Striae Alba Research Articles

Effects of Nanofat and PRP on Type I Collagen Production in Striae Distensae: Preliminary Findings from a Prospective, Randomized Single-Blind Study.

Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called "striae rubrae" (SR) and a chronic phase in which they are called striae albae (SA). This study investigates the synergistic effect of nanofat and platelet-rich plasma (PRP) injections on collagen production in fibroblasts derived from SA (SAF). A prospective, randomized single-blind study was conducted in fifty women presenting with SA in the abdominal region who had voluntarily sought a conventional abdominoplasty procedure and accepted to test an autologous treatment for their SDs. SA were treated using: PrP 10ml; PrP 2ml (20%) + nanofat 8ml (80%); nanofat 10ml. Following the abdominal dermolipectomy, biopsies from treated and untreated SDs were taken and analyzed for type I collagen quantification. Results were processed through statistical analysis models using the Student's t test. Collagen concentration in untreated SA biopsies was significantly lower than in healthy skin. Both PRP and nanofat treatments significantly increased collagen biosynthesis compared to controls, with the combined PRP-nanofat treatment showing the highest increase in collagen levels (p < 0.0001). A superior clinical improvement was observed in the areas that received the combined treatment of PRP and nanofat (p = 0.001). Our findings indicate that both PRP and nanofat treatments effectively enhance collagen production in SA, with the combined PRP-nanofat treatment showing a synergistic effect. This combined therapy holds promise for effectively treating SA, providing a new potential treatment avenue for SMs and similar skin conditions. Further studies are needed to validate these results and explore clinical applications. 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 www.springer.com/00266 .

Multiple dermatofibromas in a patient with Ehlers–Danlos syndrome: a case report

BackgroundDermatofibromas, also known as benign fibrous histiocytomas, are among the most common cutaneous soft-tissue lesions. Association of multiple dermatofibromas with some diseases was described and it has not been reported with Ehlers–Danlos syndrome before. We present a case with Ehlers–Danlos syndrome and multiple dermatofibromas.Case presentationAn 18-year-old Iranian woman presented with multiple purple nodules ranging from 0.5 to 1.5 cm in diameter, which were mobile and located on the proximal part of the lower limb. The dimple sign of these lesions was positive. During the physical examination, several features suggestive of Ehlers–Danlos syndrome were observed, including hyperextensibility and fragility of the skin, wide atrophic scars on the upper limb, hypermobility of joints and fingers, swan neck deformities of the digits, nodules on the knee, and striae alba on the leg. The patient was previously unaware of having Ehlers–Danlos syndrome. She had a history of asthma and atopic dermatitis. Family history was negative. A biopsy of the nodular lesions was performed, and the findings confirmed the diagnosis of dermatofibromas.ConclusionWe describe a patient with Ehlers–Danlos Syndrome who presented with multiple dermatofibromas. To our knowledge, this combination of findings is a previously unreported occurrence.

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

Efficacy of green tea ( Camellia sinensis Linn) 3% extract cream on improvement of striae distensae.

Striae distensae (SD) is a skin condition that frequently causes dermatological consultations and although asymptomatic, it may can cause itch and burning sensation. Green tea extract contains polyphenol, including flavanol, flavandiol, flavonoid, phenolic acid, amino acids and minerals which play a role in the repair of stretch marks through anti-inflammatory mechanism, increase collagen production, fibroblast proliferation, and skin hydration. To determine the efficacy of green tea extract cream on striae distensae. This is a pre-experimental clinical trial with a pretest-posttest design on 36 subjects with striae distensae. Diagnosis establishes through history taking and clinical evaluation. Imam Nelva Alviera (INA) score was used as SD severity before and after the application of the 3% green tea extract cream carried out at weeks 0, 2, 4, 6, and 8. Side effects and subjects' satisfaction were also recorded. Cochran test was carried out to see the difference before and after treatment, with a p-value <0.05 considered significant. Majority of study subjects were 18-25 years (77.8%), had history of pregnancy (75%), had a history of menarche at the age of 12 years (27.8%) and all subjects had striae alba. There was significant decrement in INA score for striae distensae (p<0.001) after eight weeks administration of 3% green tea extract cream. Clinical improvement and no side effects were also noted. All subjects were satisfied. The use of 3% green tea extract cream can improve the appearance of SD.

