Fractional CO2 Laser vs. Microneedling with PRP in Striae Distensae Treatment: A Comparative Analysis on Asian Skin

Abstract

Background: Stretch marks, or striae distensae (SD), are a common dermatological issue caused by skin stretching and subsequent dermal damage. Various treatments, including laser therapy and microneedling, have been explored for SD. This study evaluates and compares the effectiveness of Fractional CO2 laser and microneedling with platelet-rich plasma (PRP) for treating SD. Method: A randomized controlled trial was conducted over a year at Rohilkhand Medical College and Hospital. Ninety-eight patients aged 18-40 were enrolled and divided into two groups: Group A (Fractional CO2 laser) and Group B (microneedling with PRP), each receiving four sessions at three-week intervals. Patients' histories, including demographics and striae characteristics, were documented. The effectiveness of treatments was assessed using the Visual Analogue Score (VAS) and Patient Satisfaction Scale (PSS) at multiple follow-ups. Side effects were also recorded. Result: Group A (Fractional CO2 laser) had 49 patients with a mean age of 25.9 years, and Group B (microneedling with PRP) had 49 patients with a mean age of 26.4 years. Group A showed a significant reduction in striae width and length compared to Group B. By Week 12, 48.80% of Group A reported Excellent Improvement in VAS scores, compared to 12.80% in Group B. Patient satisfaction was significantly higher in Group A, with more patients reporting Very Satisfied and Extremely Satisfied outcomes. Side effects such as erythema and hyperpigmentation were more common in Group A. Conclusion: Fractional CO2 laser therapy is more effective than micro needling with PRP in reducing the appearance of stretch marks, with higher patient satisfaction and significant improvements in VAS scores. Despite a higher incidence of side effects, the CO2 laser provides better overall outcomes.