Open AccessSystematic Review CBD-Containing Hemp Extracts and Isolated CBD for Acne: A Systematic Review of Anti-Inflammatory Mechanisms, Clinical Signals and Sustainability Baatile Komane Baatile Komane * Thobile Kaye Thobile Kaye Somatology, Department of Human Movement and Therapeutic Sciences, Tshwane University of Technology, Arcadia Campus, Pretoria 0001, South Africa * Author to whom correspondence should be addressed. Molecules 2026, 31(12), 2017; https://doi.org/10.3390/molecules31122017 (registering DOI) Submission received: 24 December 2025 / Revised: 3 February 2026 / Accepted: 6 February 2026 / Published: 9 June 2026 Abstract Industrial hemp ( Cannabis sativa L.) has emerged as a sustainable source of bioactive compounds, with increasing interest in cosmeceutical applications for acne management. This systematic review synthesises evidence on cannabinoid-containing hemp extracts, particularly cannabidiol (CBD), with emphasis on anti-inflammatory and sebostatic mechanisms, alongside formulation considerations and supply-chain sustainability. Reporting followed PRISMA 2020 guidelines and encompassed preclinical and clinical evidence relevant to acne-associated outcomes. The review protocol was registered prospectively with PROSPERO (CRD420251272093). Across cell-based, ex vivo and early clinical studies, CBD modulated key inflammatory mediators, including TNF-α, IL-1β, IL-6 and IL-8; normalised sebocyte activity and attenuated Cutibacterium acnes ( Propionibacterium acnes)-induced inflammatory signalling. Preliminary clinical observations indicate reductions in lesion counts and erythema, with generally favourable short-term tolerability; however, interpretation is limited by small sample sizes, predominantly non-randomised designs, heterogeneous formulations and frequent co-formulation with additional active ingredients. Evidence supporting direct antimicrobial efficacy and durable clinical benefit remains limited. Lipid-rich hemp seed-derived products were considered only in a contextual capacity for barrier-supportive and nutritional properties and were excluded from efficacy synthesis unless cannabinoid content was verified. Sustainability analyses highlight hemp’s low water requirements, carbon sequestration potential and relevance to Sustainable Development Goal 3 (SDG 3: Good Health and Well-Being) and Sustainable Development Goal 12 (SDG 12: Responsible Consumption and Production), supporting its role in environmentally responsible cosmeceutical development. Overall, CBD-containing hemp extracts show biologically plausible and clinically promising adjunctive potential for mild-to-moderate inflammatory acne, but current evidence remains preliminary. This review highlights the need for methodologically rigorous and transparent clinical studies, standardised formulations, validated outcome measures and the integration of sustainability metrics to strengthen evidence synthesis, clarify clinical relevance and guide responsible cosmeceutical development. Keywords: cannabidiol (CBD); hemp oil; acne vulgaris; anti-inflammatory; sebostatic; sustainability; supply-chain resilience; Cutibacterium acnes; cosmeceuticals Graphical Abstract 1. Introduction This systematic review focuses on CBD-containing hemp extracts and isolated CBD as cosmeceutical interventions for acne, explicitly distinguishing these from hemp seed oil, which is a cold-pressed nutritional oil with negligible cannabinoids. We define the botanical source for CBD-containing extracts as flowers, leaves and aerial parts of Cannabis sativa and note formulation and standardisation considerations relevant to dermatological application [ 1, 2]. Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit characterised by hyperseborrhoea, follicular hyperkeratinisation, microbial factors and immune dysregulation, warranting interventions that target sebum regulation, inflammation and keratinisation [ 1, 2]. Mechanistic evidence demonstrates that CBD exerts sebostatic and anti-inflammatory effects in human sebocytes and modulates keratinocyte responses to Cutibacterium acnes vesicles, providing biologically plausible pathways for clinical benefit [ 1, 2]. Primary objective: To evaluate the effects of CBD-containing hemp extracts and isolated CBD on acne-related conditions in humans using methods aligned with PRISMA 2020. Specific objectives: Evaluate anti-inflammatory, antimicrobial and seboregulatory effects of CBD-containing hemp extracts and isolated CBD in preclinical and clinical models; Assess topical formulation efficacy on acne severity, sebum and Cutibacterium acnes using validated measures while identifying standardisation gaps; Examine sustainability and traceability across cultivation, extraction and regulatory frameworks relevant to CBD-containing hemp extracts. Review questions: What evidence demonstrates the anti-inflammatory, antimicrobial and seboregulatory effects of hemp extracts and cannabidiol in preclinical and clinical acne models? How do formulation strategies and concentrations influence cytokine activity, sebum regulation and Cutibacterium acnes? What sustainability practices within hemp supply chains support safe and accessible cosmeceutical applications aligned with global health goals such as SDG 3 and SDG 12? 2. Materials and Methods 2.1. Review Design and Reporting Framework The review was designed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement to ensure transparency, reproducibility and methodological rigour. 2.2. Search Strategy and Information Sources 2.3. Study Selection All retrieved records were imported into reference management software and deduplicated prior to screening. Two reviewers independently screened titles and abstracts for relevance (κ = 0.82), followed by full-text assessment of potentially eligible studies, with disagreements resolved through discussion and consensus. 2.4. PRISMA-Compliant Flow and Study Counts Narrative and scoping reviews were consulted for contextual interpretation only and were not counted as primary studies in the PRISMA flow, in accordance with PRISMA 2020 guidance [ 11, 12]. 2.5. Objectives and Eligibility Criteria The primary objective of this review was to evaluate the effects of CBD-containing hemp extracts and isolated CBD on acne-related outcomes in humans, using methods aligned with PRISMA 2020 [ 11, 12]. Eligibility criteria Population: Individuals with acne of any severity; Comparator: Any comparator, placebo or none for uncontrolled designs; Study designs: Randomised trials where available; non-randomised controlled studies; observational cohorts; and case series; Scope clarification: Evidence synthesis focused CBD-containing hemp extracts and isolated CBD (flowers/leaves/aerial parts); seed oils without cannabinoids were considered background/rationale only and excluded from efficacy synthesis; 2.6. Data Extraction and Synthesis 2.7. Risk-of-Bias Assessment Given the predominance of non-randomised clinical and observational designs, risk of bias was assessed using ROBINS-I for non-randomised intervention studies and the Joanna Briggs Institute (JBI) critical appraisal checklists for case series and uncontrolled cohorts [ 11, 12]. Domain-level judgements were reported for individual studies. The Cochrane Risk of Bias 2 (RoB-2) tool was reserved exclusively for randomised controlled trials and was not applied where randomisation was absent. The SYRCLE risk-of-bias tool was not used for in vitro studies, as it is not designed for cell-based experimental models [ 11, 12]. 2.8. Sustainability Considerations In this study ( Table 1), industrial hemp-derived cosmeceuticals, including CBD-containing hemp extracts and nano-formulated CBD products (seed oils without cannabinoids treated as background/rationale, excluded from intervention evidence). Researchers systematically screened all obtained titles and abstracts, with full-text articles assessed against eligibility criteria. Discrepancies were resolved through consensus, and the process is depicted in the PRISMA flow diagram ( Figure 1). Data extraction involved the use of a standardised form to guarantee consistency, capturing study characteristics, participant details, intervention specifics, outcome measures such as cytokine assays and microbial inhibition, and sustainability indicators such as cultivation methods and supply-chain traceability. Innovative formulations related to nano-formulated CBD referenced the original protocols to support replication [ 3, 16]. Data were synthesised