Striae Distensae: Preventative and Therapeutic Modalities to Improve Aesthetic Appearance

Autolougous platelet concentrates in esthetic medicine

This narrative review summarizes current knowledge on the use of autologous platelet concentrates (APCs) in esthetic medicine, with the goal of providing clinicians with reliable information for clinical practice. APCs contain platelets that release various growth factors with potential applications in facial and dermatologic treatments. This review examines several facial esthetic applications of APCs, including acne scarring, skin rejuvenation, melasma, vitiligo, stretchmarks, peri-orbital rejuvenation, peri-oral rejuvenation, hair regeneration and the volumizing effects of APC gels. A systematic review of literature databases (PubMed/MEDLINE) was conducted up to October 2023 to identify randomized controlled trials (RCTs) in the English language on APCs for facial rejuvenation and dermatology. A total of 96 articles were selected including those on platelet rich plasma (PRP), plasma-rich in growth factors (PRGF), and platelet-rich fibrin (PRF). Clinical recommendations gained from the reviews are provided. In summary, the use of APCs in facial esthetics is a promising yet relatively recent treatment approach. Overall, the majority of studies have focused on the use of PRP with positive outcomes. Only few studies have compared PRP versus PRF with all demonstrating superior outcomes using PRF. The existing studies have limitations including small sample sizes and lack of standardized assessment criteria. Future research should utilize well-designed RCTs, incorporating appropriate controls, such as split-face comparisons, and standardized protocols for APC usage, including optimal number of sessions, interval between sessions, and objective improvement scores. Nevertheless, the most recent formulations of platelet concentrates offer clinicians an ability to improve various clinical parameters and esthetic concerns.

Low Molecular Weight Hyaluronic Acid Added to Six Specific Amino Acids in the Treatment of Striae Alba (SA): An Observational Study

Striae distensae or stretch marks are a common complaint among women and can be distressing. The present study aimed to assess the efficacy of a mixture of low molecular weight hyaluronic acid and six amino acids when applied with a specific intradermal injection technique known as intra-mural fluid technique. A clinical study was carried out in 32 patients (with a dropout rate by 9.4%) with striae distensae alba (SA) in one or more of the following anatomical areas: breast, abdomen, inner thigh, trochanteric area, gluteal area, posterior supra-iliac area, and lumbar area. Product efficacy was assessed by the investigator using the Global Aesthetic Improvement Scale, while a Likert scale was used to evaluate to score the treatment tolerability and a QoL stretch marks questionnaire was used to investigate the patients' self-body image. The treatment was effective in improving the appearance of SA fifteen days after the second treatment and 6 months after the first treatment (and after a total of 4 treatments). The product efficacy and tolerability were also perceived by the patients during each treatment session. Our results suggest that the test treatment is a valid treatment option to decrease the appearance of SA. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266.

The role of the beautician in reducing striae

INTRODUCTION

Striae distensae are a permanent skin defect that can affect 50%-90% of the population. The appearance of the changes resembles spindle-shaped skin bands. The skin in this area is wrinkled, thin and looks like a scar. Most often, the changes are found on the skin of the abdomen, buttocks, breasts, thighs, and back. The appearance of striae means that the skin in this area has no hair follicles, sebaceous, and sweat glands. This skin is flabby, not very elastic and, what is very characteristic, the pigmentation of the skin affected by striae is much lower than in healthy skin. Cosmetology in the 21st century is developing very dynamically, new technologies are being developed, new cosmetological devices are being created and combined with treatments that have been known for a long time. Today's science offers hope for people who have struggled with reducing striae for many years and nowadays, nothing is impossible.

AIMS

The objective of this article is to provide information about cosmetological treatment used to reduce striae.

METHODS

In this article, we reviewed the published literature, article published in peer-reviewed journals.

RESULTS

Today's cosmetology offers a wide range of numerous treatments, but the best results are achieved through a synergy of two or more treatments. But we should not forget that we should respond to each customer individually.

CONCLUSION

The striae are not a problem that should be ignored. The beauty therapist is able to reduce them and help the client to improve the appearance of their skin.

