anxiety disorder. A 2019 study found that 80% of participants had reduced anxiety after a month of taking CBD.
What Triggers Flares?
Psoriasis can be triggered by certain factors in a person’s environment or even conditions within their own body, such as illness, foods, and medications.
Some common psoriasis triggers include:
- Allergies (such as those to certain foods, alcohol, or environmental conditions)
- Medication interactions
- Skin trauma/injury
- Smoking (dry and cold weather, in particular)
Some people are genetically predisposed to developing psoriatic arthritis, and approximately one in three people with psoriasis will develop PsA.
Are There Any Side Effects?
CBD is generally well-tolerated but can cause some side effects, particularly when taken in large amounts.
Possible side effects of CBD include:
- Dry mouth
- Gastrointestinal issues
- Reduced appetite
Best CBD for Managing Psoriasis Pain
There is limited research into CBD’s effectiveness at treating psoriasis, but its anti-inflammatory and pain-relieving properties are well documented. Anecdotally, some people have found that CBD helps them manage their psoriasis symptoms.
Types of CDB
There are three basic types of CBD:
Verywell / Michela Buttignol
- Full-spectrum CBD contains all the natural components found in cannabis plants (and hemp plants), including terpenes, flavonoids, and fatty acids as well as cannabinoids. Full-spectrum CBD oil contains trace amounts of THC. When these plant compounds interact with the body, they help a user obtain the desired therapeutic benefits.
- Broad-spectrum CBD is similar to full-spectrum CBD but with all traces of THC removed. Users will not experience any mind-altering effects.
- CBD isolates are produced by using a detailed extraction and purification process of the cannabis/hemp plant. All other cannabinoids, terpenes, and flavonoids are removed to create a 99% pure CBD.
There is not enough research to determine which form of CBD is best for treating psoriasis or psoriatic arthritis. You might want to try different forms and types to determine which works best for you.
Products and Delivery Methods
There are many different ways to use CBD, which means that you can tailor it to your preferences and needs. Examples of CBD products that are available include:
- Topicals (lotions, rubs, and creams)
- Tinctures (alcohol-based extracts)
- Edibles (like gummies)
- Capsules and pills
- Vaping products (oil)
How Much to Use
The Food and Drug Administration (FDA) has only approved CBD for treating epilepsy. As a result, there is no standard dosage of CBD for treating psoriasis.
Follow the recommended usage guidelines on the products that you are using. You may want to slowly increase the amount that you use until you feel that you’ve reached the right dosage for symptom relief.
How to Buy CBD
Although CBD is generally safe, the industry is poorly regulated. When you are looking for a product that meets your needs, there are a few key factors to consider.
CBD from reputable companies should have information about the product on the label, including:
- Amount of CBD per serving
- Suggested use and dosage
- Whether it is full-spectrum, broad-spectrum, or isolate
- List of ingredients
- Manufacturer and distributor name
In addition to checking the labels, make sure that you:
- Avoid products that make sweeping, definitive health claims (like promises to ‘”cure”).
- Look for companies that provide third-party testing results of their products.
- Check customer reviews for products since testimonials from users can tell you a lot about a product.
Before you try a CBD product, ask your doctor if it could interact with any over-the-counter (OTC) or prescription medications or supplements that you take.
Frequently Asked Questions
How long does it take to feel the effects of CBD for PsA?
The type of CBD that you use will determine how long it will take to feel the effects. It generally takes 15 minutes to feel the effects after vaping or using sublingual tinctures (those placed under the tongue). Ingesting CBD oil or gummies will take longer (up to two hours). Topicals may take up to an hour for effects to be felt, and they peak around 90 minutes after application.
How much CBD oil should I use for psoriatic arthritis pain?
The FDA has not released an official dosage guide for specific conditions, but many people with psoriatic arthritis report taking around 20–40 milligrams per day. Some people take higher doses during a flare-up.
Is full-spectrum CBD better for psoriasis than isolates?
