Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO(2) Fractional Laser: A Randomized Controlled Trial

You Jin Yang, Ga-Young Lee, You Jin Yang, Ga-Young Lee

Abstract

Background: Striae distensae are atrophic dermal scars with overlying epidermal atrophy causing significant cosmetic concern. Although a variety of laser and light sources have been used for the treatment of striae distensae, to date no definite 'gold standard' treatment modality has been determined.

Objective: To assess and compare the efficacy and safety of nonablative fractional photothermolysis and ablative CO(2) fractional laser resurfacing in the treatment of striae distensae.

Methods: Twenty-four ethnic South Korean patients with varying degrees of atrophic striae alba in the abdomen were enrolled in a randomized blind split study. The patients were treated with 1,550 nm fractional Er:Glass laser and ablative fractional CO(2) laser resurfacing. Each half of the abdominal lesion was randomly selected and treated three times at intervals of 4-weeks using the same parameters. Digital photography was conducted and skin elasticity and the width of the widest striae in each subject were measured at the baseline and 4 weeks after the final treatment. Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs by two blinded physicians and participant satisfaction rates were evaluated. Skin biopsies were taken from three participants. All adverse effects were reported during the study.

Results: Although they do not statistically differ, both treatments with nonablative fractional laser and ablative CO(2) fractional laser showed a significant clinical and histopathologic improvement of striae distensae over pretreatment sites.

Conclusion: These results support the use of nonablative fractional laser and ablative CO(2) fractional laser as effective and safe treatment modalities for striae distensae of Asian skin. However, neither treatment showed any greater clinical improvement than the other treatment.

Keywords: Ablative CO2 fractional laser; Nonablative 1,550 nm fractional Er:Glass laser; Striae distensae.

Figures

Fig. 1
Fig. 1
Patient 5. Improvement in clinical appearance of striae distensae. Pre-treatment (A) and post-treatment (B) with a nonablative fractional laser treatment. Baseline (C) and post-treatment (D) with a CO2 fractional laser treatment.
Fig. 2
Fig. 2
Patient 8. Improvement in clinical appearance of striae distensae. Pre-treatment (A) and post-treatment (B) with a nonablative fractional laser treatment. Baseline (C) and posttreatment (D) with a CO2 fractional laser treatment.
Fig. 3
Fig. 3
Patient 13. Skin biopsies of untreated abdominal striae distensae (A, C, E) and the same site 1 month after three times of treatment with nonablative fractional laser (B, D, F), Note the increases in the epidermal thickness and the amount of collagen and elastic fibers after laser treatment. (A, B) H&E, ×200, (C, D) Masson trichrome stain, ×200, (E, F) Miller's elastic stain, ×200.
Fig. 4
Fig. 4
Patient 13. Skin biopsies of untreated abdominal striae distensae (A, C, E) and the same site 1 month after three times of treatment with CO2 fractional laser (B, D, F), Note the increases in epidermal thickness and the amount of collagen and elastic fibers after the laser treatment. (A, B) H&E, ×200, (C, D) Masson trichrome stain, (E, F) ×200, Miller's elastic stain, ×200.

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Source: PubMed

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