Bullous striae distensae in a nephrotic syndrome patient: First case report from the Middle East of a rare presentation and review of the literature

Striae distensae is a common cutaneous phenomenon that begins as reddish linear atrophic plaques (striae rubra) that over time progress to silvery-white coloration (stria alba). Striae distensae in rare occasions becomes edematous, ulcerative, emphysematous, or urticated. Bullous striae distensae is a sequela of conditions causing interstitial edema along with systemic glucocorticoids use. To our knowledge, only eight cases of bullous striae distensae have been reported in the literature. Herein, we report a 17-year-old female, known case of nephrotic syndrome, presented to our clinic with abdominal fluid-fill cutaneous lesions only for 5 days. She had used systemic glucocorticoids for more than a decade before she was labeled as steroid resistant nephrotic syndrome. Cushingoid body habitus were observed during physical examination, in addition to translucent bullae overlying her previously known stretch marks. Punch biopsy of the lesions revealed dermal edema with thinned collagen bundles. Based on these clinicopathological findings, a diagnosis of bullous striae distensae was made. Awareness of this rare complication and unusual clinical presentation is fundamental to avoid unnecessary and excessive interventions whether investigatory or therapeutic in order to provide appropriate management of the underlying condition.

Bullous striae distensae in a young patient with cardiomyopathy

Striae distensae (SD), also known as stretch marks, are observable linear scars that appear where dermal damage has occurred as a result of prolonged stretching of the skin. The actual pathophysiology of SD is still up for debate because its origins are multifaceted. Generally, striae are benign lesions, but larger lesions may get traumatized and become ulcerated or rupture. In patients with edema and receiving systemic steroids, bullous SD could develop secondary to fluid buildup preferentially in striae. We report a case of a young patient with cardiomyopathy who received systemic steroids and developed bullous striae distensae.

Treatment of Stretch Marks Using a New Formulation Combining Nanofractional Radiofrequency Plus Magnetic Nanofractional Radiofrequency

INTRODUCTION

Stretch marks are common atrophic dermal scars with significant physical and psychological effects. Therefore, there is a need for effective cosmetics and procedures for stretch mark treatment. This study aimed to evaluate the efficacy and safety of a novel treatment for stretch marks that is made up of topical formulations containing beta-glucan combined with nanofractional radiofrequency.

METHODS

This randomized, blinded control trial enrolled 64 Chinese women aged 20-45 years at > 6 months after delivery with obvious white or silver abdominal stretch marks. Participants were randomly allocated to group A (blank group), group B (topical product group), group C (product combined with nanofractional radiofrequency), and group D (vehicle combined with nanofractional radiofrequency). The stretch mark width, skin elasticity, skin color, skin thickness, and collagen density were noninvasively measured. Two trained assessors evaluated the severity, color, outline, and relaxation of the striae.

RESULTS

Group C showed the best treatment efficacy, with no adverse effects observed during the study period.

CONCLUSION

Our findings indicate that stretch mark treatment using topical formulations containing beta-glucan, combined with nanofractional radiofrequency plus magnetic nanofractional radiofrequency, is tolerable and effective.

TRIAL REGISTRATION

ChiCTR2200056725.

Striae Distensae: Clinical Results and Evidence-Based Evaluation of a Novel 675 nm Laser Wavelength

Background: A current popular aesthetic problem, especially among younger women, is striae distensae (SD), also referred to as "stretch marks.". Aim: The potential use of the 675 nm laser has been investigated in the treatment of SD. Methods: Patients underwent three sessions of the 675 nm laser with a 1-month interval between sessions. A total of three sessions were performed. The Manchester Scar Scale was used to assess stretch mark changes, and the mean scores related to each parameter at baseline and 6M FU after the last treatment session were measured. A clinical photographic evaluation was performed to show the aesthetic improvement of SD. Results: The patients' treated areas were the abdomen, thighs, buttocks, and breasts. Mean scores related to each Manchester Scar Scale parameter, with their relative percentage change, at baseline and 6M FU after the last treatment session were significantly improved. The total mean Manchester Scar Scale score significantly diminished from 14.16 (±1.30) to 10.06 (±1.32) at 6M FU (p < 0.01). The clinical photographs showed promising aesthetic SD improvement. Conclusions: 675 nm laser therapy demonstrated a good tolerance for the treatment of stretch marks applied to various body areas preventing any discomfort for the patient and with a significant improvement in skin texture.

Treatment of Striae Distensae with Filler Injection: A Systematic Review

Background

Stretch marks, also known as striae cutis distensae (SD), are visible linear scars that occur in regions of dermal damage due to skin stretching. Stretch marks are not serious health issues, but they may have a major psychological effect on patients. Due to poor skin color improvement or prolonged skin atrophy, there is no standard treatment for SD. Fillers have been studied for their effectiveness in the treatment of SD.

