A 2024 scoping review of 46 animal and human studies finds early signals that CBD applied to the skin or eyes may help conditions like atopic dermatitis and glaucoma, but dosing information remains critically insufficient. With only 11 registered clinical trials worldwide for topical CBD, the gap between commercial availability and clinical evidence is striking and should temper any strong efficacy claims.

Topical CBD products are already commercially ubiquitous, marketed for pain, inflammation, eczema, and a growing list of skin conditions, often with claims that far outpace the evidence. Patients bring these products into clinical encounters regularly, and clinicians need a structured understanding of what the research actually shows. This review arrives at a critical moment: the gap between what consumers can buy and what scientists can confirm is widening, and without a clear evidence map, neither patients nor practitioners can make informed decisions about topical cannabidiol.

Cannabidiol’s lipophilic properties make it a pharmacologically plausible candidate for topical and transmucosal delivery, potentially allowing accumulation at the site of action while bypassing first-pass hepatic metabolism. Its known receptor targets, including CB1 and CB2 cannabinoid receptors, TRPV1 vanilloid receptors, serotonin 5-HT1A receptors, and TNF-alpha inhibition, provide a mechanistic rationale for anti-inflammatory and analgesic effects when applied to the skin or mucous membranes. This 2024 scoping review, conducted using Joanna Briggs Institute methodology, searched multiple databases and ultimately identified 46 in vivo studies spanning two decades of publication, including 21 preclinical animal studies and 25 human clinical studies across conditions such as glaucoma, atopic dermatitis, epidermolysis bullosa, and pyoderma gangrenosum.

The review found that topical CBD demonstrated biological activity across these conditions, but the evidence base is profoundly heterogeneous. Animal models used different species, formulations, concentrations, and outcome measures, making cross-study comparison unreliable. Among human studies, sample sizes were generally small and study designs varied widely. Critically, the authors explicitly acknowledge that dosing information sufficient to characterize a pharmacological response is still lacking across the included literature. A search of ClinicalTrials.gov in February 2024 identified only 11 registered clinical trials for topical CBD, compared to 330 for CBD broadly, confirming that this research area remains nascent. The authors call for larger, well-designed clinical trials with standardized dosing protocols before clinical recommendations can be supported.

I appreciate what this review does honestly: it lays out that something is happening biologically when CBD touches skin or mucous membranes, but it is equally candid that we cannot yet say what dose does what, for whom, or how reliably. The pharmacological rationale is genuinely compelling. CBD interacts with receptors that matter in inflammation and pain, and the topical route makes theoretical sense for localized conditions. But 46 studies spread across multiple conditions, two species categories, and wildly different formulations do not add up to a treatment recommendation. The distance between a signal in a rodent model and a prescription I would write for a patient remains enormous.

In practice, when patients bring me topical CBD products and ask whether they should keep using them, I focus the conversation on safety, expectations, and what we actually know. For most over-the-counter topical CBD products, the risk profile appears favorable, but I am straightforward that proven efficacy at specific doses has not been established. If a patient reports subjective benefit and there is no safety concern, I do not discourage use, but I also do not prescribe it in place of treatments with stronger evidence. This review confirms my clinical instinct: the promise is real, but the proof is still being built.

This review sits at the very beginning of the research arc for topical cannabidiol therapeutics. It performs the essential function of a scoping review: cataloguing where in vivo evidence exists and, perhaps more importantly, where it does not. For clinicians, the key takeaway is not that topical CBD “works” for any listed condition but rather that biological plausibility and early signals exist across several dermatological and ocular conditions. The evidence is insufficient to prefer topical CBD over established first-line therapies for atopic dermatitis, glaucoma, or any other listed condition. The fact that fewer than a dozen registered clinical trials existed at the time of the search underscores how much distance remains before evidence-based topical CBD prescribing becomes feasible.

From a pharmacological and safety standpoint, clinicians should be aware that transdermal CBD formulations can produce measurable systemic absorption, meaning that drug-interaction considerations relevant to oral CBD, particularly cytochrome P450 inhibition affecting warfarin, clobazam, and certain antiepileptics, may apply at higher transdermal doses. The review does not provide safety data sufficient to characterize adverse event profiles for topical use. Formulation variability across commercial products adds another layer of uncertainty, as vehicle composition dramatically affects skin penetration and bioavailability. The single most actionable recommendation from this evidence is to counsel patients that topical CBD products are not interchangeable and that product quality, concentration accuracy, and formulation design all influence whether any biological effect is likely to occur.