Research suggests that full-spectrum CBD has more obvious health benefits than isolates. Isolates are generally better for people who have negative reactions to other cannabinoids found in full-spectrum CBD.
A Word From Verywell
Psoriasis and psoriatic arthritis are painful, chronic conditions that can cause stress and anxiety. CBD is an alternative treatment that may help reduce pain and inflammation and relieve anxiety related to PsA.
Talk to your doctor before trying CBD. A physician might be able to recommend specific products and dosages that can help manage your psoriatic arthritis symptoms.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Arthritis National Research Foundation. Types of Arthritis.
U.S. National Library of Medicine. Psoriatic Arthritis.
Atalay S, Jarocka-Karpowicz I, Skrzydlewska E. Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants (Basel). 2019;9(1):21. doi:10.3390/antiox9010021
Blessing EM, Steenkamp MM, Manzanares J, et al. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. doi:10.1007/s13311-015-0387-1
Shannon S, Lewis N, Lee H, et al. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. doi:10.7812/TPP/18-041
National Psoriasis Foundation. Information for Parents.
Atalay S, Jarocka-Karpowicz I, Skrzydlewska E. Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants (Basel). 2019;9(1):21. doi:10.3390/antiox9010021
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CBD for Psoriasis and Psoriatic Arthritis: What You Should Know
Cannabidiol, or CBD, is one of the two well-known chemical compounds or cannabinoids found in marijuana or hemp. But unlike tetrahydrocannabinol (THC), it doesn’t give you a “high.” Instead, it has a mellowing effect with pain relief. Lately, CBD has been gaining popularity and trending in the health wellness sector with a wide variety of creams, lotions, oils, vape pens, or edibles like gummies or candies.
The internet is littered with information that claim CBD as a natural treatment option for a host of conditions including skin-related disorders like psoriasis or psoriatic arthritis.
Reported health benefits include relief for:
But does it work as well as claimed? Jim Snedden says that for him, it did.
Snedden, 55, was living in Connecticut in 2005 when he first noticed his legs were very dry and itchy. Soon, the itch migrated to his hands.
“I was waking up all bloody because I was digging at it,” recalls Snedden who now lives in Goshen, NY.
In 2007, after he moved to upstate New York, he had another severe flare-up. Initially, he chalked it up to change in water, but it was confirmed as psoriasis. By 2012, he had developed psoriatic arthritis (PsA). Knowing it was a “destructive disease,” Snedden asked his doctor to put him on a biologic, a powerful, genetically engineered drug that’s designed to lower or stop inflammation in your body. It kept his psoriasis symptoms at bay. But the deep, bone-aching pain from the arthritis lingered.
“I have days where I can’t pick things up. I’m dropping things all day because my fingers hurt really bad,” Snedden says.
For years, he took prescription opiates to manage the pain, but they stopped working. In 2018, his daughter, who has fibromyalgia, a condition that causes pain all over the body, urged Snedden to look into cannabidiol (or CBD) as an option for pain relief.
He did. “It did a lot of good,” Snedden says. He’s cut out all the opiates from his treatment regimen.
Does CBD Really Work for Psoriasis and Psoriatic Arthritis?
Doctors and other experts who are keeping a close eye on the growing demand for CBD say it’s hard to know for sure.
“While there are some theories to suggest CBD may have benefits for psoriasis, there is a complete absence of rigorous trials in people to prove their safety and efficacy for treatment of psoriasis,” says Joel Gelfand, MD, in an email to WebMD. Gelfand is a professor of dermatology and director of the Psoriasis and Phototherapy Treatment Center at University of Pennsylvania Perelman School of Medicine.
However, Adam Friedman, MD, professor and chair of dermatology at George Washington School of Medicine and Health Sciences in Washington, DC, says there’s “enough mechanistic data” to argue the potential benefits of CBD for psoriasis or PsA.
