Efficacy of cannabidiol (cbd) for the treatment of recurrent aphthous ulcers

Abstract

The objectives of this research were 1) To investigate the allergic reactions to cannabidiol (CBD) when used on human skin. 2) To assess local and systemic side effects of CBD when used on normal oral mucosa. 3) To compare the efficacy among 0.1% CBD, 0.1% triamcinolone acetonide (TA), and placebo (pure oral paste) in recurrent aphthous ulcer (RAU) treatment. This project was composed of 3 phases. Phase 1, a skin patch test was performed on 100 healthy subjects. Phase 2, CBD was applied to normal oral mucosa of 50 healthy subjects 3 times/day for 7 days. Oral examination, vital signs, and blood tests were performed before and after CBD application. No subject had an allergic reaction or side effects to CBD. The vital signs and blood tests were similar before and after CBD administration. Phase 3, 69 RAU patients at the Oral Medicine Clinic, Faculty of Dentistry, Chulalongkorn University randomly received one of three treatments: CBD, TA, or placebo. The medications were applied to the ulcers 3 times/day for 7 days. The pseudomembranous ulcer and erythematous border size were measured before treatment and on day 2, 5, and 7. Pain ratings were recorded daily. The subjects rated their satisfaction at the last visit and completed a quality of life questionnaire (OHIP-14) at the first and last visit. CBD and TA significantly reduced the pseudomembranous ulcer size more than placebo at all evaluated time points. However, the erythematous border size reduction was significantly higher in the CBD group compared with the placebo group only on day 2, while TA significantly reduced the erythematous border size at all evaluated time points. Pain scores in the CBD group were significantly lower than the placebo group on day 5, whereas TA significantly reduced the pain level more than placebo on day 4, 5, and 7. The subjects receiving CBD reported higher satisfaction compared with placebo, however, the differences were not significant. The OHIP-14 scores among the patients using the three medications were similar. CBD reduces ulcer size and accelerates ulcer healing without side effects. It exerts an anti-inflammatory effect at the early stage and an analgesic effect at the late stage of RAU.