narratively and thematically into four domains: anti-inflammatory mechanisms, clinical and biochemical outcomes, formulation approaches, and supply-chain sustainability. Quality assessment was conducted using validated tools, including the Cochrane Risk of Bias Tool for randomised controlled trials. Table 2 presents the evaluation of non-randomised studies (ROB-INS-I) in addition to the modified Newcastle–Ottawa scales applied to observational and preclinical studies, to classify the risk of bias and ensure methodological rigour [ 7, 8, 16, 17].The search strategy combined efficacy-related terms (industrial hemp, Cannabis sativa, CBD, cannabidiol, acne, skin health, inflammation, anti-inflammatory and antimicrobial) and sustainability-related terms (sustainability, supply chain, resilience, life cycle, SDG and traceability) following systematic review guidelines [ 16, 17]. These terms were informed by prior research on cannabidiol’s dermatological effects [ 3, 4, 5, 6] and sustainability considerations in hemp production [ 18, 19]. 3. Results Figure 2 summarises the principal mechanistic and clinical outcomes reported across the included studies. Experimental evidence consistently demonstrated suppression of key pro-inflammatory cytokines, including interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α), with reductions of approximately 40–70% observed in cell-based and ex vivo models [ 20, 21, 22]. These effects were mediated through modulation of NF-κB and MAPK signalling pathways, accompanied by normalisation of sebocyte lipid production and inhibition of Cutibacterium acnes-induced inflammatory responses [ 20, 21, 23]. Overall, the results indicate biologically plausible and clinically promising signals supporting the role of CBD-containing hemp extracts as adjunctive interventions for mild-to-moderate acne. However, methodological limitations, small sample sizes, heterogeneous formulations and the absence of randomised controlled trials necessitate cautious interpretation of efficacy [ 5, 23]. 3.1. Mechanistic Actions of Industrial Hemp Oil and Cannabidiol in Acne Pathogenesis At the sebaceous gland level, CBD demonstrates a pronounced inhibitory effect on sebocyte proliferation and lipogenesis, the two key contributors to excessive sebum production in acne vulgaris. In vitro studies using human sebocytes indicate that CBD normalises lipid synthesis while suppressing sebocyte hyperproliferation, directly targeting one of the primary drivers of acne lesion formation [ 5, 6, 26]. Acne vulgaris is a multifactorial inflammatory skin disorder driven by mechanisms such as sebaceous hypersecretion, follicular hyperkeratinisation, microbial dysbiosis (particularly Cutibacterium acnes) and immune-mediated inflammation [ 5, 13, 26, 27]. Evidence from the reviewed literature demonstrates that industrial hemp oil and its bioactive constituents, particularly CBD, modulate several of these pathogenic pathways simultaneously, supporting a mechanistic rather than symptom-based therapeutic role [ 23, 24, 25]. Despite encouraging short-term outcomes, long-term safety data remain limited. Further well-designed clinical trials are required to establish standardised dosing parameters, formulation guidelines and comprehensive safety profiles to support the sustained clinical use of CBD in acne treatment [ 5, 6]. 3.2. Modulation of Inflammatory Signalling and Sebaceous Activity CBD exerts these effects primarily through modulation of the cutaneous endocannabinoid system (ECS). As illustrated in Figure S1, cannabinoid receptors CB 1 and CB 2 are widely distributed across epidermal keratinocytes, sebaceous glands, hair follicles, sensory nerves and sweat glands, enabling CBD to regulate multiple cellular processes relevant to acne pathogenesis. Acting on CB 1 and CB 2 receptors, transient receptor potential channels (TRPV1 and TRPV4) and peroxisome proliferator-activated receptor gamma (PPARγ), CBD modulates sebocyte proliferation, lipid synthesis, inflammatory mediator release and apoptosis, thereby restoring skin homeostasis [ 3, 4, 13, 24, 25]. Figure S1 demonstrates the distribution of endocannabinoids in the skin, highlighting the downstream functional outcomes of ECS activation, including reduced inflammation, decreased cellular proliferation, enhanced apoptosis and modulation of lipid synthesis, which collectively contribute to reductions in acne lesions. In parallel, CBD’s antioxidant properties mitigate oxidative stress within the pilosebaceous unit, limiting inflammation-driven tissue damage and lesion progression. 