Striae Distensae and an Innovative Intradermal Medical Device Based on PN HPT™, Hyaluronic Acid, and Mannitol. A Real-World Insight

Introduction: Striae distensae are often more than a mere skin aesthetic trouble for their impact on self-esteem and as signals of internal medicine disorders like hypercortisolism or cachexia. There is a need to advance in treating striae distensae effectively, particularly their late atrophic hypochromic stage. PN HPT™ may help to restore and preserve a physiologically sound dermal environment. The paper reports the outcomes of a survey study based on an anonymous questionnaire. The study’s purpose was to confirm the long-term effectiveness and safety profile of an intradermal medical device based on PN HPT™ (1 mg/mL), HA (1 mg/mL), and mannitol ) within a multi-year clinical monitoring program. Methods: The investigators — dermatologists and plastic and aesthetic surgeons — carried out the study in real-world subjects, all of them women, who spontaneously sought office treatment to improve skin quality in areas of subjectively grievous striae distensae and striae albae—a total of 38 lesions. All investigators had already used the investigated intradermal device for short-term treatment and long-term maintenance. All surveyed subjects had undergone a cycle of six to eight intradermal injection sessions over three months to improve the texture of their striae distensae—a once-weekly injection for the first month and one injection every two weeks for the last two months with a tolerance of two missing injections. Assessment tools and timing: Global Improvement Scale (GIS) and Global Aesthetic Improvement Scale (GAIS) two to four weeks after the end of the treatment period. Results: At the follow-up visit, the investigators evaluated that, globally (mean GIS scores), 50.0% and 47.4% of the treated striae distensae showed moderate improvement or were much improved compared with the baseline. The corresponding outcomes for the independent evaluator were 55.3% and 44.7%. The local skin quality and texture in the lesion areas (mean GAIS scores) appeared to have improved or to be much improved by 50.0% and 50.0% according to investigators, and by 42.9% and 57.1%, respectively, according to surveyed patients, with no reported side effects. Conclusion: The real-world monitoring survey demonstrated that the NEWST ONE medical device based on PN HPT™, HA, and mannitol as an inhibitor of HA metabolism retains its long-standing record of efficient performance and excellent safety with no variations over time.

Matrix metalloproteinase-1 serum level in association with the occurrence of striae distensae

Introduction: Striae distensae are fine atrophic scar tissue on the skin. They are formed on areas with dermal collagen rupture due to excessive stretching of the skin. Matrix metalloproteinase-1 (MMP-1) is an enzyme that degrades collagen types I and III. An imbalance in the expression of MMP-1 and transforming growth factor-beta (TGF-β), cytokine that trigger the synthesis of new collagen, leads to imperfect dermis remodeling process in atrophic scar tissue, which is a clinical appearance of striae distensae. This study aimed to determine the association between serum MMP-1 level and striae distensae. Methods: We conducted an observational cross-sectional study on 40 females with striae distensae and 40 controls. History taking, physical and dermatological examination, followed by blood sampling analysis of serum MMP-1 level with ELISA method were conducted in all subjects. Results: The mean serum MMP-1 levels in the striae distensae group were 51.54±28.03 ng/dL. All subjects in the striae distensae group had striae albae and only 7 subjects (17.5%) had striae rubrae. The most common location of striae distensae is the combination of femoral and gluteus regions (25%). The results of this study showed a relationship between high MMP-1 levels and the risk of striae distensae by 4.89 times (p = 0.002). Conclusion: There was an association between serum MMP-1 levels and striae distensae.

