Ask an Expert: Can Cannabis Topicals Treat Burns?

Your skin is your body’s most important line of defense against the outside world. When its integrity becomes compromised by a burn, proper treatment is essential to prevent permanent skin damage, infections, and other problems. Cannabis is not a magic bullet for treating all these issues, but in certain cases there’s reason to believe it could be useful.

Before we continue, it may be helpful to understand the different types of burns. These can be caused by exposure to heat, radiation, or electricity, along with chemicals, friction, or even (somewhat counterintuitively) extreme cold. Regardless of their cause, they’re commonly grouped into four categories, based on the layer of skin that has been affected:

First-Degree Burns
These are considered mild, and only affect the top layer of skin (known as the epidermis). It’s common for the affected area to be red and painful. 

Second-Degree Burns
Also known as a “partial thickness burn,” this type of burn affects both the epidermis and the layer of skin beneath it, which is known as the dermis. Typical symptoms for second degree burns include blisters and swelling, along with redness and pain.

Third-Degree Burns
These are sometimes called “full thickness burns,” because they penetrate through the dermis into deeper layers of tissue. With third degree burns, the skin becomes charred (often turning either white or black in color), and the affected area may feel numb.

Fourth-Degree Burns
This is the worst-case scenario type of burn. These burns can reach past the epidermis, dermis, and deeper layers of tissue all the way to muscles and bones. Since this tends to cause nerve damage, the patient will often have no feeling in the affected area.

The final two categories of burns are extremely serious, and treating them is beyond the scope of cannabis in any form. They require urgent, professional medical attention (more on that later). For first- and second-degree burns, cannabis — particularly topicals — may have more to offer, though the existing research is limited.

A 2015 study published in the Journal of Burn Care and Research, found that cannabis use was increasingly common among patients with burns (who tended to be younger and less likely to have medical insurance), though it didn’t specify if — or how — those patients were using cannabis to treat their injuries. In 2018, a different paper in the same journal found that, “[Marijuana] use appears to be protective in acute burn admissions, despite classic teaching that illicit drug use leads to poorer outcomes.”

While no studies have specifically examined the efficacy of cannabis for treating first- or second-degree burns, some research indicates that it could be useful for managing the symptoms that tend to accompany them. For example, a 2010 paper in Future Medicinal Chemistry found that cannabis showed intriguing potential for treating pain and inflammation. This was corroborated by a 2018 study in the journal Molecules that showed CBD topicals were well-suited for relieving these symptoms — and potentially for preventing bacterial infections as well. 

How to Treat Minor Burns With Cannabis Topicals and Other Methods

If you’re interested in using cannabis plant medicine to help treat a burn, topicals are likely your best option. This is because they directly activate the cannabinoid receptors in the affected area of the skin, potentially leading to faster and more effective relief. 

But how do you choose which cannabis topical to use? First, you want to choose one that doesn’t dry right away. Although many products on the market are billed as “lightweight” or “fast-absorbing,” since most people don’t want a lingering greasy feeling from the topicals they use every day, you’ll want something with more staying power to treat a burn. In this case, the affected area needs to stay moist, and so a cannabis salve may be your best option. Ideally, you’ll want to choose a product that has mostly natural and organic ingredients — the fewer artificial chemicals your body needs to process while healing, the better. 

If you’re dealing with a first- or second-degree burn, cooling the affected area is of the utmost importance. However, this does not mean you should apply ice to it. Instead, it’s best to use a stream of cool (not cold) water. It’s also critical to keep the area moist — but you’d be wise to ignore the old wives’ tale about putting butter (or cannabutter) on the burn to do so. As researchers from the University of Alabama for Medical Sciences have explained, greasy substances like these can actually prevent the skin from cooling down, thereby making the burn worse. If you decide to use a non-greasy cannabis topical instead, you may need to re-apply it several times throughout the day.

You’ll also want to make sure that you keep the affected area completely clean. Usually, this involves covering it with non-stick bandages that are dry and sterile (though again, the affected area itself must be kept moist). If it isn’t, removing the bandage could strip away the still-healing skin cells beneath it, too. If you’re concerned the wound has become dry while wearing a bandage, you can pour normal saline — available at most pharmacies and grocery stores — over the bandage to moisten it before removing. Try your best to avoid breaking the blisters of a burn, as this can be a gateway to infection (and despite the antibacterial properties of cannabis, you don’t want to take any chances). 

If you’re dealing with a third- or fourth-degree burn, disregard all the information above and call 911 immediately. These types of burns are too serious to be treated by amateurs — the patient will have a high probability of going into shock. They’ll need to have special bandages applied and the damaged skin removed, and they may also require intravenous fluids. While they’re recovering in the hospital, doctors will need to assess the wound and devise a long-term care plan. According to Stanford Health, this could include pain management, physical therapy (if the muscle and/or bone has been damaged), skin grafts or surgeries for cosmetic reconstruction, occupational therapy to assist with daily activities, and various types of emotional counseling. 

Regardless of the type of burn, cannabis topicals shouldn’t be considered a panacea (or a replacement for professional medical attention, when necessary). In certain cases, they can be useful for providing relief from mild-to-moderate symptoms, but at best they should be viewed as an addition to traditional wound care, not a substitute for it. It’s possible that future research may yield new forms of cannabis topicals that are specifically formulated to heal burns — perhaps by repairing the CB1 and CB2 receptors contained in the skin — but until then, we should keep our expectations realistic.