3.3. Antimicrobial Effects and Microbial Balance Several studies demonstrate that hemp extracts and cannabidiol (CBD) inhibit Cutibacterium acnes biofilm formation and suppress C. acnes-induced inflammatory responses in vitro [ 16, 20, 25, 30]. Clinical evidence also reports reductions in inflammatory lesion counts, although many formulations combine CBD with other active ingredients, making it challenging to attribute antimicrobial effects solely to CBD. Nevertheless, findings support a contributory role of hemp-derived compounds in modulating microbial dysbiosis and reducing inflammation-driven lesion progression [ 16, 20, 25, 30]. Hemp extracts and cannabidiol (CBD) impairs biofilm development and bacterial proliferation, which helps minimise microbially driven irritation and lesion formation, thereby improving acne outcomes ( Figure S2). Importantly, the antimicrobial activity of hemp-derived compounds offers a promising alternative to conventional antibiotics, potentially mitigating concerns related to antibiotic resistance [ 16, 25, 30]. Multiple antimicrobial evaluations have demonstrated that CBD oil effectively hinders the growth of C. acnes, a key bacterium implicated in acne pathogenesis, and disrupts biofilm formation critical for pathogenic colonisation and persistence within pilosebaceous units [ 25, 31]. These effects collectively contribute to improved acne outcomes and position hemp-derived compounds as a viable adjunct or alternative to traditional antibiotic therapy [ 16, 25, 30, 31]. 3.4. Skin-Barrier Repair and Lipid Homeostasis 3.5. Mechanistic Effects of Industrial Hemp Extracts on Acne Pathogenesis: Sebum Regulation and Skin-Barrier Homeostasis Importantly, the balanced omega-6-to-omega-3 ratio characteristic of hemp seed-derived lipid extracts supports anti-inflammatory signalling pathways that complement sebostatic effects. Unlike highly occlusive lipid preparations, these extracts are typically non-comedogenic, allowing for modulation of sebum output without exacerbating follicular blockage. Collectively, these properties position lipid-rich hemp seed-derived extracts as supportive dermocosmetic ingredients in integrative acne management strategies, acting primarily through barrier and lipid modulation rather than direct cannabinoid-mediated effects [ 20, 27]. 3.6. Cutibacterium acnes Suppression Multiple antimicrobial evaluations have demonstrated that hemp oil effectively hinders the growth of Cutibacterium acnes, a key bacterium implicated in acne pathogenesis [ 25, 31]. This inhibition extends to the disruption of the formation of bacterial biofilms, which are critical for pathogenic colonisation and persistence within the pilosebaceous units [ 31] ( Figure S2). In impairing biofilm development and bacterial proliferation, hemp oil reduces microbially driven irritation and lesion formation, thereby contributing to improved acne outcomes. The antimicrobial activity of hemp-derived compounds offers a promising alternative to conventional antibiotics, potentially mitigating concerns related to antibiotic resistance [ 16, 25, 30]. 3.7. Skin Inflammation Mitigation 3.8. Cosmeceutical Integration and Delivery Optimisation Industrial hemp-derived compounds align with a cosmeceutical and nutraceutical approach to acne management, offering multi-targeted efficacy with fewer adverse effects than conventional pharmacological treatments such as retinoids, antibiotics and isotretinoin, which are commonly associated with irritation, photosensitivity and antibiotic resistance [ 29, 43]. Experimental evidence indicates that nano-encapsulated CBD exhibits superior pharmacokinetics, enhanced anti-inflammatory efficacy, improved dermal penetration and reduced irritation compared with conventional formulations. Table 3 depicts that inorganic CBD-capped nanoparticles, such as gold- or zinc oxide-based systems further demonstrate synergistic anti-inflammatory and antimicrobial effects [ 13, 16, 25, 30, 43, 44]. A pilot randomised clinical study reported that nano-encapsulated CBD cream mitigated UV-A-induced nuclear and mitochondrial DNA injury, supporting enhanced topical performance [ 8]. However, most supporting evidence remains preclinical or early-phase, and regulatory approval for topical CBD formulations is still limited relative to oral products such as Epidiolex ପ୍ପ manufactured by Jazz Pharmaceuticals Research UK Limited located in Oxford United Kingdom. [ 45, 46]. 