Ann Dermatol.  2011 Nov;23(4):481-489.

Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO2 Fractional Laser: A Randomized Controlled Trial

• Yang YJ
• Lee GY

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 CO2 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 CO2 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 CO2 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 CO2 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.

Keyword

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

MeSH Terms

Abdomen
Asian Continental Ancestry Group
Atrophy
Biopsy
Cicatrix
Cosmetics
Elasticity
Humans
Lasers, Gas
Light
Photography
Skin
Striae Distensae
Cosmetics

Figure

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  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.

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  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.

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  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.

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  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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