The disruption of this delicate balance might facilitate the development of multiple pathological conditions and diseases of the skin. In this article, the physiological regulatory function of the endocannabinoid system in proliferation, differentiation, apoptosis and cytokine, mediator and hormone production of various cell types of the skin and appendages are highlighted, and evidence on the putative involvement of the ECS in certain pathological conditions of the skin, such as allergic dermatitis, cutaneous itch and pain, and neoplastic cell growth, are discussed. Future preclinical and clinical research directions and strategies to therapeutically target ECS for the management of various skin diseases are also envisioned.
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Collectively, it seems that the main physiological function of the cutaneous ECS is to constitutively control the proper and well-balanced proliferation, differentiation and survival, as well as immune competence and/or tolerance, of skin cells. Pathological alterations in the activity of the fine-tuned cutaneous ECS might promote or lead to the development of certain skin diseases. Targeting the cutaneous ECS for therapeutic gain remains an intriguing and provocative possibility warranting future studies.