Should You Use Topical CBD or Oral CBD?

By Dr. Matt Esrick

This is a question we get asked on a near daily basis by patients. And the answer, as in many cases, is it depends on your reasons for using CBD and your specific health condition. We can’t decide for you, but we can help you make an informed decision by giving you the best available evidence in a simple and concise manner. So let’s begin:

What’s Topical CBD and What’s Oral

CBD topicals are those that get applied to the skin, most commonly in the form of lotions, salves, or creams. They can be applied directly to the problem area such as a sore muscle or inflamed joint. CBD oral products are those that are ingested either by absorbing under the tongue like an oil, eating it like a gummy, or drinking it in the form of a tincture.

Do they work the same way?

Depending upon how you take the appropriate dose of CBD, can drastically impact how rapidly you experience benefits. Oral CBD may take 45 minutes to two hours to be absorbed and felt. This makes it a good choice for usage early in the day so that the effects kick in as the day wears on. Or alternatively after dinner, so as to help soothe you before bedtime. Comparatively, topical CBD takes roughly 15 minutes to 1 hour to be absorbed and felt in the affected area. Topical CBDs do not enter the bloodstream and remain in the tissue to where it is applied, therefore making them the choice for more rapid and specifically targeted relief. Often topicals are combined with relaxation techniques such as massage to increase the immediate benefits. However, topicals cannot be combined with other substances. An oral CBD tincture can easily be blended with your favorite electrolyte drink or tea to combine multiple elements in your health routine.

Do they benefit me differently?

Topical CBD and oral CBD also differ in what are known as bioavailability and absorption. This is the proportion of a CBD that has a practical effect when introduced into the body The higher the bioavailability, the greater the impact you will experience. Topical CBD products typically have a bioavailability rate of around 45%(4), while Oral CBD products bioavailability has ranged from about 13-19%(3,5). Absorption is the level of effectiveness in delivering the CBD to your body and the way your body puts it to use. Absorption levels can fluctuate greatly depending upon several factors, however only two of those you can actually modify such as: the route you consume the CBD (oral/topical) and the time of day you consume the CBD (1). For example, one study suggests that a potential method to increase oral bioavailability is to administer CBD alongside a high-fat/high-calorie meal, which could increase bioavailability up to 4x versus consuming CBD on an empty stomach (2). It can be challenging to pinpoint exactly how you’ll best absorb CBD. To better understand how your body processes and utilizes CBD, we recommend keeping a log to help narrow down what works best for you.

Is one form of CBD safer than the other?

Lastly, there is the matter of safety. While there are very few known interactions between CBDs (whether they are orally or topically used) it is always better to consult with your doctor should you be on a specific drug or pharmacological regimen. This is always why we typically recommend topical CBD over oral CBD, simply because the risk of an adverse event is significantly lower because you are not consuming the product in a manner that puts it into systemic circulation.

RESOURCES

Cannabinoid Delivery Systems for Pain and Inflammation Treatment
Molecules (Basel, Switzerland), 23(10), 2478.

Towards Better Delivery of Cannabidiol (CBD)
Pharmaceuticals (Basel, Switzerland), 13(9), 219.

Cannabinoid Delivery Systems for Pain and Inflammation Treatment
Molecules (Basel, Switzerland), 23(10), 2478.

Cannabidiol bioavailability after nasal and transdermal application: effect of permeation enhancers
Drug Development and Industrial Pharmacy, 36:9

Cannabidiol in medicine:
a review of its therapeutic potential in CNS disorders.