Treatment Of Striae Alba Research Articles

Microneedling with Topical Insulin versus Microneedling with Topical Saline in Treatment of Striae Alba

Abstract Background Striae distensae, an extremely common condition, are a challenging cosmetic problem and pose a significant psychological burden for patients. Various treatment modalities have been applied with low satisfaction rate. Objectives To evaluate the clinical response, efficacy, safety and adverse effect of combined microneedling with topical insulin compared to microneedling alone in the treatment of striae alba. Patients and Methods This randomized prospective controlled comparative study included 20 patients suffering from stria albae on both sides of the abdomen. The diagnosis was made via clinical diagnosis of dermatological findings. All patients were consecutively selected from the dermatology outpatient clinic, Ain-Shams University Hospitals in the period from November 2021 till April 2022. Results The result The study showed that there was significant improvement in striea alba indentation index after treatment in both the insulin sides and placebo sides, the insulin sides being superior. In comparing both methods, there was no statistically significant difference between them as regards Erythema and hyperpigmentation. The current study showed nearly equal patient satisfaction scores in both groups. Conclusion Both microneedling alone and microneedling with topical insulin were effective and safe methods in treating patients with striae alba. Using topical insulin had better result than microneedling alone. Both methods are tolerated regarding Microneedling with insulin had no short term side effects.

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

Comparative Study Between the efficacy of Long-Pulsed Neodymium- YAG Laser and Fractional Co2 Laser in the Treatment of Striae Distensae.

Introduction: Stretch marks, or striae distensae (SD), are the lesions of the dermis caused by its linear atrophy at the sites of stretching. They occur in more than 70% of pregnant women and adolescents as a result of cutaneous stretching. This study aimed at evaluating and comparing the clinical and histological efficacy of the fractional CO2 laser versus the long pulsed (LP) Nd: YAG laser in the treatment of striae alba. Methods: Thirty female subjects having bilateral symmetrical stretch marks were managed by the LP Nd: YAG laser on the right side and the fractional CO2 laser on the left side. The laser treatment course consisted of 3 sessions with an interval of 3 weeks. The patient satisfaction score and the Global Aesthetic Improvement Scale (GAIS) were employed in the study in order to assess the improvement 3 months after therapy. Punch biopsies measuring 4 mm were extracted from one lesion on each side at baseline and after the last treatment session by 3 months to evaluate the thickness of both collagen and epidermis Results: Clinical improvement was more significant in the lesions treated by the LP Nd:YAG laser than those treated with the fractional CO2 laser. The patient satisfaction score and the GAIS were higher with a statistically significant value in the side treated by the LP Nd:YAG laser. Collagen and epidermal thickness increased more in the LP Nd: YAG laser-treated lesions in comparison to their thickness in the fractional CO2 laser-managed lesions, but this difference did not have a statistical significance. Conclusion: The clinical efficacy of the LP Nd-YAG laser exceeded that of the fractional CO2 laser in the treatment of striae alba without severe side effects in spite of the insignificant histological difference between the two lasers.

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 = <0.0001) and placebo sides (p = <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.

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.

Efficacy of carboxytherapy in the treatment of striae alba

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.

Fractional microneedling radiofrequency in striae alba: Do growth factors add value?

Various treatment modalities have been applied to treat striae alba (SA) with low satisfaction rate. Fractional microneedling radiofrequency (FMR) provides deep dermal coagulation, thereby inducing collagen synthesis and tissue tightening. The addition of platelet-derived lyophilized growth factors may add to the effect of FMR. To evaluate and compare the efficacy and safety of FMR alone or combined with lyophilized growth factors in the treatment of SA. In this left-right comparative study, 25 patients suffering from SA on the abdomen received four sessions of FMR with lyophilized growth factors on one side and with saline (as placebo) on the other side at 4weeks interval. Photographic and biopsy documentation of the progress of the SA was carried out before the start of the treatment and 4weeks after the last session. Calculation of the width of SA before treatment and after 4 sessions was done by Adobe Photoshop CS6. There was a significant improvement in SA width after treatment in both the lyophilized growth factors (P=<.0001) and placebo sides (P=<.0001), the lyophilized growth factors being superior (P=.002). Patient satisfaction was more on the lyophilized growth factors (LGF) side (P=.034). Erythema and hyperpigmentation were less on the lyophilized growth factors side. Histopathologically, both showed improvement with no difference between LGF and placebo (epidermal thickness (P=.456), collagen content (P=.297), elastin content (P=.239)). The combination of FMR and lyophilized growth factors improves SA outcome.

Evaluation of the efficacy and safety of microneedling with 5-fluorouracil for the treatment of striae alba: double-blind, randomized clinical trial

Evaluation of the efficacy and safety of microneedling with 5-fluorouracil for the treatment of striae alba: double-blind, randomized clinical trial

Uso do laser de baixa potência em estrias de distensão: ensaio clínico randomizado controlado

