Could Topical CBD Help Treat Severe Keloid Scarring?

Cannabidiol is frequently associated with oils, capsules, and other products intended to produce effects throughout the body. However, researchers are also investigating whether CBD could act locally when applied directly to the skin.

A newly published case report in JAAD Case Reports¹ offers an unusually striking example. A patient with severe, treatment-resistant keloids on his feet experienced near-complete flattening of the scars after beginning topical CBD oil. The improvement restored his ability to wear work boots and substantially improved his quality of life.

The outcome is intriguing because the patient had already received numerous conventional treatments with little success. However, this was one patient using CBD alongside other therapies. It does not establish CBD oil as an effective keloid treatment.

What the case does provide is a credible reason to investigate whether CBD’s anti-inflammatory and possible antifibrotic properties could be useful in conditions involving excessive scar tissue.

How Graft-Versus-Host Disease Led to Severe Scarring

The patient was a 37-year-old man with relapsed severe aplastic anemia, a rare condition in which the bone marrow fails to produce enough blood cells. He underwent a hematopoietic stem cell transplant using cells from a matched unrelated donor.

Although stem cell transplantation can be lifesaving, donor immune cells can sometimes begin attacking the recipient’s tissues. This complication is known as graft-versus-host disease, or GVHD. Chronic GVHD can affect nearly any organ, with cutaneous involvement occurring in up to almost 80% of cases described by the authors.

The patient developed biopsy-confirmed sclerotic cutaneous and myofascial chronic GVHD. Large pink papules and plaques appeared around his ankles and across the tops of his feet, accompanied by joint stiffness. Further biopsies ultimately identified the prominent scars as keloids.

Keloids form when the skin continues producing scar tissue beyond what is required to repair an injury. Unlike an ordinary scar, a keloid can extend beyond the original damaged area, remain raised, and cause itching, pain, stiffness, or restricted movement. The American Academy of Dermatology’s keloid guidance explains that these scars can also return after treatment.

In this case, the location made the problem particularly disruptive. The scars interfered with the patient’s ability to wear the abrasive boots required for his occupation. The lesions were therefore not simply cosmetic. They had become a source of functional impairment.

Standard Treatments Provided Little Relief

Corticosteroids remain a cornerstone of GVHD treatment, but the patient’s disease was steroid-refractory. He received several additional therapies, including ibrutinib, ruxolitinib, extracorporeal photopheresis, mycophenolate mofetil, and rituximab.

Belumosudil improved some of his myofascial symptoms but produced no meaningful improvement in the skin lesions. Local treatments, including triamcinolone injections and laser therapy, also provided minimal benefit.

This illustrates one reason difficult keloids can become such a persistent medical problem. Available options may include corticosteroid injections, laser treatment, 5-fluorouracil, surgery, and radiation. Outcomes vary, repeated appointments may be necessary, and recurrence remains common. Procedures can also cause pain, bleeding, and other adverse effects.

When a scar restricts movement, unsuccessful treatment carries a cost beyond appearance. It can affect employment, footwear, physical activity, and independence. That helps explain why the functional recovery reported in this case may be more clinically meaningful than the photographs alone suggest.

What Happened After Topical CBD Was Introduced?

Because the keloids remained resistant to treatment, the clinical team initiated a trial of a commercially available CBD oil. The patient applied it directly to the affected areas three times daily for six months and then once or twice daily afterward. He continued treatment for a fixed period of 24 months and reported no side effects.

Medical photography documented a dramatic reduction in the raised scars. According to the report, the patient experienced meaningful functional and quality-of-life improvements soon after starting CBD, while near-complete flattening became evident at approximately 12 months.

Following the regression of the keloids, he was also able to taper mycophenolate mofetil and corticosteroids. This potentially reduced his exposure to medication-related complications, including the elevated risk of opportunistic infection that accompanies immunosuppression.

How Could CBD Affect Keloid Tissue?

The researchers propose two overlapping possibilities: inflammation and fibrosis.

Chronic GVHD begins with tissue damage and immune activation. This process can generate growth factors that encourage fibrosis, causing excessive extracellular matrix and collagen to accumulate in affected tissues. Keloids also involve abnormal fibroblast activity and excessive collagen production.

