Vet Blog | 11th November 2025 The Role of Cannabidiol (CBD) in Canine Atopic Dermatitis: A Natural Adjunct in Dermatologic Care
Canine atopic dermatitis (AD) is a multifactorial allergic skin disease associated with immune dysregulation and abnormal skin barrier function and is a major cause of pruritus. Affecting up to 27% of the canine population, this chronic, inflammatory condition significantly impairs quality of life—not only for the patient but also for caregivers.
Management is often multimodal, including diet modification, pharmacologic therapy, and environmental interventions. With growing interest in plant-based therapeutics, cannabidiol (CBD)—a non-psychoactive compound derived from Cannabis sativa—has emerged as a promising adjunct for managing pruritus and inflammation in canine AD.
Understanding the Skin and the Endocannabinoid System (ECS)
The skin is a complex, multifunctional organ that provides a barrier against trauma, pathogens, and allergens, while also contributing to:
• Temperature regulation
• Immune defense
• Sensory processing
• Regeneration and repair
A key regulator of these functions is the endocannabinoid system (ECS), sometimes referred to as the “c(ut)annabinoid system” as it relates specifically to skin. Reminder, the ECS consists of:
• Endogenous cannabinoids (e.g., anandamide [AEA], 2-arachidonoylglycerol [2-AG])
• Cannabinoid receptors (CB1 and CB2)
• Degradative enzymes (e.g., FAAH and MAGL)
These components help maintain skin homeostasis by influencing keratinocyte function, sebum production, mast cell activity, nerve signaling, and immune responses. ECS elements are expressed in keratinocytes, mast cells, sebocytes, melanocytes, sweat glands, macrophages, and sensory nerve fibers, enabling CBD and other cannabinoids to modulate inflammation, itch, and barrier integrity.
Mast Cells and the Neuroimmune Skin Response
Mast cells reside in the dermis alongside blood vessels and nerve endings, where they play a central role in neuroimmune regulation. They sense antigens, pathogens, and tissue damage, and respond rapidly via degranulation, releasing inflammatory mediators including histamine, serotonin, cytokines, and nerve growth factor (NGF). Mast cells are crucial in wound healing, epidermal barrier regulation, and the development of allergic skin inflammation.
Importantly, mast cells metabolize endocannabinoids, uptake them, and express multiple cannabinoid receptors. Activation of CB2 receptors on mast cells modulates degranulation and suppresses proinflammatory mediator release. In dogs, NGF has been identified as a key pruritogenic mediator, making mast cell–CB2 interactions a critical therapeutic target.
Mechanisms of CBD in Skin Disease
CBD exerts therapeutic effects in dermatology through multiple pathways:
• CB1/CB2 receptors: Modulate mast cell activity, keratinocyte function, immune responses, and barrier homeostasis. CB2 receptors are upregulated during early phases of inflammation.
• TRPV1 channels: Involved in itch and pain perception.
• GPR55, GPR119, PPAR-α receptors: Regulate inflammation and immunity.
• Adenosine A2A receptors: Promote immunosuppressive and anti-inflammatory outcomes.
• NF-κB inhibition and cytokine modulation: Downregulates IL-6 and IL-17 while upregulating IL-10.
• FAAH and MAGL inhibition: Increases endocannabinoid levels, prolonging anti-pruritic and anti-inflammatory effects.
Overall, CBD helps restore skin homeostasis by modulating mast cells and other skin cell types. Generally speaking cannabinoid receptor agonists attenuating inflammation while antagonists may exacerbate it.
Evidence Supporting CBD in Canine Atopic Dermatitis
Several studies support the efficacy and safety of CBD for canine AD:
• Randomized Controlled Trial (4.5 mg/kg/day, oral): Significant reduction in scratching behavior (p = 0.03) (ref. The Potential of Cannabidiol for Treating Canine Atopic Dermatitis).
• Double-Blind Placebo-Controlled Trial (2 mg/kg BID for 28 days): One-third of treated dogs showed pruritus score reduction from ~5.5 to <1.9, reaching the normal range, with no improvement in placebo dogs (ref. CBD Substantially Improves Atopic Dermatitis Symptoms in Dogs).
• Retrospective Study (titrated oral CBD oil, 0.07–1.43 mg/kg BID): Improvement in both CADESI and pruritus scores (ref. The effect of a mixed cannabidiol and cannabidiolic acid-based oil on client-owned dogs with atopic dermatitis).
• 8-Week Clinical Trial: Treated dogs demonstrated a 51% reduction in CADESI-4 scores by Day 56, with significant pVAS reduction at Days 14 and 28 and no adverse effects reported (ref: Cannabinoids in dermatology: a scoping review).
These studies indicate that CBD is not only effective in reducing clinical signs but is also well-tolerated across varying doses and durations
Clinical Considerations
CBD is best used as part of a multimodal treatment plan, alongside diet, environmental control, and conventional pharmacologic therapy. Whilst we have focused on canine AD, there are potential applications in other veterinary skin conditions and species (e.g., feline eosinophilic granulomas).
Dosing:
• Start low: 0.5–1 mg/kg BID
• Titrate according to response, up to 2–4.5 mg/kg/day
Formulation & Storage:
Particularly as we are coming into warmer weather, remember –
• CBD is oxidatively unstable; store in amber bottles with seal-safe adapters in a cool, dry, dark place.
• Avoid refrigeration, which may cause crystallization, and protect from direct sunlight and heat.
Canine atopic dermatitis is a complex, multifactorial disease requiring individualised, multimodal therapy. CBD offers a promising, natural adjunct with multi-targeted effects on mast cells, keratinocytes, immune cells, and sensory nerve fibers.
By modulating inflammation and itch while supporting skin homeostasis, CBD complements conventional therapy, particularly in cases where traditional treatments are insufficient or poorly tolerated. Its favorable safety profile, along with emerging clinical evidence, puts CBD as an increasingly chosen option for veterinary dermatology.
As research continues to evolve, it is important to stay informed and consider CBD as part of an evidence-based, integrative approach for managing pruritus, inflammation, and skin barrier dysfunction in canine atopic dermatitis. Moreover, these principles may extend to other dermatologic conditions across veterinary species, potentially expanding the therapeutic impact of cannabinoids in animal health.
References
1. Chapter 9-Dermatology : Endocannabinoids and Related N-Acylethanolamines in the Skin
Cannabis Therapy in Veterinary Medicnie, A complete guide
2. The Potential of Cannabidiol for Treating Canine Atopic Dermatitis
3.Cannabinoids in dermatology: a scoping review – PubMed
4.Cannabinoid receptors in the inflammatory cells of canine atopic dermatitis – PubMed
5. CBD Substantially Improves Atopic Dermatitis Symptoms in Dogs