Application of Picosecond Laser in Dermatology

ABSTRACT Background: Lasers are one of the most important treatment modalities in dermatology. Lasers interact with chromophores through several mechanisms that depend on fluence and pulse durations. Early lasers worked by photothermal interaction with pulse durations of 1 microsecond to 1 second. A picosecond laser is developed to confine photothermal effects and produce photomechanical effects and plasma induction. Purpose: To understand the mechanism of action and application of picosecond lasers for dermatological disorders. Review: Non-fractional picosecond lasers work by photomechanical interaction. Photomechanical interaction happens when pulse duration is less than inertial confinement time, causing fractures of chromophores with lower energy, or “cold ablation”. Fractional picosecond lasers work by laser-induced optical breakdown (LIOB). In LIOB, accelerated seed electrons cause an electron avalanche that produce a collection of free electrons called plasma, which ablates tissues. LIOB in the skin is always followed by photodisruption. In LIOB, vacuoles and debris were eliminated transdermally and dermal collagen and elastin increased. Picosecond laser may be applied in disorders requiring destruction of chromophores and for collagen and elastin disorders. It is currently the first-line treatment for tattoo removal (Nevus of Ota and Acquired Bilateral Nevus of Ota-like macules, or ABNOM). It has good efficacy and safety for solar lentigines, freckles, and cafe-au-lait macules (CALM). It is an additional treatment for moderate to severe melasma and hypertrophic scars, in combination with other treatments. The fractional picosecond laser showed moderate improvement and low risk of postinflammatory hyperpigmentation (PIH) for atrophic acne scars and produced improvement in striae alba.

PN HPT™ and Striae Albae-Exploratory Interim Analysis of a Randomised Prospective Study

Introduction: The outcomes of striae albae remodelling are currently disappointing. Replenishing the fibroblast pool of nucleotide precursors through passive exposure to Polynucleotides Highly Purified Technology (PN HPT™) facilitates the dermal production of new fibres. The manuscript reports on the outcomes of a prospective study with an intradermal PN HPT™-based medical device. Methods: Intra-subject-controlled randomised real-world study to evaluate the efficacy and safety of a medical device containing 20 mg/mL of PN HPT™ (functional ingredient) intradermal gel as therapy for moderate-to-severe striae albae. Based on a preliminary sample size assessment, the study estimated the need to enrol at least 65 mature albae from 18-to-55-year-old male and female subjects seeking ambulatory treatment (mean age: 34.1 ± 10.65). Up to eight symmetrical striae albae in the target areas (breast, abdomen, buttocks, thighs) per enrolled subject underwent randomisation into the two parallel “PN HPT™ intradermal infiltration” active group and “no-treatment striae albae” intra-subject control group. Actively treated striae albae underwent a four-session intradermal therapy cycle with the PN HPT™ device. Comparative efficacy assessments, performed at the two final evaluation visits by independent evaluators: Width of actively treated and untreated control striae albae (digital calliper). Global Aesthetic Improvement Scale (GAIS) outcomes (by investigators and subjects, respectively; assessments on digital photographic documentation). Width and wrinkling of actively treated and control striae albae (quantitative Antera 3D CS skin imaging technology). Results: The digital-calliper-assessed width for the exploratory sample of the 44 actively treated striae albae (29 control striae) decreased, on average, from 4.6 ± 2.31 at the V1 baseline visit to 2.7 ± 1.42 at V5 (first follow-up visit) one month after the last PN HPT™ intradermal infiltration at V4 (–40.8% vs. baseline, p &lt;0.01). In a subset of 17 striae (7 subjects), the mean digital-calliper-assessed width was still a significant 2.0 ± 0.94 at the final V6 follow-up visit, six months after V1 and three months after V4 (–54.5% vs control striae albae at V6, p &lt;0.05). At the V5 assessment, three months after V1 and one month and a half after V4, investigators and treated subjects reported average GAIS scores of 3.8 ± 0.51 (median, 4.0) and 4.0 ± 0.66 (median, 4.0) out of 5.0 as GAIS maximum score for both. The occasional mild local pain and irritation at the injection site, expected and known in the previous PN HPT™ literature, were of no clinical significance and rapidly transitory. Discussion: PN HPT™ are an innovative option with a solid rationale for treating mature striae albae. The efficacy outcomes of PN HPT™ dermal infiltrations appear noteworthy, with excellent safety and ease of use, confirming the previous results. However, waiting for complete results and confirmation by other controlled studies is prudent.