Preclinical studies have found that CBD can influence inflammatory signaling, fibroblast activity, and collagen synthesis. CBD has also demonstrated antifibrotic effects in experimental models involving other organs. These findings do not prove that the same processes caused the patient’s improvement, but they provide a biologically plausible foundation for further investigation.

Several mechanisms deserve closer attention:

• Reducing persistent inflammatory signaling in damaged skin
• Limiting excessive fibroblast activity and collagen production
• Influencing immune pathways involved in chronic GVHD
• Supporting localized treatment while limiting systemic exposure

The localized nature of the treatment is especially interesting. A topical formulation could theoretically deliver CBD near the affected tissue without requiring high concentrations throughout the body. However, applying CBD to the skin does not guarantee that a consistent amount reaches the cells involved in fibrosis.

The Formulation May Matter as Much as the CBD

CBD is lipophilic, meaning it dissolves more readily in fats than in water. The skin is also designed to prevent outside substances from passing through it. Oils, emulsifiers, penetration enhancers, particle size, and the condition of the skin can therefore influence how much CBD reaches deeper tissue.

As explained in MyCannabis coverage of CBD absorption and nanotechnology, researchers are developing delivery systems intended to improve CBD’s stability, penetration, and controlled release. This case involved a conventional commercial oil rather than a precisely engineered pharmaceutical formulation, and the paper does not provide the product’s CBD concentration or a complete ingredient profile.

That missing information limits reproducibility. Scientists cannot determine whether CBD alone was responsible, whether another ingredient affected absorption, or what dose actually reached the scar tissue. The broader cannabis topicals guide also highlights the important distinction between products that act near the application site and transdermal formulations designed to move compounds into circulation.

If CBD is studied for keloids in a clinical trial, researchers will need a standardized formulation with verified cannabinoid content, stability, dosing, and skin penetration. A consumer product can generate a useful clinical observation, but pharmaceutical development requires something reproducible.

Why This Case Is Promising but Not Proof

The improvement was objectively documented, occurred after CBD was introduced, and was substantial enough to restore function. Those features make the case difficult to dismiss. Nevertheless, temporal association does not establish causation.

The patient was receiving other treatments, including belumosudil, and chronic inflammatory conditions can change over time. There was no untreated comparison lesion, placebo product, blinding, or independent way to isolate CBD’s effect. A single case also cannot reveal how often patients might respond or identify uncommon adverse reactions.

The next step should be a prospective study enrolling people with clearly defined treatment-resistant keloids. Researchers could compare standardized topical CBD against a placebo vehicle while measuring scar height, surface area, flexibility, pain, itching, range of motion, and quality of life. Biopsies or noninvasive imaging could help determine whether any visible changes correspond with altered collagen structure or inflammatory activity.

Product quality would also require close attention. The FDA’s information on CBD products cautions that many commercially available products have not been evaluated for effectiveness, proper dosing, drug interactions, or other safety concerns. That is particularly relevant for transplant recipients and other patients taking immunosuppressive drugs.

A Small Study With a Larger Research Question

This case does not justify recommending over-the-counter CBD oil for keloids. It does, however, introduce a valuable question: Could a standardized topical cannabinoid therapy interrupt the combination of inflammation and fibrosis that makes some scars so resistant to treatment?

The most important outcome was not simply that the lesions became flatter. The patient regained function after conventional therapies had provided limited relief. That makes the observation worthy of controlled research, especially for patients whose scars cause pain, restricted movement, or occupational limitations.

For now, topical CBD remains an experimental possibility rather than an established treatment. The response reported here provides a compelling starting point, but properly designed trials must determine whether it can be repeated, which patients are most likely to benefit, and what formulation can deliver CBD safely and consistently.

References:

¹ Kalra, A. G., Shalabi, R., Wells, B., & Childs, R. W. (2026). Cannabidiol oil therapy for function-limiting keloids associated with graft-versus-host disease: A case report. JAAD Case Reports. Advance online publication. https://doi.org/10.1016/j.jdcr.2026.09.001