Objective

This systematic review aims to determine the efficacy of fillers on SD.

Methods

This systematic review is reported following PRISMA guidance. We included all relevant articles published up to November 2022 in the following electronic databases: Science Direct, Midline, the Web of Science, CINAHL, and Google Scholar. The initial search yielded 119, of which seven were included after applying inclusion and exclusion criteria.

Results

The systematic review included a total of 184 female participants who were over the age of 18 years old. Three studies used jet volumetric remodeling (JVR) to inject HA pneumatically. One study injected polycaprolactone filler. One study used calcium hydroxylapatite, micro-needling, and ascorbic acid. MFU-V and CaHA were given in one study. One study delivered MFU-V using micro-focused ultrasound. All studies showed that it reduces SD with only mild, temporary side effects. More favor was given to combining CaHA and MFU-V, which had the fewest side effects compared to other dermal fillers.

Conclusion

As monotherapy or combination therapy, injectable dermal fillers may treat SD with minimal adverse effects. We suggest that more RCTs look into injectable dermal filler to find out what is best for patients with SD and compare it to other treatment methods in terms of results, costs, and side effects to provide satisfactory practice and basic guideline interventions for these cases.

Improving the outcome of treating striae gravidarum by combined therapies using topical β-glucan and 1565-nm non-ablative fractional laser: A prospective randomized vehicle-controlled parallel group study

Striae gravidarum (SG) is a kind of dermal scar associated with psychosocial and therapeutic challenge. Topical reagents and non-invasive laser are more preferred than invasive procedures for less pain and shorter downtime. However, there are few studies on comparing and combining these two modalities. The aim of the present study was to evaluate the efficacy and tolerance of a topical regimen containing β-glucan, 1565-nm non-ablative fractional laser (NAFL; ResurFX), and combination of them for SG. A total of 128 unilateral abdomens from 64 subjects were randomly divided into four strategies and were followed up for 12 weeks: topical vehicle (Veh); topical β-glucan (B); 1565-nm NAFL combined topical vehicle (NAFL); 1565-nm NAFL combined topical β-glucan (B + NAFL). NAFL was applied three times with a 4-week interval. Topical reagent was applied b.i.d. for 12 weeks. Global Aesthetic Improvement Scale (GAIS) scores were assessed by blinded physician according to standard photograph, and by subjects at 12th week. The degree of SG atrophy was assessed by blinded physician before treatment and at the 12th week according to a standard 5-point scale. Collagen remodeling was evaluated by histological analysis and all adverse effects were recorded. A total of 56 women (112 unilateral abdomens) completed all study. The GAIS scores by blinded physician showed greater improvement in NAFL as compared with β-glucan, and by subjects showed greater improvement in β-glucan as compared with vehicle. In terms of striae atrophy scale, the improvement of SG atrophy was more prominent in NAFL compared to β-glucan, and in β-glucan + NAFL compared to Veh + NAFL. All treatments were well tolerated. Topical β-glucan regimen can mildly improve SG. NAFL showed better results than topical β-glucan regimen. The combined strategy may further improve the SG atrophy compared with single treatment strategy.

Clinical Relevance of Elastin in the Structure and Function of Skin

Elastin is the main component of elastic fibers, which provide stretch, recoil, and elasticity to the skin. Normal levels of elastic fiber production, organization, and integration with other cutaneous extracellular matrix proteins, proteoglycans, and glycosaminoglycans are integral to maintaining healthy skin structure, function, and youthful appearance. Although elastin has very low turnover, its production decreases after individuals reach maturity and it is susceptible to damage from many factors. With advancing age and exposure to environmental insults, elastic fibers degrade. This degradation contributes to the loss of the skin's structural integrity; combined with subcutaneous fat loss, this results in looser, sagging skin, causing undesirable changes in appearance. The most dramatic changes occur in chronically sun-exposed skin, which displays sharply altered amounts and arrangements of cutaneous elastic fibers, decreased fine elastic fibers in the superficial dermis connecting to the epidermis, and replacement of the normal collagen-rich superficial dermis with abnormal clumps of solar elastosis material. Disruption of elastic fiber networks also leads to undesirable characteristics in wound healing, and the worsening structure and appearance of scars and stretch marks. Identifying ways to replenish elastin and elastic fibers should improve the skin's appearance, texture, resiliency, and wound-healing capabilities. However, few therapies are capable of repairing elastic fibers or substantially reorganizing the elastin/microfibril network. This review describes the clinical relevance of elastin in the context of the structure and function of healthy and aging skin, wound healing, and scars and introduces new approaches being developed to target elastin production and elastic fiber formation.