Comparative Study Between the Efficacy of Fractional CO2 Laser/Radiofrequency, PRP and a Combination of Both in the Treatment of Striae Distensae: A Pilot Study.

PurposeThe work aims to compare the effect of platelet-rich plasma versus fractional CO22 laser/radiofrequency versus both methods combined in treating striae distensae.Patients & MethodsThe study included ten female patients with striae alba with Fitzpatrick IV skin. Three sites of striae were chosen; one was treated with platelet-rich plasma, another with fractional CO2 /radiofrequency (CO2/RF), and the third received both treatments. Every patient received three treatment sessions one month apart. Patients were photographed, and a skin biopsy was taken from each area before and one month after treatment.ResultsAssessment of the clinical photos showed that fractional CO2/radiofrequency gave a mild improvement in 22%, moderate improvement in 55.5% and marked improvement in 22.5%. Clinically, the combined treatment showed mild improvement in 44% of patients, moderate results in 33% and marked improvement in 23% of patients. The PRP as an only mode of treatment showed poor improvement in 22%, mild improvement in 23% and moderate improvement in 55% of patients. Biopsy results showed a decrease in collagen and elastin after treatment with the solitary methods, while the combined approach resulted in an increase in collagen and a reduction in elastin.ConclusionFractional CO2 laser/radiofrequency combined with PRP or either of them showed clinical improvement to variable degrees with superior results clinically and histologically with the combined method.

O uso da câmera termográfica no diagnóstico auxiliar do aspecto celulítico

Aesthetic cellulite is a disorder characterized by the skin with an “orange peel” appearance and has negatively affected the self-esteem and social life of more than 80% of post-pubertal women. The content in question covers the scarcity of evaluative studies in the area of aesthetics and favors the standardization of a technique for evaluating this dysfunction. The present study aimed to verify the use of thermography as an auxiliary method in the diagnosis of possible circulatory alterations in the gluteal region, as in cases of cellulite appearance, and to investigate the possibility of preventing its worsening. This is an observational study, carried out with eighteen female volunteers aged between 18 and 35 years old, with striae alba in the gluteal region, without drug treatment with photosensitive substances, or using isotretinoin, or still applying any specific topical treatment on the buttocks. The participants were divided into 2 groups, which were group 1 (non-uniform thermographic images) and group 2 (uniform thermographic images). Assessments of the cellulite’s appearance were performed through conventional photographs, thermography, and by 3 specialists in the field of dermatofunctional physiotherapy. The results showed that the severity of cellulite cannot be classified only through a visual assessment or questionnaires, since the participants who do not have the physical characteristic of cellulite, demonstrated through the thermography, a circulatory compromise, which suggests a possible risk in developing cellulite. Therefore, this study concluded that a previous diagnosis through a thermographic camera can help in the prevention of this dysfunction.

Subcision, chemical peels, and platelet-rich plasma: Combination approaches for the treatment of striae distensae.

Striae distensae (SD) are disfiguring skin condition causing cosmetic troubles and psychological distress. The aim was to compare the efficacy and safety of platelet-rich plasma (PRP) versus its combination with subcision or medium-depth peeling (glycolic acid 70% followed by trichloroacetic acid [TCA] 35%) for SD treatment. Seventy-five female patients with SD were divided into three equal groups with the contralateral side in each patients represented the control group. Group A treated with PRP, group B received PRP + subcision while group C received PRP + combined peeling (GA 70% + TCA 35%). Primary outcome included clinical improvement, patients' satisfaction, and Dermatology Life Quality Index (DLQI). Striae measurement, skin biopsies were also assessed. Very much improvement was achieved in 28%, 44%, and 36% in groups A, B, and C respectively. The combined groups (B and C) showed significantly higher patients' satisfaction and DLQI than group A (p= 0.03), (p < 0.0001). A significant decrease in all striae measurements was achieved with all groups (p<0.001); however, groups B and C showed more decrease (p=0.2 and 0.4). A highly significant decrease in the mean number of sessions was found in group B (p < 0.0001). All groups demonstrated improvement in dermal collagen deposition, which was higher in the combined groups. Side effects were mild and well tolerated. The combination of PRP with subcision or peeling was more effective and offered a higher therapeutic response than PRP alone. Moreover, the subcision has superior efficacy in striae albae and safer in darker skin types.