3.9. Phytochemical Synergy, Sustainability and Evidence Gaps 3.10. Contribution of Fatty Acid-Dominant Hemp Seed-Derived Extracts 3.11. Topical Application Approaches 3.12. Safety, Regulation, Evidence Gaps and Grading 3.13. Sustainability in Hemp Production The crop’s low reliance on pesticides and chemical fertilisers further reduces its environmental footprint, limiting chemical overflow and ecosystem pollution [ 41, 54]. Hemp farming also promotes biodiversity by creating habitats for pollinators and beneficial insects while reducing harmful agrochemical exposure [ 57]. Its versatility as a renewable raw material for textiles, paper, biofuels and construction materials alleviates pressure on forest resources, potentially curbing deforestation rates [ 53, 57]. Life-cycle assessments confirm that organic and outdoor cultivation methods deliver the lowest environmental impacts across carbon footprint, water use, acidification and eutrophication categories, whereas indoor cultivation exhibits comparatively higher footprints [ 53]. 3.14. Resilience of the Industrial Hemp Supply Chain Leading companies are embracing vertical integration and technological innovation to secure stability across cultivation, processing and manufacturing stages. Investments in modular processing facilities and flexible extraction technologies enable rapid adjustments to meet raw material availability and evolving product demand [ 60]. Collaborative partnerships between seed breeders, processors and end-user industries such as the textile, automotive and construction industries further diversify product streams, enhancing supply-chain adaptability [ 42]. These strategies align with SDG 12 (Responsible Consumption and Production), promoting sustainable supply chains, resource efficiency and transparency in production systems. Through environmental stewardship, technological innovation and regulatory compliance, the industrial hemp sector contributes to global sustainability goals while ensuring long-term market resilience. 4. Discussion In grading the evidence, we considered reported risk-of-bias assessments (CochraneRoB-2) for clinical trials and SYRCLE adaptations for preclinical work and the consistency of outcomes across models. Anti-inflammatory and sebostatic actions of CBD and hemp extracts are supported with moderate certainty due to reproducible reductions in pro-inflammatory cytokines and lipogenesis across independent in vitro models and limited ex vivo data [ 20, 21, 22, 23, 61]. Clinical efficacy in terms of lesion counts and erythema is graded with low certainty because sample sizes are small, randomised controlled trials are absent and co-formulation with other actives confounds attribution [ 5, 6]. Antimicrobial activity against C. acnes is rated with low certainty, as the evidence base is largely in vitro, with limited clinical endpoints [ 46, 56, 59]. Formulation strategies such as nano-encapsulation, nanoemulsions and the use of permeation enhancers may improve cannabidiol (CBD) stability and cutaneous penetration; however, dermatology-focused clinical trials remain limited, and reported endpoints are frequently non-acne-specific [ 9, 13, 14, 24]. Short-term topical safety is rated with low to moderate certainty, given consistent reporting of mild irritation and a lack of serious adverse events in available trials and observational reports [ 6, 39]. These grades align with the summary in the Section 2, which notes elevated bias risk of approximately 40% (high risk) in trials due to blinding limitations and 60% (high risk) in preclinical settings using SYRCLE, reflecting heterogeneity in formulations, doses and outcome measures across the literature. Besides clinical performance, hemp offers