Authors
1 Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
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.
Keywords
1. | Zheng P, Lavker RM, Kligman AM. Anatomy of striae. Br J Dermatol 1985;112:185-93. |
2. | Jiménez GP, Flores F, Berman B, Gunja-Smith Z. Treatment of striae rubra and striae alba with the 585-nm pulsed-dye laser. Dermatol Surg 2003;29:362-5. |
3. | Chang AL, Agredano YZ, Kimball AB. Risk factors associated with striae gravidarum. J Am Acad Dermatol 2004;51:881-5. |
4. | Cho S, Park ES, Lee DH, Li K, Chung JH. Clinical features and risk factors for striae distensae in Korean adolescents. J Eur Acad Dermatol Venereol 2006;20:1108-13. |
5. | Neve S, Kirtschig G. Elastotic striae associated with striae distensae after application of very potent topical corticosteroids. Clin Exp Dermatol 2006;31:461-2. |
6. | Ammar NM, Rao B, Schwartz RA, Janniger CK. Adolescent striae. Cutis 2000;65:69-70. |
7. | de Angelis F, Kolesnikova L, Renato F, Liguori G. Fractional nonablative 1540-nm laser treatment of striae distensae in Fitzpatrick skin types II to IV: Clinical and histological results. Aesthet Surg J 2011;31:411-9. |
8. | Elsaie ML, Baumann LS, Elsaaiee LT. Striae distensae (stretch marks) and different modalities of therapy: An update. Dermatol Surg 2009;35:563-73. |
9. | McDaniel DH, Ash K, Zukowski M. Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser. Dermatol Surg 1996;22:332-7. |
10. | Bak H, Kim BJ, Lee WJ, Bang JS, Lee SY, Choi JH, et al. Treatment of striae distensae with fractional photothermolysis. Dermatol Surg 2009;35:1215-20. |
11. | Alster TS, Tanzi EL, Lazarus M. The use of fractional laser photothermolysis for the treatment of atrophic scars. Dermatol Surg 2007;33:295-9. |
12. | Kim BJ, Lee DH, Kim MN, Song KY, Cho WI, Lee CK, et al. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol 2008;9:33-7. |
13. | Channual J, Choi B, Osann K, Pattanachinda D, Lotfi J, Kelly KM. Vascular effects of photodynamic and pulsed dye laser therapy protocols. Lasers Surg Med 2008;40:644-50. |
14. | Moari C, Powell J. Atrophies and disorders of dermal connective tissues. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3 rd ed. Philadelphia, PA: Elsevier, Saunders; 2012. p. 1631-40. |
15. | Naein FF, Soghrati M. Fractional CO2 laser as an effective modality in treatment of striae alba in skin types III and IV. J Res Med Sci 2012;17:928-33. [PUBMED] |
16. | Piérard GE, Nizet JL, Adant JP, Camacho MA, Pans A, Fissette J. Tensile properties of relaxed excised skin exhibiting striae distensae. J Med Eng Technol 1999;23:69-72. |
17. | Stotland M, Chapas AM, Brightman L, Sukal S, Hale E, Karen J, et al. The safety and efficacy of fractional photothermolysis for the correction of striae distensae. J Drugs Dermatol 2008;7:857-61. |
18. | Lee SE, Kim JH, Lee SJ, Lee JE, Kang JM, Kim YK, et al. Treatment of striae distensae using an ablative 10,600-nm carbon dioxide fractional laser: A retrospective review of 27 participants. Dermatol Surg 2010;36:1683-90. |