Ultrasound and 3D Skin Imaging: Methods to Evaluate Efficacy of Striae Distensae Treatment

Mariella Bleve, Priscilla Capra, Franca Pavanetto, Paola Perugini, Mariella Bleve, Priscilla Capra, Franca Pavanetto, Paola Perugini

Abstract

Background. Over time, the striae rubra develop into striae alba that appear white, flat, and depressed. It is very important to determine the optimum striae management. In order to evaluate the effectiveness of these therapies, objective measurement tools are necessary. Objective. The aim of this study is to evaluate if ultrasonography and PRIMOS can be used to obtain an objective assessment of stretch marks type and stage; furthermore, we aim to apply these techniques to evaluate the efficacy of a topical treatment. Methods. 20 volunteers were enrolled with a two-month study. A marketed cosmetic product was used as the active over one body area. The controlateral area with stretch marks was treated with a "placebo" formulation without active, as a control. The instrumental evaluation was carried out at the beginning of the trial (baseline values or t(0)), after 1 month (t(1)), and at the end of the study (t(2)). Results. PRIMOS was able to measure and document striae distensae maturation; furthermore, ultrasound imaging permitted to visualize and diagnose the striae. Statistical analysis of skin roughness demonstrated a statistically significant reduction of Rp value only in a treated group. In fact, the Rp value represented a maximum peak height in the area selected. These results demonstrated that after two months of treatment only the striae rubra can be treated successfully. Conclusions. This work demonstrated that the 22MHz ultrasound can diagnose stretch marks; PRIMOS device can detect and measure striae distensae type and maturation. Furthermore, the high-frequency ultrasound and the 3D image device, described in this work, can be successfully employed in order to evaluate the efficacy of a topical treatment.

Figures

Figure 1
Figure 1
Schematic representation of steps used to produce two-dimensional sonographic cross-section of skin [42].
Figure 2
Figure 2
Principle of in vivo measurement of the skin.
Figure 3
Figure 3
Striae rubra (yellow) and striae alba(green/blue).
Figure 4
Figure 4
B-mode image of skin in which epidermis and dermis are visualized as echo-rich characteristics and striae as echo-low zone inside the dermis: (a) healthy skin; (b)skin with stretch marks.
Figure 5
Figure 5
B-mode image of skin after two months of treatment: (a) skin treated with active product in which epidermis and dermis are visualized as echo-rich characteristics and a new white echo-rich zone appears instead of striae; (b) skin treated with placebo in which striae are visualized as echo-low zone.
Figure 6
Figure 6
Curve trend of epidermis-dermis thickness in placebo and active-treated area.
Figure 7
Figure 7
Curve trend of Rp and Rv in control and treated skin area.
Figure 8
Figure 8
Stretch marks in 3D mode and in color scale and in grey scale images obtained before (a) and after two months of treatment (b).
Figure 9
Figure 9
Skin analysis in a subject with striae rubra and striae alba before (T0) and after 2 months of treatment (T2).
Figure 10
Figure 10
Skin analysis in a subject with striae alba before (T0) and after 2 months of treatment (T2). Again it could maintain that the treatment of striae alba didnot permit to obtain a reduction of this kind of stretch marks.

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