Friedman explains that when CBD enters your body, it binds with several receptors including receptors called endocannabinoids that affect pain, itch, and inflammation. There are two types of receptors in the endocannabinoid system: cannabinoid type 1 and 2 (CB1 and CB2). THC binds with CB1 located in the central nervous system, which gives you the fuzzy feels when you take marijuana, and CBD binds with CB2.
When CBD binds with the CB2 receptor found on immune cells throughout the body, it has effects on the body’s immune function.
“When CBD binds to various receptors, CB2 and others, from an immune perspective, what it does is it induces inflammation resolution,” Friedman says. Meaning it activates signals in your body that makes the cells that cause inflammation to change and subside.
In terms of psoriasis, according to Friedman, CBD can reportedly stimulate the secretion and recruitment of cells that are important to remove skin cell debris and to allow your skin to mature and heal properly.
In a 2019 study, 20 participants with psoriasis or atopic dermatitis, another skin-related disorder, were asked to apply a CBD ointment on affected skin twice daily for three months. The CBD ointment, without any THC, was able to improve skin hydration and elasticity. It also improved participants’ quality-of-life when it was measured against the Psoriasis Area Severity Index.
In a recent 2020 study, 50 people with scalp psoriasis or seborrheic dermatitis, a type of condition that causes dry, flaky skin mostly on the scalp, were asked to use a shampoo with CBD for 2 weeks. The shampoo was able to reduce itching, burning, the severity of the inflammation in the scalp.
But Friedman notes that there’s a lot more research to be done to see the full extent of CBD’s impact on your body. “Our understanding of the endocannabinoid system is incomplete.”
Moreover, Friedman says when it comes to cannabinoids like CBD and THC, if you’re buying over-the-counter creams and other topics products infused with it, it may not be getting absorbed properly through the skin barrier. This is because “cannabinoids are lipophilic.” This means they are likely to stay in a fatty environment — something your top layer of skin has plenty of. So if you apply a cream on your skin, only “a fraction of it” may actually get through.
“Purposeful delivery [of CBD] is what you have to think about versus asking ‘do cannabinoids work?’” Friedman says.
CBD and Potential Risk
Studies done on CBD to date are not conclusive. The lack of tests on safety and effectiveness is also because of the confusion around government regulations around CBD. It’s made it hard to study the plant and its potential use, risks, and benefits. Laws for legal access to CBD differ from state to state. So there are a lot of CBD-infused products on the market that are not regulated by the FDA.
“Due to current lack of FDA regulation for CBD, retailers may not adequately disclose the amount of THC in their products, potentially resulting in a positive drug screen. Also, CBD products are available for purchase online with little consumer safety oversight and can contain unknown and potentially dangerous elements,” says James Ralston, MD, a dermatologist at Dermatology Center of McKinney in Texas.
In fact, the FDA has served citations to several companies selling CBD-infused products or food supplements over safety concerns.
In 2017, one study looked at 84 CBD products manufactured by 31 companies and sold online in 2016, to see how accurate the labels were about the ingredients. Turns out, nearly 43% of the products were under-labeled, meaning they had 10% more CBD that advertised. Around 26% of the products were over-labeled, meaning they had 10% less CBD than advertised. Only about 31% of the products were accurately labeled.
Cynthia Covert, 52, from Moreno Valley, CA has been living with PsA since 2003. Covert has tried both THC and CBD products. Both have helped her manage her pain to a certain degree. But CBD products, she says, have too much hype surrounding it. She blames the market that’s flooded with CBD products to meet the growing demands.
“When it comes to CBD alone, I think it’s way too much hype, and it really does disappoint me. Because I know everyone just wants to make money off it, whether it’s the person who’s affiliated with it, or a salesman for it.”
Besides inaccurate ingredients on CBD products, research shows that there may be potential side effects to CBD use. It can:
- Cause liver injury
- Interact with other medications that can cause serious side effects
- Lead to physical injuries if mixed with alcohol or other drugs that can alter your brain activity
- Affect fertility in men or male offspring of women exposed to CBD as seen in some animal studies
There are also a lot of unanswered questions that scientists are trying to figure out when it comes to CBD use. This includes:
- What happens if you take CBD daily for a long period of time?