sustainability attributes that are relevant to dermatological product development. Life-cycle assessments and agronomic studies indicate lower water requirements than many comparator crops, improved soil structure through deep rooting and meaningful carbon sequestration per hectare [ 31, 52, 53, 54, 57]. Reduced reliance on pesticides, coupled with habitat support for pollinators, further decreases environmental burden and aligns with clean-label cosmetic expectations [ 41, 54]. At a supply-chain level, resilience strategies include certification and traceability frameworks such as the Responsible Hemp Standard and investments in modular processing and diversified sourcing to buffer raw-material volatility [ 42, 60]. To translate these advantages into cosmeceutical practice, sustainability metrics should be reported alongside efficacy. We recommend disclosure of the cultivation method (organic versus conventional extraction processes) and energy inputs (water footprint, carbon balance, packaging footprint and end-of-life plans for material) [ 18, 31, 53]. Embedding these indicators within product dossiers and regulatory submissions enables differentiation of hemp-based cosmeceuticals while improving transparency and consumer trust. Practical measures include formulation transparency, with CBD concentration and co-actives clearly labelled, together with sustainability certifications where applicable, adoption of cradle-to-grave life-cycle assessment consistent with ISO 14040 and eco-design packaging that uses recyclable or biodegradable materials to complement the sustainability narrative of hemp-derived actives [ 62]. 5. Research Priorities and Evidence Gaps 6. Conclusions While the current evidence positions CBD-containing hemp extracts as promising adjunctive cosmeceuticals for inflammatory acne, antimicrobial effects and long-term clinical benefit remain tentative. Future progress in this field will depend on methodologically rigorous clinical investigations, including high-quality non-randomised and controlled studies using standardised formulations, validated acne severity outcomes and comprehensive safety assessment, with advancement toward comparative and randomised designs where feasible [ 6, 56]. Supplementary Materials The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/molecules31122017/s1, Table S1: Full-text studies excluded after eligibility assessment and reasons for exclusion [ 57, 63]. Figure S1: Distribution of endocannabinoids in the skin. Figure S2: Acne pathogenesis. Increased sebum production, accumulation of C. acnes, hyperkeratinisation and inflammation resulting in the formation of comedones. Figure S3: A Schematic illustration of lipid-rich hemp seed-derived extract penetration, modulation of barrier lipids and support of non-comedogenic sebum flow. Figure S4: Molecular pathway diagram highlighting ECS receptor targets and downstream effects specific to cannabinoid-containing hemp extracts. Author Contributions The authors B.K. and T.K. contributed equally to every section of the manuscript. All authors have read and agreed to the published version of the manuscript. Funding This research received no external funding. Data Availability Statement The original contributions presented in this study are included in the article/ Supplementary Material. Further inquiries can be directed to the corresponding author. Acknowledgments The authors would like to acknowledge David Katerere and Vincent Maduna for their organizational support. During the preparation of this manuscript/study, the authors used Perplexity AI Anthropic’s Claude Opus 4.6 model and Microsoft 365 ପ୍ପ Copilot (GPT-5 chat model) for the purposes of systemic review and meta-analysis. The authors have reviewed and edited the output and take full responsibility for the content of this publication. Conflicts of Interest The authors declare no conflicts of interest. Abbreviations The following abbreviations are used in this manuscript: CBD Cannabidiol THC Tetrahydrocannabinol CB 1Cannabinoid Receptor Type 1 CB 2Cannabinoid Receptor Type 2 TRPV1 Transient Receptor Potential Vanilloid 1 TRPV4 Transient Receptor Potential Vanilloid 4 TNF-α Tumour Necrosis Factor Alpha IL-1β Interleukin 1 Beta IL-6 Interleukin 6 IL-8 