Cannabis Was the Most Common Psychedelic to Cause Skin Reactions | Research

The takeaway

In a review of skin reactions to psychedelics and hallucinogens, cannabis accounted for nearly half of all reported cases, most commonly causing allergic reactions from topical exposure, while MDMA, ketamine, and psilocybin also caused various skin problems.

Dermatologists, allergists, cannabis industry workers, and consumers experiencing unexplained skin reactions.

Cannabis accounted for nearly half of all documented skin reactions to psychedelics

What the researchers found

Of 22 studies meeting inclusion criteria (40 total patients), cannabis accounted for 10 studies. The most common cannabis skin reaction was type I hypersensitivity from topical exposure (n=21). Three patients had type IV reactions (vesicular contact dermatitis) from cannabis-derived oils. MDMA caused acneiform eruptions and Stevens-Johnson syndrome. Ketamine caused type I hypersensitivity. Psilocybin caused vesicular eruptions.

Why it matters

As cannabis and psychedelic use increases, clinicians need to recognize associated skin reactions. Cannabis allergy is increasingly documented and can range from mild contact reactions to potentially serious systemic allergic responses.

The numbers in context

22 studies, 40 patients total; cannabis: 10 studies, 21 cases of type I hypersensitivity, 3 cases type IV; MDMA: 5 studies; ketamine: 4 studies; psilocybin: 3 studies; 8 resolved with cessation alone

How the study worked

Systematic review of PubMed and Scopus from database inception to August 2023 for cutaneous reactions to psychedelics and hallucinogens (cannabis, MDMA, LSD, ketamine, psilocybin, and others).

What this study cannot tell us

Limited to published case reports and small studies. Likely underrepresents true incidence. No standardized diagnostic criteria across studies. Many cases had incomplete follow-up.

How to read the evidence

Systematic review but of mostly case reports with small patient numbers and inconsistent follow-up.

When this study was published

Published in 2024.

The bigger picture

Cannabis allergy is an emerging clinical concern that may be underrecognized. As cannabis becomes legal and more people handle cannabis products (especially in agricultural and dispensary settings), occupational skin reactions may increase.

Questions still open

Is cannabis allergy becoming more common with increased exposure?
Should cannabis dispensary and agricultural workers be screened for cannabis skin sensitivity?

Common questions

Can cannabis cause skin reactions?

Yes. The most common was allergic reactions from topical exposure (touching cannabis plants or products). Some people developed contact dermatitis from cannabis-derived oils.

Are cannabis allergies common?

They appear to be increasingly recognized, particularly among people who handle cannabis occupationally. But the true prevalence is unknown.

Read the original research

Trips Through the Skin: Reviewing Cutaneous Drug Reactions to Psychedelics and Hallucinogens.

Dermatitis : contact, atopic, occupational, drug, 35(6), 605-613

View on PubMed ↗Publisher’s paper ↗

Citation

Rahman, Syed Minhaj; Salem, Yousef; Hussain, Aamir. (2024). Trips Through the Skin: Reviewing Cutaneous Drug Reactions to Psychedelics and Hallucinogens.. Dermatitis : contact, atopic, occupational, drug, 35(6), 605-613. https://doi.org/10.1089/derm.2023.0292