Study on the methodology of striae gravidarum severity evaluation

Evaluation of the tissue repair process and immunomodulatory action of Platelet-Rich Plasma (PRP) in the treatment of abdominal stretch marks

The aims of this study were to characterize and to compare the structural alterations of collagen and elastic fibers in the abdominal stretch marks of patients submitted to intralesional and per quadrant (region close to stretch marks) Platelet-Rich Plasma (PRP) treatment, as well as, to establish the possible mechanisms of action of this treatment involving toll-like receptors (TLRs) signaling pathways and growth factors. Incisional biopsies were collected from abdominal stretch marks with a 2 mm diameter punch in female patients, at the beginning of treatment, after 6 and 12 weeks of treatment, and submitted to morphological analyzes of elastic and collagen fibers, and immunohistochemistry for TLRs signaling pathways and growth factors. Our results demonstrated PRP per quadrant treatment was most effective in reducing the area of the abdominal stretch marks, with consequent stimulation of the synthesis and remodeling of collagen and elastic fibers. Also, PRP per quadrant treatment promoted an increase in TLR2 and TLR4 immunoreactivities, with consequent increase in TNF-α, VEGF and IGF-1. Based on the current findings, PRP constitutes a promising therapeutic approach in patients with stretch marks, since it promoted modulation of inflammatory cytokines and growth factors, with consequent remodeling of extracellular matrix, culminating with tissue improvement.

Efficacy of Combined Treatment with Intense Pulsed Light and Erbium Fractional Laser in Striae Gravidarum

Purpose

Laser and intense pulsed light (IPL) treatments are preferred over invasive procedures due to less pain. This study looked at the efficacy and safety of IPL and Erbium fractional laser for patients with striae gravidarum (SG).

Patients and Methods

All 60 patients with SG were successfully enrolled in the study. IPL treatment was followed by Erbium fractional laser (wavelength 2940 nm) treatment at 4-week intervals for a total of three treatments. SG elasticity was assessed with a SEM575 custom instrument and patients were scored for SG span with an Antera 3D multifunctional skin imaging analyzer. A 3D skin impact system was used to assess patients' epidermal thickness. A visual analog scale (VAS) was used to assess patients' pain scores during the treatment period. Improvement in stretch marks was assessed with the Global Aesthetic Improvement Scale (GAIS). The occurrence of adverse events was recorded at a follow-up of 3 months. Patient satisfaction with the outcome of the treatment was also recorded.

Results

Area of stretch marks decreased from 7.89 ± 0.49 cm² pre-treatment to 4.94 ± 1.16 cm² post-treatment (P < 0.001). The grayness values and atrophy of stretch marks were reduced after treatment. Furthermore, skin elasticity and thickness at the lesions of patients increased significantly after the treatment (P < 0.001), while the width of the stretch marks significantly decreased (P < 0.001). The VAS score was 5.45 ± 1.31, the incidence of adverse events was 25%, and patient satisfaction with the efficacy was 96.67%.

Conclusion

IPL combined with Erbium fractional laser improves the area and atrophy of SG, lightens the color, and increases the elasticity and thickness of the skin, with high treatment safety and remarkable clinical results.