Treatment of Striae Alba using Fractional Radiofrequency with and without Lyophilized Growth Factors

Abstract Background Various treatment modalities have been applied to treat striae alba with low satisfaction rate. Fractional Microneedling radiofrequency provides deep dermal coagulation, thereby inducing collagen synthesis and tissue tightening. The addition of platelet lyophilized growth factors may add to the effect of fractional Microneedling radiofrequency. Objectives To evaluate and compare the efficacy and safety of fractional Microneedling radiofrequency alone or combined with lyophilized growth factors in the treatment of striae alba. Methods In this left-right comparative study, 25 patients suffering from striae alba on the abdomen received sessions of fractional microneedling radiofrequency with lyophilized growth factors on one side and with saline (as placebo) on the other side at 4 weeks interval. Patients‘ satisfaction was evaluated at the end of study using a questionnaire (Patients were asked the following questions: Are you satisfied with this treatment (completely satisfied, satisfied, partially satisfied, or not satisfied)?. Results There was a significant improvement in striae alba after treatment in both the lyophilized growth factors (p = &amp;lt;0.0001) and placebo sides (p = &amp;lt;0.0001), the lyophilized growth factors being superior (p = 0.002). Patient satisfaction was more on the LGF side (p = 0.034),where 6 versus 3 patients were completely satisfied. Erythema and hyperpigmentation were less on the lyophilized growth factors side. Conclusion The combination of fractional microneedling radiofrequency and lyophilized growth factors improves striae alba outcome.

Efficacy of Fractional Co2 Laser and Human Lyophilized Growth Factors in the Treatment of Stretch Marks: A Clinical and Histopathological Study

Abstract Background Striae distensae are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The natural evolution of striae is from red or purple, raised wavy lesions (striae rubra) to white atrophic lesions with wrinkly surface (striae alba). Objectives The present study was designed to compare the efficacy of fractional CO2 laser alone or combined with lyophilized growth factors or to its efficacy alone in the treatment of striae distensae. Patients and Methods The present study included 20 female patients with SD; they were all recruited from Dermatology Outpatient Clinic, Ain Shams University from may 2017 to march 2018. An informed consent for treatment, photography and punch biopsy was taken before enrollment and the study was approved by Dermatology Research Ethical Committee. Results The present study showed statistically significant clinical and histopathological improvement in areas A and B after treatment. This impronment was in rubra more than alba. Area C showed no clinical and histopathological improvement. Area B showed better results than area A.We propose that LGF alone did not show clinical or histopathologiacl improvement. Treatment was tolerated well by all patients where side effects were minimal in the form of transient PIH that resolved after using bleaching creams. There was no statistically sgnificant difference in the incidence of PIH between areas A&amp; B. Conclusion We concluded that fractional CO2 alone is effective in treatment of SD especially stria rubra in skin type III and IV.

An update in the etiopathogenesis of striae distensae: A review article.

Striae distensae (SD), also known as stretch marks, are common skin lesions causing significant psychological stress and cosmetic disfigurement. They are common to be seen during pregnancy, rapid weight change, puberty and many other pathological conditions including Cushing disease, anorexia nervosa or even excessive use of certain drugs. Clinically, they appear as either red raised linear bands known as striae rubrae (SR) or white depressed atrophic bands known as striae albae (SA). They were first described histopathologically in 1889. Many theories have been established to explain the etiopathogenesis of SD, yet the exact mechanism is still unclear. Also, many treatment modalities have been applied to reach the maximum efficacy with the least side effects. The aim of this review article is to optimize the most recent and accepted concepts on etiopathogenesis and pathophysiology of SD which may help in finding the best lines of management with the most satisfactory outcomes.