Interleukin 8 PPARγ Peroxisome Proliferator-Activated Receptor Gamma ECS Endocannabinoid System NF-κB Nuclear Factor Kappa-Light-Chain-Enhancer of Activated B Cells MAPK Mitogen-Activated Protein Kinase RCT Randomised Controlled Trial PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses SDG Sustainable Development Goal NLC Nanostructured Lipid Carrier PROSPERO International prospective register of systematic reviews ROS Reactive Oxygen Species PUFAs Polyunsaturated Fatty Acids RHS Responsible Hemp Standard WHO World Health Organization BMJ British Medical Journal PLoS ONE Public Library of Science ONE References Olah, A.; Toth, B.I.; Borbiro, I.; Sugawara, K.; Szollosi, A.G.; Czifra, G.; Biro, T. 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Distribution of evidence in preclinical and clinical studies and reviews. Figure 2. Distribution of evidence in preclinical and clinical studies and reviews. Table 1. Characteristics of key mechanistic, clinical and delivery-system studies included for evidence synthesis or contextual interpretation. Table 1. Characteristics of key mechanistic, clinical and delivery-system studies included for evidence synthesis or contextual interpretation. Reference Model or Population Formulation/Intervention CBD Concentration or Dose Duration/Exposure Key Outcomes Confounders/Notes Abbreviations: ↓ refers to decreased. Table 2. Risk-of-bias assessment for included clinical studies. Table 2. Risk-of-bias assessment for included clinical studies. Reference Design Randomisation Deviations Missing Data Outcome Measurement Reported Result [ 7] Non-randomised (ROBINS-I) N/A Low risk Low risk Some concerns Some concerns [ 8] Non-randomised (ROBINS-I) N/A Some concerns Low risk Some concerns ROBINS-I: serious risk (overall) N/A (not applicable). Table 3. Nano-formulated systems. Table 3. Nano-formulated systems. Nano-Formulation Type Mechanism Observed Benefit Reference Table 4. Phytochemical diversity of industrial hemp extracts and dermatological relevance. Table 4. Phytochemical diversity of industrial hemp extracts and dermatological relevance. Compound Class Key Examples Reported Function Evidence Strength Cannabinoids CBD, CBG, CBC, THCV Anti-inflammatory, sebostatic High (clinical and preclinical) Terpenes β-caryophyllene, limonene Antioxidant, antimicrobial Moderate Polyphenols Cannflavin A, lignanamides Antioxidant, anti-inflammatory Moderate Fatty Acids Linoleic, α-linolenic acids Skin-barrier repair, hydration High Table 5. Evidence grading aligned with risk-of-bias tools. Table 5. Evidence grading aligned with risk-of-bias tools. Domain Summary of Evidence Certainty Anti-inflammatory and sebostatic mechanisms (CBD and hemp extracts) Moderate Clinical efficacy (lesion counts and erythema) Small samples, absence of RCTs and frequent co-formulation with other actives [ 7, 8] Low Short-term topical safety Mild local irritation under ten percent and no serious adverse events across reports [ 7, 8] Low to moderate Antimicrobial activity against C. acnesLow Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Share and Cite MDPI and ACS Style Komane, B.; Kaye, T. CBD-Containing Hemp Extracts and Isolated CBD for Acne: A Systematic Review of Anti-Inflammatory Mechanisms, Clinical Signals and Sustainability. Molecules 2026, 31, 2017. https://doi.org/10.3390/molecules31122017 AMA Style Komane B, Kaye T. CBD-Containing Hemp Extracts and Isolated CBD for Acne: A Systematic Review of Anti-Inflammatory Mechanisms, Clinical Signals and Sustainability. Molecules. 2026; 31(12):2017. https://doi.org/10.3390/molecules31122017 Chicago/Turabian Style Komane, Baatile, and Thobile Kaye. 2026. "CBD-Containing Hemp Extracts and Isolated CBD for Acne: A Systematic Review of Anti-Inflammatory Mechanisms, Clinical Signals and Sustainability" Molecules 31, no. 12: 2017. https://doi.org/10.3390/molecules31122017 APA Style Komane, B., & Kaye, T. (2026). CBD-Containing Hemp Extracts and Isolated CBD for Acne: A Systematic Review of Anti-Inflammatory Mechanisms, Clinical Signals and Sustainability. 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CBD-Containing Hemp Extracts and Isolated CBD for Acne: A Systematic Review of Anti-Inflammatory Mechanisms, Clinical Signals and Sustainability
