Pruritus, or chronic itching, is characterized exactly as it’s called, by an unrelenting and sometimes even debilitating sensation to itch. It has been known to plague people for years.
With few FDA-approved therapies, treating the condition has been very difficult. Now, a recent case study by Johns Hopkins Medicine researchers shows that medical cannabis could be an effective and promising treatment for pruritus patients.
“Chronic itch can be an especially difficult condition to treat, with off-label therapeutics often utilized,” says Shawn Kwatra, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine. “With the increased utilization of medical marijuana and our knowledge of the role of the endocannabinoid system [a complex cell-signaling system that regulates a variety of functions in the body] in chronic itch, we decided to try medical marijuana with a patient who failed several therapies and had few options left”.
Kwatra and his colleagues had the opportunity to examine a 60-year old African American woman who had carried chronic itch around for 10 years. She initially arrived at the Johns Hopkins “Itch Center” with complaints of extreme pruritus on her arms, legs and stomach. A physical examination revealed hyperpigmented, raised lesions that were very inflamed.
Phototherapy, steroid cream, and nasal sprays were all administered, but they all failed.
Dr. Kwatra says that using medical marijuana — either by smoking or in liquid form —provided the woman with nearly instantaneous improvement.
“We had the patient rate her symptoms using a numerical rating scale, where 10 is the worst itch and zero is no itch at all,” Kwatra says. “She started at 10 but dropped to 4 within 10 minutes after initial administration of the medical marijuana. With continued use of the cannabis, the patient’s itch disappeared altogether”.
It’s not altogether surprising, as cannabidiols acts on the immune system in powerful ways. WaL reported that CBD, the most commonly administered cannabidiol “effectively reversed” the triggering of a hyperinflammatory response—the so-called “cytokine storm” COVID-19-positive patients, as well as dropping the level of cellular inflammation, not just to the levels of an uninfected patient, but of one being treated with CBD.
“If you go back and look at the literature, from the Romans to the Egyptians, you can literally go down the list of all kinds of inflammatory diseases… and it suggests that the utility has been there,” said Samoon Ahmad, MD, Chief of the Inpatient Unit at Bellevue Hospital, who was not involved in the treatment and corresponding research.
The researchers believe that the psychoactive ingredients in medical marijuana, particularly tetrahydrocannabinol — commonly known by its abbreviation THC — attaches itself to brain receptors that influence the nervous system. When this occurs, inflammation and nervous system activity decrease, which also could lead to a reduction in skin sensations such as itchiness.
Kwatra says that although conclusive studies have yet to be done to validate medical marijuana as an effective measure for the relief of previously unmanageable itch, he believes it warrants further clinical trials.
“Controlled studies are needed to determine dosing, efficacy and safety for medical marijuana in the treatment of various human itch subtypes, and once those are performed, we will better understand which patients are most likely to benefit from this therapy,” he said, according to Johns Hopkins.