Stretch marks: a review

Stretch marks (SM) feature visible linear scars developing on the body in the areas of excessive stretching of the skin. This is a benign skin condition, but because of their aesthetic implications, they can cause distress among their sufferers. SM show high prevalence, probably more than 50 % among pregnant women, and 50 to 90 % in the general population. SM affect more likely certain ethnic groups, especially dark-skinned patients. During pregnancy, risk factors include family history, but also important weight gain whilst more generally elevated body mass index also constitutes a risk factor. Clinically, the initial erythematous and violaceous lesions referred to as striae rubrae fade into wrinkled, hypo-pigmented, atrophic scar-like marks named striae albae. Four main theories support SM formation: 1) mechanical stretching of the skin; 2) hormonal changes; 3) an innate structural disturbance of the integument; 4) genetic predispo­sitions. Histologically various abnormalities of collagen and elastic fibres are described at dermal level. The treatment of SM is always deceptive. Topical treatments are the commonest, among them Centella asiatica or hyaluronic acid creams, almond oil, topical retinoids, cocoa butter or olive oil are the most popular. Chemical peels may also be used with limited success. Various office procedures may also be performed, such as microdermabrasion, radiofrequency, laser/light therapy, platelet-rich plasma and others, but the results are often limited and deceptive for both the patient and the dermatologist. More remains to be done about the study of this frequent dermatological disorder.

Efficacy and Side Effects of Fractional Carbon Dioxide Laser for Acne Scars, Keloids, and Striae Albae in the Dermatovenereology Clinic of Tertiary Hospital: A Retrospective Study

Background: Fractional Carbon Dioxide (CO2) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose: To evaluate the efficacy and side effects of fractional CO2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods: Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result: A total of 42.9% of patients underwent fractional CO2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respectively. There was a statistically significant decrease in the degree of acne scar (2.72 ± 0.83), keloid height (2.2 ± 0.405), and striae width (0.39 ± 0.02). The statistically significant side effects were hyperpigmentation (59.5%), crustae (26.2%), erythema ≥ for 4 days (19%), and new acne (19%). Conclusion: Fractional CO2 LASER was effective for treating scar tissue (acne scars, keloids, and striae albae) with a higher incidence of side effects in population with darker skin and post-inflammatory hyperpigmentation.

Striae Distensae: In Vitro Study and Assessment of Combined Treatment With Sodium Ascorbate and Platelet-Rich Plasma on Fibroblasts.

Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called "striae rubrae" (SR) and a chronic phase in which they are called striae albae (SA). Fibroblasts seem to play a key role in the pathogenesis of stretch marks. This study was aimed at describing and analyzing stretch marks-derived fibroblasts (SMF), the differences between SR- and SA-derived fibroblasts (SRF, SAF), testing two treatments in vitro (sodium ascorbate and PrP) on SAF. To characterize the SMF, the expression of alpha smooth muscle actin (alpha SMA) was investigated. Type I collagen expression was measured in SAF, before and after adding different PrP concentrations and sodium ascorbate in the culture medium. Results were processed through statistical analysis models using the Student's t-test. A significant increase in alpha SMA (P <0.001) was observed in SRF. SAF treated with PrP and sodium ascorbate showed a resumption of their metabolic activity by an increase in collagen type I production and cell proliferation. After 24 h of incubation with PrP 1% and PrP 5% + sodium ascorbate, cell viability was increased by 140% and 151% and by 156 and 178% after 48 h, respectively, compared to the control. Our study shows that a biologically mediated improvement in SMF metabolic activity is possible. Our promising results require further trials to be able to confirm the reproducibility of this combined treatment, particularly in vivo. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable.

Comparative study of treatment for striae alba stage striae gravidarum: 1565-nm non-ablative fractional laser versus fractional microneedle radiofrequency.

