How cannabis topicals work and why they're not yet regulated

Recreational marijuana is poised to become legal in a matter of months, but some products — such as cannabis topical creams and ointments — will take a year longer to enter the legal market.

Topicals are made from oils or other extracts from the cannabis plant and are applied to the skin to relieve a range of skin conditions.

A consumer does not get high from its use.

Dr. Bonnie Goldstein, a doctor in California and advisor to the cannabis company Weedmaps, told CBC Greenlit columnist Rohit Joseph that cannabis topicals are not a cure for health issues. But they can help patients with conditions like eczema or psoriasis. 

"[People] want to put topical cannabis right on the rash to help with [inflammation] and itching. And in general I find that they tend to be very effective," Goldstein said.

Concern about topicals​

Right now, the only legal way to get topicals is as a patient approved by a medical practitioner and Health Canada, Joseph told On the Coast  guest host Matthew Lazin-Ryder.

Once regulated, consumers will be able to buy topicals without a prescription.

But the way topicals are manufactured is not yet government-regulated, so there are risks, said Joseph.

There are concerns that the cannabis that topical creams contain could have traces of pesticides, fungus or contaminants, according to Dr. Lydia Hatcher, a physician and associate clinical professor at McMaster University.

Access to topicals​

It is not easy to get legitimate medical approval for cannabis, said Joseph.

Dispensary customer Jacquie Nassar uses cannabis topicals to treat her arthritis. She said her doctor was reluctant to give her approval.

"Basically they said they would be ostracized if they were to do that," said Nassar.

She instead got approval from a naturopath.

Hatcher thinks many Canadian doctors are hesitant, even with imminent legalization of recreational cannabis, to approve a patient for medical marijuana.

Hatcher told Joseph that doctors receive no education on cannabis in medical school.

"If you don't know anything about it … the likelihood is you're not going to give a prescription," she said.

Joseph says that once topicals are regulated, the cannabis industry will see some change in how the product is viewed by the public.

"If you're able to buy a cannabis topical over the counter, without any prescription, and it is indeed certified by our own government and scientists to help with certain aches, pains, and skin conditions … then the cannabis as a wellness product gains a lot more legitimacy," said Joseph.

Health Canada's statement

In a statement, Health Canada told the CBC that the experiences of other jurisdictions that have legalized cannabis for non-medical purposes have shown that topical products pose health and safety risks.

In the case of creams, controls to prevent the use of ingredients that are known allergens or skin irritants will need to be put in place, the statement said. 

"Designing an appropriate regulatory system is a complex undertaking and there are unique potential health risks and harms that need to be carefully understood before the development and coming into force of these regulations," said Health Canada.  

"For this reason, the Government of Canada will need to take an appropriate amount of time to develop, and implement regulations that will result in safe cannabis products eventually coming to market."

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With files from On the Coast