The trial worth knowing about
A randomised, placebo-controlled trial published in Current Pharmaceutical Biotechnology in 2020 gave 29 people with peripheral neuropathy of the lower limbs topical CBD oil or placebo for four weeks. The CBD group reported lower scores for intense pain, sharp pain, and cold and itchy sensations.
Twenty-nine people is small and one trial is one trial. It is still the only positive randomised result for CBD in pain of any kind, and it is the reason a topical deserves to be taken more seriously than a tincture on this particular question.
Set it against the other end of the evidence. The largest CBD trial in arthritis — oral capsules, twelve weeks, 136 people — found no difference from placebo at all. Route, condition and dose all changed between the two, which is why neither settles the other.
Why a topical is different
Swallowed CBD goes through the liver before it circulates, and only a fraction of the dose arrives. Applied to the skin over the place that hurts, it does not: whatever penetrates is acting locally, at the joint or the nerve under it.
That is the pharmacological reason to expect more from a topical where the problem is close to the surface — a small joint in the hand, a nerve in the foot — and not to expect a cream to do anything for the rest of you. Systemic absorption through skin is minimal.
What you are actually feeling
This is the part no product page mentions, and it changes how the whole category should be judged.
| Ingredient | What it does on skin |
|---|---|
| Menthol | Triggers cold receptors. The cooling is immediate and unmistakable, and it has nothing to do with CBD. |
| Camphor | Warms and mildly numbs. Often paired with menthol for the hot-and-cold sensation. |
| Capsaicin | Burns, then dulls with repeated use. A serious ingredient with its own literature. |
| Arnica | A herbal fixture in rubs, with its own separate and thin evidence base. |
| Camphorated menthol rubs without any CBD | Are sold everywhere, work the same way, and are the honest comparison for a cream that cools. |
A cream that announces itself on contact has announced the menthol. If you want to know what the CBD is doing, the only clean test is a cream that contains no counter-irritant at all.
Why the milligram number misleads
A tub stating 1000 mg sounds ten times stronger than one stating 100 mg, and might not be. What matters is milligrams per millilitre of product and how much you actually apply, and the front of a tub gives you neither.
- Divide the total by the volume. 1000 mg in 100 ml is 10 mg per millilitre; 1000 mg in 30 ml is more than three times that.
- Note how much you use. A fingertip of cream over a knee is not a measured dose, and it is the only quantity that matters.
- Consistency beats concentration if you are trying to judge it: same tub, same amount, same place, for a fortnight.
What a label has to carry
A 2017 analysis in JAMA of 84 CBD extracts bought online found around seven in ten inaccurately labelled. Topicals are cosmetics on most shelves, which means less scrutiny rather than more.
- Milligrams per container and the container size, so the arithmetic above is possible.
- A batch certificate matching the code on the tub.
- The full ingredients list, which is where the menthol is.
- Spectrum: full spectrum carries a trace of THC even in a cream.
Balm, lotion, roll-on or patch
The same cannabinoid is sold in four carriers, and the carrier decides how much stays where you put it.
| Format | What it suits |
|---|---|
| Balm or salve | Thick, waxy, stays put. Best over a small area — a knuckle, a wrist — and the least likely to spread somewhere you did not want it. |
| Lotion or cream | Thinner, spreads further, absorbs faster. Better over a large area, and less of the product lands on any one spot. |
| Roll-on | A lotion with an applicator. Convenient, hard to measure, and usually the most heavily mentholated of the four. |
| Patch | Holds a fixed amount against one place for hours, which is the only format here that controls both the amount and the duration. |
If you want to run the honest test described below, a balm or a patch makes it easier: both keep the product where you put it, which a lotion does not.
What a patch changes
A patch is the closest a topical gets to a measured dose. The amount is fixed by the manufacturer, the contact area is fixed by the backing, and the duration is fixed by how long you leave it on — three variables that a fingertip of cream leaves entirely to chance.
It is worth knowing that "transdermal" on a box is a claim about design rather than a demonstration. Getting a large lipophilic molecule through skin and into circulation needs penetration enhancers and the right vehicle, and no CBD patch has trial evidence that it achieves systemic delivery. What a patch reliably gives you is consistency of application, which is not nothing when you are trying to judge a product.
How much to put on
No topical dose is established, so the useful advice is about repeatability rather than amount. A fingertip unit — the line of cream from the tip of an adult index finger to the first crease — is the measure dermatology uses for prescribing topical medicines, and it is roughly half a gram. It is a good enough unit here for the same reason: it is the same tomorrow.
Enough to cover the area in a thin film, rubbed in until it stops being visible, is the standard instruction on any topical. More than that sits on the surface and comes off on your clothes.
Carried across from the earlier version of this page so the formats can be compared side by side. These are not recommendations: we have not tested them, and the details on each need checking against current listings before anyone acts on them.
CBDMD CBD CREAM
CBDmd CBD Cream
Budget
- 300, 750 or 1000mg of CBD
CBDmd has also CBD Oil Topicals for you. The American brand has three creams available with different strengths: 300, 750 and 1000mg of CBD.
