Laser and Light Treatments for Striae Distensae: A Comprehensive Review of the Literature

Abstract

Striae distensae (SD) are common dermatologic lesions that often arise as a result of rapid weight change, certain endocrine conditions, or prolonged exposure to steroids. SD initially present as raised edematous plaques (striae rubra), after which they become white and atrophic (striae alba) owing to local breakdown and reorganization of collagen and elastin. There currently exists no reliable treatment option, though numerous topical applications have been attempted. Lasers and light represent emerging noninvasive therapies that have demonstrated some success targeting vascular chromophores in striae rubra and stimulating collagen and elastin production in striae alba. An extensive literature review was performed to gather all available articles studying laser and light treatments for SD. Lasers and light can significantly improve the appearance of both striae rubra and striae alba. Generally, striae rubra are more responsive to therapy and can be treated successfully with a variety of lasers without major adverse effects. Fractional lasers exhibit the strongest results for striae alba repigmentation and collagen induction, and several other lasers produce temporary repigmentation. Lasers in combination with other modalities such as topical agents and additional energy devices have also demonstrated promising preliminary results; however, large comparative studies are necessary to validate these outcomes.

Striae gravidarum: Risk factors, prevention, and management

“…Pulsed dye laser results in textural improvements but has shown a limited benefit to treat striae alba (McDaniel et al, 1996). It may be beneficial in striae rubra by reducing erythema (Aldahan et al, 2016). Nd:YAG laser, also a vascular laser, demonstrated excellent improvement of up to 70% or more, even though it is specifically for immature striae rubra (Goldman et al, 2008).…”

Evaluation of a non‐ablative, fractional 1565 nm laser for the improvement of striae distensae albae

“…In particular, white lesions seem very resistant to treatment attempts. 12 Topical management, like retinoic acid and chemical acid peels, shows very little evidence of efficacy with positive results limited to early stages of SD. 13,14 Different approaches like medical needling, resulting in micro trauma extending to the papillary dermis, believed to increase collagen and elastin production, or radiofrequency (RF) devices, delivering current to skin, converting into heat, subsequently leading to an increased collagen production, both showed small clinical improvements in SD albae.…”

Fractional Laser Photothermolysis in the Treatment of Skin Defects: Possibilities and Effectiveness (Review)

“…Although many studies have showed the advantages of non-ablative FP through involving minimal side effects and a quicker recovery [85][86][87][88][89][90][91], it should be noted that this technology is less effective than ablative resurfacing with CO 2 or Er:YAG lasers even if the treatment involves several procedures. Implementation of ablative fractional laser treatment leads to reduced recovery times after the procedure (compared to conventional treatment) as well as to a reduced risk of additional scarring and damaged pigmentation.…”