Efficacy of platelet-poor plasma gel in combination with fractional CO2 laser in striae distensae: A clinical, histological, and immunohistochemical study

BACKGROUND

Platelet-poor plasma gel is a semi-solid plasma formulation that recently recommended as autologous bio-filler for treatment of atrophic dermal scars.

AIM

To compare the therapeutic efficacy and safety of intradermal injection of plasma gel in combination with fractional CO₂ laser versus fractional CO₂ laser alone in striae distensae (SD).

PATIENTS AND METHODS

This study included 36 SD patients treated by three sessions (one session/1.5 months) of fractional CO₂ laser on all SD lesions following intradermal injection of plasma gel on one side and saline (as placebo) on the other side.

RESULTS

Significant clinical improvements associated with remarkable narrowing of SD lesions and prominent enhancement of skin texture were observed on both treatment sides. Obviously, higher degrees of clinical improvements of SD lesions were reported following combined therapy with fractional CO₂ laser and plasma gel rather than fractional CO₂ laser monotherapy. However, post-inflammatory hyperpigmentation (PIH) was reported more frequently with fractional CO₂ laser monotherapy. Histopathological and immunohistochemical examinations revealed significant epidermal improvement, and homogenization, and orientation of dermal collagen bundles as a result of both therapeutic procedures.

CONCLUSION

Plasma gel in combination with fractional CO₂ laser could be considered a promising novel treatment modality for SD. Plasma gel not only improves the efficacy of fractional CO₂ laser but also decreases the frequency of PIH.

Platelet-rich plasma for striae distensae: What do we know about processed autologous blood contents for treating skin stretchmarks?-A systematic review

Striae distensae, also known as stretch marks, particularly associated with female sex, pregnancy, obesity, and/or hormonal change, are linear bands of benign dermal lesions. Although not posing any health risk, aesthetically unpleasing stretch marks can cause significant psychological distress among those affected. In abundance of therapeutic approaches, some literature sources proclaim platelet‐rich plasma to be a promising treatment modality for striae distensae. We aimed to shed some light on the current literature evidence of platelet‐rich plasma for treating stretch marks and performed an English literature analysis with two independent reviewers in accordance with PRISMA guidelines searching the PubMed and Web of Science databases in June 2019. Of the 12 found studies, 6 matched inclusion criteria. With no control groups in two, just two other reports used intraindividual comparisons, and all but one publication performed histopathological assessments. All studies observed clinical and subjective improvements without using validated scores or patient‐reported outcome measures (PROMs). The main findings were that multiple treatments with platelet‐rich plasma demonstrated increased epidermal thickness, rete ridges formation, and collagen/elastin formation, while decreasing the inflammatory cell infiltrate. The current literature evidence supporting the use of platelet‐rich plasma for striae distensae is poor. We propose in this review an outline for a study protocol with intraindividual control groups, standardised scores, validated PROMs, and participant incentives to enhance the scientific power in future clinical trials.

Treating Striae Distensae Albae in Asians: Efficacy and Safety of Combined MFU-V and CaHA

This study evaluated the efficacy and safety of a single treatment combining microfocused ultrasound with visualization (MFU-V) and subdermal diluted calcium hydroxylapatite with lidocaine (CaHA+) for Striae Distensae Albae (SDA).

Comparative effectiveness of different therapies for treating striae distensae: A systematic review and network meta-analysis

BACKGROUND

Striae distensae (SD) are common and aesthetically undesirable dermal lesions. The aim of this study is to comprehensively evaluate the effectiveness of different therapies in treating striae distensae using network meta-analysis.

METHODS

A systematic search of electronic databases up to December 1, 2019 was conducted. Randomized controlled trails (RCTs) examining the effectiveness of different methods in treating striae distensae were included. The primary outcomes are clinical effective rate and patient's satisfaction degree. Risk of bias was assessed by the Cochrane risk of bias tool. Network meta-analysis was based on Bayesian framework.

RESULTS

Fourteen trails that met the criteria with 651 subjects were included. The results of the network meta-analysis show that topical tretinoin combined bipolar radiofrequency showed the highest probability of being the best method to improve the clinical effectiveness and patient satisfaction rate of treating SD (84.5% and 95.7% respectively), closely followed by bipolar radiofrequency (75.3% and 84.3% respectively). Among laser treatment, CO2 fractional laser is superior to other lasers in the clinical effectiveness and patient satisfaction (72.0% and 58.1% respectively). Statistics showed the topical tretinoin was the worst-performing option in improving the clinical effectiveness and patient satisfaction rate of SD treatment (5.4% and 5.1% respectively).