Freeze, Inflammation Formula, and Moisturizing Lotion are the names and formulas for these creams. Freeze topical is perfect as a pain relief gel after exercise, the Inflammation Formula (as its name suggests) was made to recover from inflammation problems caused by nerves, tendons, muscles, and ligaments; and the Moisturizing Lotion is the perfect way to take care of your skin, revitalize it and make it softer.
Besides, you can choose between different formats: roller (very easy to apply), tub our squeeze. Read more about them in our cbdMD review.
CBDFX HEMP LOTION
CBDFx Hemp Lotion
Budget
- 100mg or 150mg of CBD
CBDFx has recently launched a new line of CBD topicals. This potent lotion comes in two sizes: 50mL with 150mg of CBD and 30mL with 100mg of CBD. It’s made with hemp, pharmacist formulated, tested by third-party labs and made in America with a CO2 extraction process to preserve its purity and potency.
Besides, these creams are made with non-toxic components only containing white willow bark extract, menthol, camomille, and caffeine to have a daily relief with a natural boost.
KOI CBD LOTION
Koi CBD Lotion
Budget
- 200mg of CBD
Koi’s CBD lotion combines 200mg of all-natural CBD with soothing skin ingredients like organic aloe, organic coconut, and lavender extract. The product is completely free of THC and the company makes sure to use plants that are grown, harvested, produced, and lab tested right in the United States. It’s recommended to store your CBD lotion at room temperature away from heat and sunlight, so it’s perfect for keeping in your nightstand and moisturizing before bedtime. The soothing lavender aroma will help your brain wind down and fall asleep with ease.
DIAMOND CBD CREAM
Diamond CBD Cream 250mg
Budget
- 250mg of CBD
Diamond CBD’s Biotech Pain Relief CBD Cream comes highly recommended for pain relief on achy muscles and joints after a long workout or to relieve chronic pain from illness. The rub combines 250mg of all-natural CBD hemp oil with menthol for a recipe that’s made to loosen you up and help you recover quickly with safe ingredients. It’s most effective in high concentrations to increase the number of cannabinoids penetrating your skin. If you rely on menthol or eucalyptus-based products for their soothing cooling effect, this is an excellent option with an added boost of CBD power. According to reviews, people love Diamond CBD Cream for neck and joint pain.
GREEN ROADS CBD CREAM
Green Roads CBD Pain Relief Cream
Budget
- 300mg of CBD
This pain cream by Green Roads was formulated by a licensed pharmacist with more than 20 years of experience, so you can feel confident knowing you’re receiving a quality product made by someone who’s incredibly knowledgeable about the modern medicine and cannabis industries. It’s perfect for overall stiffness, joint pain, and muscle fatigue that’s holding you back from enjoying life, whether it’s from sports, illness, or a past injury. Each bottle contains 150mg of high-quality hemp oil (learn more about their method of extraction in our Green Roads CBD review).
MEDTERRA CBD CREAM
MedTerra CBD Pain Cream
Budget
- 250mg of CBD
MedTerra’s CBD pain cream is a powerful combination of CBD hemp oil, menthol, and arnica for a rapid cooling effect on sore muscles and achy joints. Each 3.4oz bottle contains 100ml of CBD, designed to provide long-lasting relief with all-natural ingredients. If you crave the cooling relief of menthol, this is a superior product that comes highly recommended.
Where a cream is the wrong answer
Not on broken skin, not on a rash nobody has looked at, and not instead of seeing someone about pain that is new, severe, or accompanied by swelling, numbness or fever. A topical is for a known, local, ordinary ache. Nothing on this page is a reason to delay having something looked at.
How to test one properly
Topicals are the easiest CBD format to run a fair test on, because you have two of most things.
- Use it on one side only. One knee, one wrist, one foot, for a fortnight.
- Keep everything else the same — same activity, same painkillers, same time of day.
- Score it at the same time daily, out of ten, written down at the time.
- Check the ingredients first. If it contains menthol, you are testing menthol too, and the test cannot separate them.
The products this page covers
Questions people ask
Does CBD cream work?
A four-week randomised trial in 29 people with peripheral neuropathy of the legs found lower pain scores against placebo — the only positive randomised result for CBD in pain. It is small, and it is more than any other CBD format has.
Is it the CBD or the menthol?
On most creams, the menthol. It triggers cold receptors within seconds and is doing something you can definitely feel. A cream with no counter-irritant in it is the only way to test the cannabinoid on its own.
Will a CBD cream get into my bloodstream?
Very little. Skin is a barrier and CBD is applied over the area that hurts rather than to circulate, which is the point of the format — and the reason a cream is not a route to anything whole-body.
How many milligrams should a cream have?
No topical dose is established. Divide the container total by its volume to compare products, then keep the product and the amount constant for a fortnight if you want to know whether it does anything for you.
Sources
- Xu DH, et al. The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities. Curr Pharm Biotechnol. 2020;21(5):390-402. accessed Sep 18, 2026
- Vela J, et al. Cannabidiol treatment in hand osteoarthritis and psoriatic arthritis: a randomized, double-blind, placebo-controlled trial. Pain. 2022;163(6):1206-1214. accessed Sep 18, 2026
- FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol. US Food and Drug Administration. .gov accessed Sep 18, 2026
- Bonn-Miller MO, et al. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708-1709. accessed Sep 18, 2026