AIMS: To analyze the effects of low-level laser therapy (660nm) in the treatment of striae alba.METHODS: A randomized clinical trial was conducted with 20 women equally divided into a control group and a treatment group. For inclusion, they should have striae alba in the gluteal region and accept to participate in the study. Exclusion criteria were other treatment for striae, pregnancy, steroid use, smoking, cancer diagnosis, hemorrhagic areas on the skin, diagnosis of epilepsy, diagnosis of thrombosis, or any cognitive impairment. Twelve applications of 660 nm laser were performed for four weeks. After another four weeks of follow-up, a reevaluation was performed. After each application, photos were taken from the region to evaluate the size of the striae by means of scanned planimetry, which calculates the percentage of area occupied by the striae. For this evaluation, the photos taken at the first application (AV1), the sixth (AV2), the 12th (AV3) and the last evaluation, after four weeks of treatment completion (AV4), were used. Qualitative evaluations were also performed by touch (depth) and visual inspection (hue and size).RESULTS: The analysis by planimetry showed that there was no difference between the area occupied by the striae when comparing the various evaluations of the same group, until the AV3. However in AV4 (four weeks after the last laser application) of the treatment group, there was a statistically significant decrease of the stria area in relation to AV1. In the control group, there was no difference between AV4 and the other evaluations. In the comparison between the two groups, there was no difference in the first three evaluations. However in AV4 the treatment group showed a smaller area of the striae in relation to the control group. In the qualitative analysis the treated group had lower visibility and less depth of the striae to the touch.CONCLUSIONS: Therapy with 12 sessions of low-level laser for four weeks had a positive effect on the treatment of striae alba, with results becoming evident only four weeks after the last application. The 660 nm laser showed to be a non-invasive, painless and fast-applied method.

Fractionated CO2 Laser in the Treatment of Striae Alba in Darker Skinned Patients - A Prospective Study.

Introduction: In recent years, the positive effect of fractional CO2 laser on increasing collagen fibers, and consequently its effect on treating striae has been suggested. The present study aims to assess the effectiveness of CO2 fractional laser 10600-nm in the treatment of striae alba. Methods: In this prospective clinical trial, 2 treatment sessions of fractional CO2 laser with 4-week interval was given to 30 patients with striae alba. Cutaneous resonance running time (CRRT) was measured at baseline and at week 4 and 3 months after the last session of laser therapy. The level of improvement was assessed by 2 independent dermatologists and patients after 3 months of follow up. Results: 16.7% of patients had moderate improvement, 63.3% had minimal improvement, and 20% had no improvement. A statistical significant difference was found in median CRRT during the study (P < 0.0001). The median CRRT levels were significantly higher in week 4 and 3 months after the last treatment compared to the baseline (both P < 0.001). Likewise, a significant increase was observed in median CRRT level from week 4 till the end of study (P < 0.001). Evaluation of participant satisfaction revealed that 10% were very satisfied, 10% satisfied, 3.3% slightly satisfied, and 76.7% unsatisfied. Conclusion: Striae alba remain a challenging condition to treat. The treatment of striae alba with CO2 fractional laser results in minimal improvement with mild side effects.

Promising Option for Treatment of Striae Alba: Fractionated Microneedle Radiofrequency in Combination with Fractional Carbon Dioxide Laser.

Background. A consistent treatment has not been proposed for treatment of Striae Alba (SA). The present study was designed to compare the fractionated microneedle radiofrequency (FMR) alone and in combination with fractional carbon dioxide laser (FMR + CO2) in the treatment of SA. Methods. Forty-eight pairs of SA from six patients were selected. Right or left SAs were randomly assigned to one of the treatment groups. The surface area of the SA before and after treatment and clinical improvement using a four-point scale were measured at the baseline, after one and three months. Results. The mean age of the patients was 30.17 ± 5.19 years. The mean difference of the surface area between pre- and posttreatment in the FMR + CO2 group was significantly higher than that in the FMR group (p = 0.003). Clinical improvement scales showed significantly higher improvement in the FMR + CO2 group than in the FMR group in the first and second follow-up (p = 0.002 and 0.004, resp.). There were no major persistence side-effects in both groups. Conclusions. The results showed that FMR + CO2 laser was more effective than FMR alone in the treatment of SA.

Comparison of the fractional CO2 laser and the combined use of a pulsed dye laser with fractional CO2 laser in striae alba treatment.

Background:No ideal treatment has been established for Striae distensae (SD), particularly in the late phase (Striae Alba (SA)). Various types of lasers have been recently proposed as treatment options for SD. This study aims to compare the clinical efficacy of a fractional CO2 laser as well as a combination of fractional CO2 laser and Pulsed dye Laser (PDL) in the treatment of SA.Materials and Methods:Eighty-eight SA lesions in three female patients were included. Lesions on each half of the body were randomly enrolled in each group. Group 1 (n = 44) were treated by Fractional CO2 laser resurfacing and group 2 (n = 44) by a combination of PDL and Fractional CO2 laser, alternately. Digital Photographs were taken and the surface area of each lesion was measured digitally (using the PictZar Digital Planimetry Software) at the baseline and four weeks after treatment. The clinical improvement was assessed by comparison of the pre- and post-treatment photos and the participants’ views about their degree of improvement, using a 10-point verbal analog scale (VAS).Results:The mean surface area decreased significantly in both groups after treatment. The mean difference between the pre- and post-treatment surface area was 0.62 ± 053 for group 2 and 0.41 ± 0.43 for group 1 (P-value = 0.03). Mean VAS and dermatologist assessed improvement scale in group 2 (6.68 ± 0.77 and 2.2 ± 0.76 respectively) were significantly higher than those in group 1 (5.45 ± 0.90 and 1.8±0.72 respectively, P-value <0.001 and 0.04 respectively).Conclusion:The combination of PDL and fractional CO2 laser was more effective than fractional CO2 laser alone and could be suggested as a clinical option in the treatment of SA.