This is a scoping review conducted under Joanna Briggs Institute methodology, designed to map the breadth and nature of available evidence rather than to synthesize effect sizes or assess risk of bias. It sits below systematic reviews and meta-analyses in the evidence hierarchy because it explicitly does not grade study quality. The single most important inference constraint is that low-quality, biased, or underpowered studies are treated with the same weight as rigorous ones within this framework, meaning that positive findings in the included literature may reflect weak evidence that would not survive formal quality appraisal.

The review’s characterization of topical CBD as pharmacologically plausible but clinically underexplored is consistent with the broader cannabinoid literature, which has advanced much further for oral and inhaled routes than for topical applications. The only FDA-approved CBD product, Epidiolex, is an oral formulation for specific epilepsy syndromes, and its approval does not validate topical formulations whose pharmacokinetics differ fundamentally. The ClinicalTrials.gov search finding of only 11 registered topical CBD trials versus 330 for CBD overall confirms the field’s early stage.

This review extends prior narrative overviews by applying structured scoping methodology and separating preclinical from clinical data, but it does not contradict or challenge existing conclusions in the field. Rather, it provides the most current and systematic catalogue of where in vivo topical CBD evidence exists, reinforcing that the translational gap between animal and human studies remains a central obstacle to clinical progress.

The most likely overinterpretation is reading this review as proof that topical CBD effectively treats atopic dermatitis, glaucoma, or any other listed condition. It does not. A scoping review maps where studies exist; it does not assess whether those studies are well-designed or whether their results are reliable. The 46 included studies span different species, formulations, doses, and outcome measures, and their quality has not been evaluated. Concluding that “46 studies confirm topical CBD works” fundamentally mischaracterizes what this evidence represents.

Equally problematic is the assumption that animal study results reliably predict human outcomes. Twenty-one of the 46 studies used animal models, and skin pharmacokinetics differ substantially between rodent or canine models and human skin. Finally, some readers may assume that because CBD has a generally favorable safety profile orally, topical use is safe at any dose, but transdermal formulations can produce systemic absorption, and dose-response safety data for this route are insufficient.

This scoping review contributes a structured, methodologically sound catalogue of where in vivo evidence for topical CBD currently exists, spanning dermatological and ocular conditions. It does not establish efficacy, optimal dosing, or comparative effectiveness for any indication. Its most consequential finding is the striking gap between commercial product availability and registered clinical trial activity. For clinicians, this review supports informed conversations with patients about topical CBD but does not support prescribing or recommending specific products over established therapies.

Does this study prove that topical CBD treats eczema or other skin conditions?

No. This is a scoping review that catalogues where research has been conducted, not a clinical trial demonstrating that CBD works for specific conditions. Early signals are encouraging for conditions like atopic dermatitis, but the studies are small, heterogeneous, and have not been assessed for quality. Much more rigorous clinical trial evidence is needed before any treatment claims can be made with confidence.

Is topical CBD safe to use?

The review does not provide sufficient safety data to make definitive statements about topical CBD safety. While CBD is generally considered to have a favorable safety profile, transdermal formulations can lead to systemic absorption, which means drug interactions and side effects associated with oral CBD could potentially apply. Patients taking medications that interact with the cytochrome P450 enzyme system should discuss topical CBD use with their clinician.

How much topical CBD should I use?

This is one of the most important unanswered questions identified by the review. The authors explicitly acknowledge that dosing information sufficient to characterize a pharmacological response is still lacking. There are no evidence-based dosing guidelines for topical CBD for any condition at this time. Product concentrations, formulation vehicles, and application sites all affect how much CBD actually reaches the target tissue.

Are the CBD creams I can buy at a store the same as what was studied?

Almost certainly not. The formulations used in research studies are carefully controlled for concentration, purity, and vehicle composition, while commercial products vary enormously in quality and actual CBD content. Independent testing has repeatedly found that many over-the-counter CBD products contain less CBD than labeled or include unlisted ingredients. Research formulations and retail products should not be considered interchangeable.

Should I stop my current treatment and switch to topical CBD?

No. This review does not provide evidence sufficient to recommend topical CBD as a replacement for any established treatment. For conditions like atopic dermatitis or glaucoma, well-studied therapies with demonstrated efficacy exist, and substituting an unproven product could lead to disease progression. If you are interested in adding topical CBD to your regimen, discuss it with your clinician to ensure it does not interfere with your current treatment plan.

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