Comparison of the efficacy of microneedling versus CO ₂ fractional laser to treat striae alba: A randomized clinical trial

Abstract

Striae distensae (SD) are common skin conditions that have posed a significant challenge regarding their assessment and treatment. The present study aimed to evaluate the efficacy of microneedling in comparison to fractional CO 2 laser therapy. Similar striae were selected and photographed. Each side was randomly assigned to be treated with CO 2 fractional laser or microneedling four times at monthly intervals and followed up for 10 months. Outcome measures including the length and width of the largest striae, dermatologist assessed improvement, patients' satisfaction, and visual analog scale (VAS) were assessed. Wilcoxon signed-rank test and Mann-Whitney U test were used to assess the efficacy of treatments. Forty patients with a mean age of 28.1 years were included. The median cross-section of the largest striae decreased significantly in both groups (P-value <0.001), without statistically significant differences between the two groups before and 6 months after treatment. VAS also improved significantly in both groups, and there were no statistically significant differences between the two treatments in all visits. No clinically significant adverse effects were observed. Fractional CO 2 laser and microneedling are both efficient treatments to resolve SD. A new light should be shed on the microneedling modality as it is more economical than the other treatment options.clinical trial, fractional CO 2 laser, microneedling, stretch marks, striae distensae | INTRODUCTIONStriae distensae (SD) are perceptible linear scars that emerge due to the disproportionate skin stretching. It occurs in several conditions, including growth spurt in puberty, pregnancy, and rapid changes in particular body regions. 1,2 SD occurs with a number of histopathological alterations, for instance, mid-dermis elastolysis, which is observable due to macrophage stimulation and degranulation of the mast cells. 3

A comparative study of microneedling versus microneedling with topical Ascorbic Acid in the treatment of striae distensae

“…The most common site of lesion in our patients is the abdomen (28.6%), This is in agreement with the studies of Hodeib et al, (2018) (14) and Saafan et al, (2022) (15) . The most common possible cause of striae among our studied cases is weight gain (53.6%), This finding agrees with the studies done by Abdelsamiea et al, (2021) (16) , Salve et al, (2021) (17) and Saki et al, (2022) (18).…”

New Progress in Therapeutic Modalities of Striae Distensae

“…Of concern is that the higher the laser energy, the greater the risk of post-inflammatory hyperpigmentation, and in some patients, PIH can last up to a year. 14 Studies have also shown comparable efficacy of FrCO 2 laser and micro-needling for SR. 15 …”

“…Of concern is that the higher the laser energy, the greater the risk of post-inflammatory hyperpigmentation, and in some patients, PIH can last up to a year. 14 Studies have also shown comparable efficacy of FrCO 2 laser and micro-needling for SR. 15 Fractional Er:YAG Laser Fractional Er:YAG laser has similar treatment effects to the Fractional Ablative CO 2 laser described above, but the 2940 nm Er:YAG causes less thermal damage to the surrounding tissues and thus allows for faster wound healing causing milder side effects such as erythema, edema, and PIH. PIH is more difficult to accept for Fitzpatrick skin type IV-V people so it can be used as favorable alternative treatment for darker skin people.…”