- How much is too much CBD?
- Can different methods or types of CBD such as creams, gummies, oils, etc., affect you differently?
- What effect does CBD have on the developing brain of children?
- How does CBD affect a fetus or a breastfed newborn?
Things You Should Be Aware of Before You Try CBD
If you’re thinking of trying CBD for relief from psoriasis or PsA, there are a few things you should keep in mind.
Before you try, talk to your doctor about it. Snedden spoke to his neurologist, a doctor who specializes in nerves, brain, and the spinal cord before he decided to try CBD. He also gets frequent migraines and has three herniated discs. He was worried about some of his prescription drugs mixing with CBD.
“Talk to your doctor first because anything can interact with anything,” Snedden says.
Do your research beforehand. Friedman says he urges anyone who wants to try CBD to first do their “due diligence” in researching all they can about CBD and the different brands and methods.
“I think the easiest is to go on Google or whatever search engine and type in Department of Health medical cannabis program,” Friedman says especially if cannabis is legalized in your state.
If you’re going to buy CBD products online or over the counter at your local drugstore, research and write down a few things to check on the labels before you buy it. Once you buy it, Friedman says it’s always a good idea to test it out.
“I typically tell patients to start by doing a test site on a small area for a couple days to make sure that it doesn’t cause irritation or allergic reaction. If they tolerate it, then they can apply to affected areas twice a day, ongoing,” Friedman says.
Start low and slow. When Snedden first started using CBD, it was a bit of a learning curve, especially with what type to use and how much. He researched online on what types or brands would work best. He tried three different types before he found that worked best for him — a tincture, an alcohol-based liquid extract that you put under your tongue.
“I started with one drop and I wasn’t really noticing anything. So I decided to take two drops and it was fine. I started to sleep through the night, I was able to relax. A lot of the pain was gone,” Snedden says.
It’s important to remember that each person reacts different to CBD so it’s always good to start small and see how it goes.
Manage your expectations. CBD isn’t the same as THC. It won’t deliver quick results and it’s definitely not a “cure all.” You may have to continue your regular treatments for psoriasis and PsA and compliment it with approved CBD products to help with the pain.
“If you’re going to use CBD, you can’t go in with the expectation that it’s going to relieve all your pain. And that it’s not going to relieve your pain as soon as possible like an opiate would or smoking a joint. What you are going to get though is a wonderful muscle relaxation,” Covert says. “You’re going to sleep better [and] you’re going to be less stressed. All those things over time will lead to a decrease in pain.”
However, if you notice any allergic reaction or side effects on your skin after CBD use, tell your doctor about it.
National Psoriasis Foundation: “CBD for Psoriasis and PsA.”
FDA: “What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD,” “FDA warns 15 companies for illegally selling various products containing cannabidiol as agency details safety concerns,” “FDA Warns Companies Illegally Selling Over-the-Counter CBD Products for Pain Relief.”
Karger Journals: “Efficacy and Tolerability of a Shampoo Containing Broad-Spectrum Cannabidiol in the Treatment of Scalp Inflammation in Patients with Mild to Moderate Scalp Psoriasis or Seborrheic Dermatitis.”
La Clinica Therapeutica: “Anandamide Suppresses Proinflammatory T Cell Responses In Vitro through Type-1 Cannabinoid Receptor-Mediated mTOR Inhibition in Human Keratinocytes.”
JAMA: “Labeling Accuracy of Cannabidiol Extracts Sold Online.”
Cedars Sinai: “CBD: What You Need to Know Before You Try.”
Adam Friedman, MD, professor and chair of dermatology, George Washington School of Medicine and Health Sciences.
Joel Gelfand, MD, professor of dermatology and of epidemiology; vice chair of clinical research and medical director, Dermatology Clinical Studies Unit; director, Psoriasis and Phototherapy Treatment Center, University of Pennsylvania Perelman School of Medicine.