As consumers continue to look for alternatives to conventional pharmaceuticals for health and wellness, CBD-based therapies are rapidly making their way into the spa and wellness industry.
By: Adam Abodeely MD, MBA, FACS, FASCRS

In 2018 the value of the topical cannabis industry was roughly $350 million with a predicted compound added growth rate of 37% by 2024. CBD-based therapies have taken the health and wellness industries by storm. Individuals with skin problems, chronic pain, and autoimmune conditions represent a sizeable market due the growing interest and research into the applications of topical creams, lotions, and oils.

As a Double-Board Certified surgeon specializing in surgical oncology and gastrointestinal surgery, I have witnessed the health benefits that cannabis can provide in treating a variety of medical ailments. As humans, we have an innate desire to heal with natural remedies. I observe patients desperately searching for alternatives to conventional pharmaceutical drugs which are often associated with numerous undesirable side-effects. The cannabis plant continues to show a great deal of promise for those aspirations.

The cannabis plant is a complex organism consisting of thousands of different chemicals. The 3 largest categories of chemically active and medically relevant compounds found within the plant include 1. Cannabinoids (over 100 identified including THC, CBD, CBC, CBG, CBN, etc.), 2. Terpenes (aromatic compounds found within plants), and 3. Flavonoids which are powerful antioxidants.

The increased understanding and accessibility to cannabis has been welcomed and embraced by the millions of Americans who can attest to the beneficial effects of cannabidiol (CBD) and several other cannabinoids. As we continue to pursue ways to improve our health and cure medical ailments in a natural way, it should come as no surprise why CBD is rapidly being utilized in traditional spas, medical spas, and various other healthcare practices.

Although we still have a great deal to learn about the healing applications of cannabis, the science supporting its use continues to grow and overall early outcomes have been enormously encouraging. Much of the research on the health benefits of cannabis are criticized because they are not considered high quality by traditional medical and pharmaceutical standards. The main reason this dilemma exits is because it is difficult to conduct studies on the plant due to the uncertainty of the legal system, and the difficulty in standardization of the “drug”. As physicians, we are accustomed to working with single molecule drugs and the FDA prefers to approve single molecule drugs since the study-designs are much easier. Every cannabis plant can vary with respect to their relative ratios of cannabinoids, terpenes, flavonoids, and other chemically active compounds. This coupled with the numerous routes of administrations (inhalation, tinctures, edibles), which all have varying absorptions and effects, make treating the cannabis plant as a traditional pharmaceutical drug nearly impossible.

Although we still need more clinical studies in humans, preclinical studies (animal and bench research) have recognized cannabinoids for their ability to act as anti-inflammatories, modulate pain, act as an antibiotic and antifungal, and potentially protect against cancer cell growth. After studying the science and treating thousands of patients with cannabinoid therapy, there is no doubt that the cannabis plant possesses healing properties and can help support general wellness by supporting the human endocannabinoid system.

The human endocannabinoid system plays a crucial role in maintaining homeostasis. It is a source of balance, in other words, and helps to stabilize the various physiological processes that keep us alive, including when we are enduring stress, injury, or illness. The endocannabinoid system is alive and well in the skin as well as every other organ in the human body.

The use of CBD in traditional and medical spas which offer such services as massages, facials, body treatments, manicures, and several other body and skin services, is rapidly growing. The one thing that the majority of these treatments have in common is that they involve the application of a variety of topical salves, balms, and oils. The skin is the largest human organ and is rich in cannabinoid receptors making it an ideal target for CBD therapy. Activation of the endocannabinoid receptors in the skin can help regulate pain and inflammation, enhance the skin immune system, protect the skin from cellular damage and aid in the repair of damaged skin cells.

One of the most challenging aspects of the topical applications of cannabinoids revolves around the poor skin absorption of cannabis oils. Cannabinoids including CBD are hydrophobic meaning they don’t mix well with water. The skin is an aqueous barrier leading to difficulty in deep tissue penetration of the oils produced from cannabis. Despite this, numerous studies have reported benefits of the cannabinoids to the more superficial layers of the skin and have the potential to block ultraviolet radiation, decrease inflammation, enhance skin cell proliferation, provide anti-bacterial and anti-fungal activities. Additionally CBD-based oils are an excellent source of antioxidants. There are several ways to formulate products in ways which allow for better tissue absorption. One of these ways is through the use of terpenes. Terpenes are compounds commonly found within flowering plants that are responsible for the aroma of plants and provide several protective effects and are often touted for their own therapeutic value. The combination of all the compounds in the plant work together to provide a combined therapeutic effect commonly referred to as the “Entourage Effect”.

In order for a spa to successfully utilize CBD-based treatments there are several keys to success. First, success begins by offering the highest quality products with varying routes of administration. Choosing a high quality product is based on several factors including identifying formulations designed to have optimal absorption, and synergy with the human endocannabinoid system. This also involves the use of broad or full-spectrum products as opposed to isolates which only contain a single cannabinoid and is void of the full “entourage effect”. The products should also be transparent with regards to sourcing, ingredients, extraction techniques, and be able to provide access to 3rd party testing results.

The combination of the rapidly evolving science and growing number of product offerings will make salesforce training challenging and imperative at the same time in order to ensure the best consumer experience. If quality products are combined with educational support and adequate training, spas will likely continue to see considerable growth and consumer satisfaction.