Comprehensive pathogenesis and clinical therapy in striae distensae: An overview and current perspective

The pathogenesis of striae distensae(SD) is complicated and has not yet been fully elucidated. Hormonal changes,overstretched skin, and structural and functional changes in the skin may be crucial factors in the development of SD. Therapy aims to stimulate dermal collagen synthesis and improve skin texture. Mainstream treatments include topical medications, chemical peeling, laser and radiofrequency therapy, microdermabrasion, microneedle therapy, and filler injection therapy. In the present review, we summarize current perspectives on the pathogenesis and clinical therapy of SD.

Striae gravidarum as a predictor of spontaneous preterm delivery: A case control study

Background/Aims: The association between striae gravidarum (SG) and preterm delivery may be postulated because of sharing similar poor organization of extracellular matrix in both skin and cervix. Our goal was to compare the frequency of striae gravidarum in women who gave preterm birth and women who gave term birth. Methods: A case-control study was conducted in women who gave preterm birth (n = 66) and age matched women who gave term birth (n = 68). Cases and controls were recruited from puerperal women consequently seen at delivery wards of perinatology unit. All women underwent dermatologic examination in terms of SG blindly to theirs gestational weeks of delivery. The frequency of SG was compared in all groups. Results: The frequency of SG was 63.6% in women with preterm birth and 54.4% in women with term birth (p = 0.278). SG is five times more common in late preterm group than in women with term group, but this difference was not statistically significant [(p = 0.227, OR: 5.02, CI 95% (0.5 - 44.0)]. The rate of preventive cream usage was not statistically different in women with SG and without SG (p = 0.245). Conclusions: It seems that there was no statistically significant association between the risk of preterm labor and the presence of striae gravidarum. Larger prospective observational studies are needed to state expressly the probable clinical association between the presence of SG and preterm delivery.

Carbocysteine: A New Way for Stretch Marks Treatment

Background/Purpose: Although stretch marks (or striae) do not represent a medical problem, they are considered as the cause of psychological distress for women of any age that need to be treated. There are many cosmetic products or procedures claiming to improve the appearance of striae, but most of them are able to affect only striae appearance rather than physical characteristics or, even worse, they are provided with untoward effects. Our aim was to find a more efficacious and safe alternative to the existing tools. Methods: A randomized, blind observer study was conducted on 33 women to test the efficacy and safety of P-3059, a new product containing carboxymethylcysteine, Vitamin E and sweet almond oil. P-3059 was applied twice daily for 8 weeks and it was tested intra-subject in a split-body design versus an untreated area (negative control), comparing two symmetric areas with striae selected on the body/legs of each subject. The main study endpoint was the visual evaluation of striae, by means of the validated POSAS scale (consisting of two parts, OSAS and PSAS), at the end of treatment in comparison with baseline. Results: The comparison of the individual parameters of OSAS, showed significantly improved mean values for striae thickness, relief and pliability at the end of treatment (p < 0.05). The PSAS evaluation showed a statistically significant benefit in the improvement in thickness of the striae towards that of normal skin (p < 0.044). Conclusion: The new product based on carboxymethylcysteine leads to an improvement in the appearance and in the physical characteristics of striae, reducing their thickness and improving relief and pliability, as well as subjects satisfaction.

Effects of Semi-Ablative Fractional Radiofrequency Associated with Growth Factors in Stretch Marks: A Randomized Controlled Trial

Background: To investigate the effects of the association of semi-ablative fractional radiofrequency (RFF) with growth factors in stretch marks. Methods: This is a randomized controlled trial. The sample consisted of 28 female patients with complaints of gluteus or abdomen striae and divided into 2 equitable groups, named G1 (semi-ablative RFF without active principle association) and G2 (semi-ablative RFF with active principle association), being subdivided into G-1A and G-2A (abdominal applications) and G-1B and G-2B (gluteus applications). A photographic and histological analysis was performed using questionnaires about inflammation, presence of adverse effects and satisfaction of volunteers. Photographic analysis showed a reduction in the amount of striae alba in all groups. Results: The histological analysis showed an increase in fibroblast activity, collagen type I, and blood vessels, especially in the groups that associated the RFF with the active principle. In the inflammation analysis, the groups that performed intervention with active ingredients showed lower inflammatory signal. All groups had a reasonable level of satisfaction after the interventions;however, the group that used active ingredients reported greater results. Conclusion: The association of semi ablative RFF with growth factors showed a reduction in clinical inflammatory signs, mainly in the first 15 days, as well as higher collagen production, verified in 30 days, with satisfactory clinical results in all groups.