Histological and quantitative morphometric evaluation of striae distensae treated by long-pulsed 1064-nm Nd

Abstract

BackgroundStriae distensae are frequent undesirable skin lesions that result in considerable esthetic concern. Treatment has always been challenging. Several modalities are available; however, none of them is consistently effective. Laser has become a popular therapeutic alternative. ObjectiveThe aim of this study was to evaluate the possible therapeutic effect of a long-pulsed 1064 nm Nd:YAG laser in striae distensae using histological and quantitative morphometric studies. Patients and methods Forty female patients with striae (group I: striae rubra and group II: striae alba) were included. All patients received four laser sessions at 4-week intervals. Three skin biopsies were obtained from every patient: one from normal control skin, the second from the selected striae before treatment, and the third from the same striae 1 month after treatment. Paraffin-embedded skin sections were subjected to histological and quantitative morphometric studies for assessment of collagen and elastic fibers. ResultsIn both groups, some clinical improvement was achieved, which was statistically nonsignificant. However, histological examination showed increased collagen and decreased elastic fibers with reorganization after treatment. The image analyzer showed a significant quantitative increase in the mean area percent of collagen fibers and decrease in the mean area percent of elastic fibers. Side effects were nonsignificant, mostly pain during the session and pigmentary alterations. ConclusionAlthough the clinical improvement in the treated striae was nonsignificant, the histological improvement was significant, with few side effects. The use of different laser parameters with a long follow-up period may improve the clinical response.

Systematic review of single and combined treatments for different types of striae: a comparison of striae treatments

“…Both fractional and non‐fractional RF are effective and safe for SD treatment 12,63–65 . Long‐pulsed 1064‐nm Nd:YAG and IPL show acceptable improvements in SD patients 61,66 . PDL laser therapy shows satisfactory results only for striae rubrae, and excimer 308‐nm laser is effective for lightening scar pigmentation 67,68 .…”

“…Topical therapies and light/laser‐based devices are the most common modalities used for SD 17–21,49–61 . In the topical therapies category, water‐in‐oil creams containing argan oil, bio‐oil and gels are effective, especially in the early phase of SD 49,51 .…”

“…Topical therapies and light/laser-based devices are the most common modalities used for SD. [17][18][19][20][21][49][50][51][52][53][54][55][56][57][58][59][60][61] In the topical therapies category, water-in-oil creams containing argan oil, bio-oil and gels are effective, especially in the early phase of SD. 49,51 Tretinoin 0.025 is not effective, but tretinoin 0.1% is an effective clinical treatment in the active and early stages of stretch-mark development, especially pregnancy-related stretch marks.…”

“…12,[63][64][65] Long-pulsed 1064-nm Nd:YAG and IPL show acceptable improvements in SD patients. 61,66 PDL laser therapy shows satisfactory results only for striae rubrae, and excimer 308-nm laser is effective for lightening scar pigmentation. 67,68 Meanwhile, diode 1450-nm laser is not an effective modality.…”

Striae distensae treatment review and update

“…[53] An Egyptian study by El-Ramly et al failed to show any statistically significant clinical improvement in SD after four sittings of Nd:YAG laser. [54]…”