CONCLUSION

Based on the results of network meta-analysis, we recommend treating striae distensae with bipolar radio frequency combined topical tretinoin. The commonly used CO2 fractional laser can be considered as alternative treatment candidate. Additional large-scale RCTs are necessary to obtain more precise estimates of their relative efficacy.

Utility of platelet-rich plasma for treatment of striae distensae: A current exploration

Platelet-rich plasma (PRP) has recently become a popular treatment for various skin conditions, including striae distensae, acne scars, traumatic scars, hair regrowth, and cutaneous rejuvenation. Although PRP has been utilized in orthopedics for many years, its recent entry into dermatology has been met with controversy. While the recent research has generally been limited and is often contradictory, this has differed from the persuasive marketing campaigns targeting patients and consumers. Aesthetic practitioners should be knowledgeable with the available evidence for PRP in the treatment of striae distensae. Here, we review the pertinent literature and offer additional insights.

Consumer Preference of Products for the Prevention and Treatment of Stretch Marks: Systematic Product Search

Background

Striae distensae, or stretch marks, are a common and distressing condition affecting females two-and-a-half times more frequently than males. Despite the numerous products available for stretch mark prevention and treatment, there have been few studies that consider consumer product preference.

Objective

The aim of this study was to determine which products were preferred by consumers for the prevention and treatment of stretch marks based on product vehicle and product ingredients.

Methods

In January 2020, a search was conducted on internet retailer Amazon for products related to stretch marks. The top products were identified as those with 100 reviews or greater and a rating of 4 or higher. The products were classified as either stretch mark–specific or non stretch mark–specific. Price, rating, type of vehicle, and specific ingredients of both product groups were compared. Vehicle-type and ingredients in both product groups were compared with two-tailed two-sample proportion tests to determine if certain vehicles or ingredients were more likely to be found in stretch mark–specific products. P<.05 indicated statistical significance.

Results

Out of over 10,000 products, 184 were selected as the top products according to the review and rating criteria of which 117 (63.6%) were stretch mark–specific and 67 (36.4%) were non stretch mark–specific. Oil was the most common vehicle (131/184, 71.2%) while vitamin E was the most common ingredient (58/184, 31.5%). Oil, as a vehicle, was more likely to be found in stretch mark–specific products than in non stretch mark–specific products (P=.001). Olive oil (P=.02) and cocoa butter (P=.08), Centella asiatica (P=.01), and shea butter (P=.003) were the ingredients more likely to be found in stretch mark–specific products than in non stretch mark–specific products.

Conclusions

This study demonstrated that there are many products available for the prevention and treatment of stretch marks and identified specific ingredients in the products preferred by customers. There are few studies investigating the effectiveness of the major ingredients in the stretch mark products that are preferred by consumers. Future studies can focus on the effectiveness of the ingredients found in the products that are preferred by consumers.

Dermoscopy and VISIA imager evaluations of non-insulated microneedle radiofrequency versus fractional CO2 laser treatments of striae distensae

BACKGROUNDS

Striae distensae (SD) has a known psychological impact due to the resulting cosmetic disfigurement. Many treatment modalities have been used over the years, but no standard interventions or evaluation methods have been proposed to date.

OBJECTIVE

We compared the efficacy and safety of non-insulated microneedle radiofrequency (NIMRF) and fractional CO₂ laser treatments of SD by objective measurements with dermoscopy and VISIA.

METHODS

Fourteen females with severe SD were enrolled. These subjects had been treated three sessions of NIMRF and fractional CO₂ laser for the right and left abdomen, respectively. Dermoscopy and VISIA imaging data, and photographs were collected at baseline and 2 months after the last treatment session. The global aesthetic improvement scale (GIAS) was scored by patients, and blinded investigators, pain score and satisfaction score were also documented. Any side effects were recorded.

RESULTS

Ten patients completed the study. The GIAS from investigators and patients showed an overall improvement but without a significant difference (P = 0.18, P = 0.17, respectively). The decreased width measured by dermoscopy was between 5% and 32% (right side) and 6-31% (left side). There was no significant difference between both sides in either the per-protocol or intention to treat analyses (P = 0.149, P = 0.161, respectively). The mean pain score was 5.35 and 2.35 on the right side and left side, respectively, which was significant (P = 0.0016). Post-inflammatory hyperpigmentation (PIH) manifested in six patients on their left sides and four patients on their right sides. In most cases, this had resolved by the 3-month follow-up.