Striae gravidarum is a common dermatologic condition for females caused by multiple factors during pregnancy. It remains a therapeutic challenge especially in the striae alba (SA) stage, generating psychological and emotional distress to those affected. This study aims to compare the efficacy and safety of 1565-nm non-ablative fractional laser (NAFL) and fractional microneedle radiofrequency (MRF) for treatment of SA striae gravidarum. Fourteen Chinese women with SA striae gravidarum were included in this study. Patient abdomens were randomly divided into NAFL and MRF treatment sides, treated three times at 6-week intervals. Treatment efficacy was evaluated by subjective (clinical assessments, patient satisfaction rating, adverse effects assessment) assessments and objective (skin melanin index measurement, histological study) assessments. Clinical assessment suggested MRF was more effective (P = 0.0143) for improving the appearance of SA striae gravidarum. Both NAFL and MRF demonstrated effective improvement (P = 0.0082 and P = 0.0158, respectively), with no significant difference according to patient satisfaction ratings and changes in melanin index (P = 0.5900). Both treatments induced limited adverse reactions, but MRF treatment caused significant pain compared with the more moderate NAFL treatment (P = 0.0003). MRF treatment increased neocollagen and elastic fibers more significantly than NAFL, based on histological assessments (P = 0.0298 and P = 0.0048, respectively). MRF treatment improved collagen regeneration in SA striae gravidarum more than NAFL but caused considerable pain during treatment. Corresponding treatment or therapeutic strategies should be applied according to clinical scenario.

Effects of Semi-Ablative Fractional Radiofrequency Associated with Growth Factors in Stretch Marks: A Randomized Controlled Trial

Background: To investigate the effects of the association of semi-ablative fractional radiofrequency (RFF) with growth factors in stretch marks. Methods: This is a randomized controlled trial. The sample consisted of 28 female patients with complaints of gluteus or abdomen striae and divided into 2 equitable groups, named G1 (semi-ablative RFF without active principle association) and G2 (semi-ablative RFF with active principle association), being subdivided into G-1A and G-2A (abdominal applications) and G-1B and G-2B (gluteus applications). A photographic and histological analysis was performed using questionnaires about inflammation, presence of adverse effects and satisfaction of volunteers. Photographic analysis showed a reduction in the amount of striae alba in all groups. Results: The histological analysis showed an increase in fibroblast activity, collagen type I, and blood vessels, especially in the groups that associated the RFF with the active principle. In the inflammation analysis, the groups that performed intervention with active ingredients showed lower inflammatory signal. All groups had a reasonable level of satisfaction after the interventions; however, the group that used active ingredients reported greater results. Conclusion: The association of semi ablative RFF with growth factors showed a reduction in clinical inflammatory signs, mainly in the first 15 days, as well as higher collagen production, verified in 30 days, with satisfactory clinical results in all groups.

Optical Coherence Tomography-Assisted Evaluation of Fractional Er:YAG Laser Versus Fractional Microneedling Radiofrequency in Treating Striae Alba.

Striae distensae (SD) is a challenging skin condition. Striae alba (SA) represents the chronic late atrophic stage of SD. Fractional laser technology is among the modalities used for treating SD. Lately, fractional microneedling radiofrequency (FMR) is gaining increased popularity in treating SD. The aim of our study was to assess and compare the efficacy of FMR and fractional Er:YAG laser in the treatment of SA. Twenty female patients were enrolled in the study fulfilling all inclusion and exclusion criteria. On a randomly selected half side of the body, the patients were treated with 2940 nm fractional Er:YAG laser while the other half side was treated with the FMR. Both modalities showed a significant reduction in the width of the widest striae (P < 0.005); however, there was no significant difference between them. Using optical coherence tomography, all patients demonstrated a mean significant increase in epidermal thickness; however, the FMR-treated sites showed significantly better results when compared with the ER:YAG-treated sides (P = 0.029). Scar improvements in both modalities did not correlate to skin type, duration, or site of the striae. Er:YAG and FMR represent two safe, effective, tolerable modalities for treating SA and are associated with minimal side effects. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.