Chronic wounds closed sooner and cleaner when topical cannabis was applied.
WARNING: This article contains photos of patient wounds that may be upsetting or triggering to some readers.
They say time heals all wounds, but could cannabis give it a boost? Chronic wounds can come with a range of debilitating symptoms including bleeding, odor, crusting, exudation, pain, mass effect, and aesthetic distress. Research reveals that 67.7 percent of malignant wounds have at least one of these symptoms, and 11.5 percent have three of these symptoms.
Wounds interrupt the integumentary system, with structures such as skin, hair, and nails, that protect the body from damage. These wounds can often reoccur and the extended experience of pain can seriously reduce quality of life. Pain from these wounds, ranging from moderate to severe, is common. Unfortunately, appropriate treatment is often unavailable, so painkillers such as opioids are a common treatment. Given the serious side effects of opioids, a safer treatment for the management of chronic wound pain is needed.
Open wounds can also result in infection, which can drastically increase hospitalization, healthcare costs, and potentially even morbidity. A 2001 study found that, even after clean and sterile surgery, the rate of wound infection is eight percent. This risk increases substantially in elderly patients, with a 25 percent infection rate after sterile surgery for patients above 60-years old.
Wounds can also be incredibly hard to heal. Malignant wounds can even be life threatening. Palliative wound care focuses on treating pain and other symptoms since healing is unlikely.
Topical Cannabis as a Treatment for Chronic Wounds
One 2017 study published in Journal of Pain and Symptom Management looked to solve the problem of pain management for wound patients. Researchers turned to cannabis for possible answers.
With plenty of anecdotal and historical evidence of the application of various cannabis products to open wounds, as well as some pre-clinical studies, the researchers of this study investigated the effect of topical medical cannabis on open wounds. Participants all received wounds through biopsies that were necessary to rule out other possible diseases. There were three participants, or cases, in this study. They self-reported pain levels daily on a scale from zero to ten. Patients were then given wound treatment with topical medical cannabis and again asked to report daily pain scores. Patients also had their opioid use recorded.
The study lasted for seventeen, twenty-one, and twelve weeks before the topical cannabis treatment for patients one, two, and three. Then thirty-three, nine, and twenty-one weeks after the topical cannabis treatment. The results showed that all three patients found that the topical medical cannabis induced a pain-relieving effect within three to five minutes of application. There was also a significant reduction in daily pain scores for the first two patients after the introduction of the topical cannabis treatment. Impressively, all patients reported clinically significant reductions in pain. A pain reduction of 30 percent or more is the clinical standard bar to meet for pain reduction, and all of the patients saw a pain reduction greater than 30 percent. Patient one saw a 66.5 percent reduction, patient two a 73.4 percent reduction, and patient three a 65 percent reduction.
The researchers concluded that these cases demonstrate that topical medical cannabis treatments may provide effective pain relief for wound patients. Moreover, this pain relief may occur through THC and CBD absorption.
Cannabis and Wound Closure
With significant evidence demonstrating cannabis’ ability to reduce wound pain, the next question is, what can cannabis do for closure of chronic wounds?
Wound healing requires the occurrence of many extracellular and intracellular systems to successfully combine. This is often incredibly difficult to achieve and can require a range of therapies. Burn wounds, in particular, are difficult to treat and heal.
One study from 2016 looked into how a combination of plant-derived traditional medicines might help such burn wounds. Made with a combination of oils from sesame, wild pistachio, walnut, and the cannabis sativa (hemp) plant, this formula was used to treat burn wounds on mice. Patients applied the treatment topically twice a day for twenty-one days, with a control group left untreated.
The results showed that the hemp-containing product significantly improved the closure of burn wounds from treatment day ten. While researchers didn’t look at the mechanisms of the treatment, and there were other plant oils included, it is an indication that cannabis may help to close and heal wounds.
Another study from 2018 reviewed the effects of cannabidiol (CBD), an active cannabinoid, on oral wound healing. Using rat models, the study injected rats with varying doses of CBD after induced mouth ulcers. The results showed that although the injection treatment didn’t result in clinical improvement levels, CBD seemed to have an anti-inflammatory effect on early wound healing.
As with most cannabis research, we need larger clinical trials before making definitive conclusions. But this is a promising start that can provide some hope for chronic wounds patients.