Efficacy of carboxytherapy in the treatment of striae alba

Abstract

Background Striae alba represent frequent cosmetic complaints among women. Different treatment modalities are available. However, none is satisfactory with the risk of pigmentation, especially among darker skin types. Carboxytherapy is widely used in the treatment of striae without enough evidence to support its use. Aims To assess the effectiveness of carbon dioxide therapy in the treatment of striae alba from clinical, histopathological, and immunohistochemical aspects. Patients and methods A total of 30 female patients with abdominal striae alba were randomly selected and received ten carboxytherapy sessions 1 week apart. Clinical assessment was done using standard photography and patient satisfaction. Moreover, biopsies were obtained from all patients before treatment and 2 months after the last treatment session. Routine hematoxylin and eosin stain, Masson's trichrome stain, and Orcein stain were used to measure the epidermis thickness and recognize collagen fibers and elastin fibers, respectively. The average blood vessel count was estimated by examining CD31-immunostained slides. Results Our results revealed a statistically significant clinical difference in striae staging before and after the treatment. Moreover, significant histopathological differences were recorded regarding epidermal thickness, collagen, elastin bundle thickness, and increase in blood vessel count. Adverse effects were mild, transient, and tolerable. Conclusion Carboxytherapy is an effective and safe modality for treating striae alba, especially in darker skin types. It acts through collagen and elastic fiber stimulation and remodeling together with neoangiogenesis.