CONCLUSION

Non-insulated microneedle radiofrequency and fractional CO₂ laser are both effective and safe treatment options for SD. PIH is a possible side effect but is more likely with fractional CO₂ laser treatment. However, it clears up in most cases. Dermoscopy and VISIA are both convenient, digitalized methods of tracking subtle changes and monitoring the efficacy of SD treatments.

Beyond the Booth: Excimer Laser for Cutaneous Conditions

The excimer laser has emerged as an efficacious treatment modality for many dermatologic diseases. The excimer laser is an alternative to standard narrowband ultraviolet B (NBUVB) phototherapy treatment in patients with limited disease. In comparison to standard NBUVB, the excimer laser requires fewer treatment sessions, has reduced treatment duration, requires a lower cumulative UVB dose, and limits UVB exposure to lesional skin. This review addresses the mechanism, safety, application, and efficacy of the excimer laser for the treatment of these conditions.

Investigation of coenzyme Q10 levels and predisposing factors in patients with striae gravidarum

BACKGROUND

Striae gravidarum (SG) can cause pregnant women severe psychological stress.

OBJECTIVE

This study aimed to compare primigravidas with and without SG concerning fasting blood coenzyme Q10 (CoQ10), age, skin type, family history, gestational weight gain, pre- and post-pregnancy BMI, daily water consumption during pregnancy, gender and weight of baby, and the educational level.

METHODS

The study included 79 primigravidas in the gestational week of 36 or above. The patients were divided into two groups based on the presence of SG. The fasting blood CoQ10 levels and other associated parameters were compared between the groups.

RESULTS

Of the 79 primigravidas, 35 (44.3%) had SG. There was no statistically significant relationship between striae and CoQ10 (P = 0.144 and P = 0.189, respectively). Predisposing factors for striae were young pregnancy, light skin color, family history, high pre- and post-pregnancy BMI, increased gestational weight gain, and increased newborn weight. There was no significant relationship between striae development and educational level or water consumption during pregnancy.

CONCLUSION

This is the first study to show that CoQ10 did not significantly differ between women with and without SG. Further studies with a larger case series are needed to elucidate predisposing factors for striae and involvement of CoQ10 in this condition.

Efficacy of Microneedling Versus Fractional Non-ablative Laser to Treat Striae Alba: A Randomized Study

BACKGROUND

Striae distensae (SD), an unsightly cutaneous condition characterized by epidermal atrophy, can affect the quality of life of women.

OBJECTIVES

The aim of our study was to compare the efficacy of a neodymium:yttrium-aluminum-perovskite 1340 nm non-ablative fractional laser (NAFL) and the microneedling (MN) technique to treat striae alba (SA).

MATERIALS AND METHODS

NAFL and MN were used to treat striae on the longitudinally divided abdominal surface of 20 women classified as Fitzpatrick skin type III or IV (five sessions at monthly intervals). Photographs and skin biopsies were obtained during pretreatment and after the third and fifth treatment sessions for all patients. Patients and two independent evaluators assessed the clinical response using the Global Aesthetic Improvement Scale.

RESULTS

Patient-reported evaluation showed improvement of striae using both modalities, with no statistically significant difference between the groups. Collagen and elastic fibers were significantly increased (p < 0.01) after the third and fifth treatment sessions, with no significant difference between the modalities. In addition, Dermatology Life Quality Index scores showed significant improvement (p < 0.001) after the third and fifth treatment sessions compared with pretreatment values, with average values of 8.4 (standard error [SE] ± 1.21), 3.17 (SE ± 0.55), and 2.64 (SE ± 0.60), respectively. The mean pain score using the Visual Analog Scale in the MN group versus the NAFL group was 5.23 (SE ± 0.31) versus 2.39 (SE ± 0.22) [p < 0.001], and the mean duration of adverse events in the NAFL group versus the MN group was 4.03 days (SE ± 0.45) versus 3 days (SE ± 0.37) [p = 0.02].

CONCLUSION

NAFL and MN are safe for treating SD, particularly in individuals classified as phototype III or IV. MN is a useful non-technology-dependent, low-cost alternative therapy for SA.

CLINICAL TRIAL REGISTRATION NUMBER

NCT03390439.