Skip to main content
SpringerLink
Log in

Efficacy of Microneedling Versus Fractional Non-ablative Laser to Treat Striae Alba: A Randomized Study

  • Original Research Article
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background

Striae distensae (SD), an unsightly cutaneous condition characterized by epidermal atrophy, can affect the quality of life of women.

Objectives

The aim of our study was to compare the efficacy of a neodymium:yttrium–aluminum–perovskite 1340 nm non-ablative fractional laser (NAFL) and the microneedling (MN) technique to treat striae alba (SA).

Materials and Methods

NAFL and MN were used to treat striae on the longitudinally divided abdominal surface of 20 women classified as Fitzpatrick skin type III or IV (five sessions at monthly intervals). Photographs and skin biopsies were obtained during pretreatment and after the third and fifth treatment sessions for all patients. Patients and two independent evaluators assessed the clinical response using the Global Aesthetic Improvement Scale.

Results

Patient-reported evaluation showed improvement of striae using both modalities, with no statistically significant difference between the groups. Collagen and elastic fibers were significantly increased (p < 0.01) after the third and fifth treatment sessions, with no significant difference between the modalities. In addition, Dermatology Life Quality Index scores showed significant improvement (p < 0.001) after the third and fifth treatment sessions compared with pretreatment values, with average values of 8.4 (standard error [SE] ± 1.21), 3.17 (SE ± 0.55), and 2.64 (SE ± 0.60), respectively. The mean pain score using the Visual Analog Scale in the MN group versus the NAFL group was 5.23 (SE ± 0.31) versus 2.39 (SE ± 0.22) [p < 0.001], and the mean duration of adverse events in the NAFL group versus the MN group was 4.03 days (SE ± 0.45) versus 3 days (SE ± 0.37) [p = 0.02].

Conclusion

NAFL and MN are safe for treating SD, particularly in individuals classified as phototype III or IV. MN is a useful non-technology-dependent, low-cost alternative therapy for SA.

Clinical Trial Registration Number

NCT03390439.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ross NA, Ho D, Fisher J, Mamalis A, Heilman E, Saedi N, et al. Striae distensae: preventative and therapeutic modalities to improve aesthetic appearance. Dermatol Surg. 2017;43(5):635–48.

    Article  CAS  Google Scholar 

  2. Al-Himdani S, Ud-Din S, Gilmore S, Bayat A. Striaedistensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol. 2014;170(3):527–47.

    Article  CAS  Google Scholar 

  3. Tyler KH, Zirwas MJ. Pregnancy and dermatologic therapy. J Am Acad Dermatol. 2013;68(4):663–71.

    Article  Google Scholar 

  4. Soltanipoor F, Delaram M, Taavoni S, Haghani H. The effect of olive oil on prevention of striae gravidarum: a randomized controlled clinical trial. Complement Ther Med. 2012;20(5):263–6.

    Article  CAS  Google Scholar 

  5. Di Lernia V, Bonci A, Cattania M, Bisighini G. Striae distensae (rubrae) in monozygotic twins. Pediatr Dermatol. 2001;18(3):261–2.

    Article  Google Scholar 

  6. Gilmore SJ, Vaughan BL, Madzvamuse A, Maini PK. A mechanochemical model of striae distensae. Math Biosci. 2012;240(2):141–7.

    Article  Google Scholar 

  7. Cordeiro RCT, Moraes AM. Striae distensae: fisiopatologia. Surg Cosmet Dermatol. 2009;1(3):137–40.

    Google Scholar 

  8. Darvay A, Acland K, Lynn W, Russell-Jones R. Striae formation in two HIV-positive persons receiving protease inhibitors. J Am Acad Dermatol. 1999;41(3 Pt 1):467–9.

    Article  CAS  Google Scholar 

  9. Har-Shai Y, Barak A, Taran A, Weissman A. Striae distensae of augmented breasts after oral contraceptive therapy. Ann Plast Surg. 1999;42(2):193–5.

    Article  CAS  Google Scholar 

  10. Maia M, Marçon CR, Rodrigues SB, Aoki T. Striae distensae in pregnancy: risk factors in primiparous women. An Bras Dermatol. 2009;84(6):599–605.

    Article  Google Scholar 

  11. Crocco EI, Mantovani PA, Volpini BM. Em busca dos tratamentos para Striae rubra e Striae Alba: o desafio do dermatologista. Surg Cosmet Dermatol. 2012;4(4):332–7.

    Google Scholar 

  12. McDaniel DH. Laser therapy of stretch marks. Dermatol Clin. 2002;20(1):67–76.

    Article  Google Scholar 

  13. Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis : a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426–38.

    Article  Google Scholar 

  14. Yang YJ, Lee GY. Treatment of striae distensae with nonablative fractional laser versus ablative CO2 fractional laser: a randomized controlled trial. Ann Dermatol. 2011;23(4):481–9.

    Article  Google Scholar 

  15. Geronemus RG. Fractional photothermolysis: current and future applications. Lasers Surg Med. 2006;38(3):169–76.

    Article  Google Scholar 

  16. de Angelis F, Kolesnikova L, Renato F, Liguori G. Fractional nonablative 1540-nm laser treatment of striae distensae in Fitzpatrick skin types II to IV: clinical and histological results. Aesthet Surg J. 2011;31(4):411–9.

    Article  Google Scholar 

  17. Cachafeiro T, Escobar G, Maldonado G, Cestari T, Corleta O. Comparison of nonablative fractional erbium laser 1340 nm and microneedling for the treatment of atrophic acne scars: a randomized clinical trial. Dermatol Surg. 2016;42(2):232–41.

    Article  CAS  Google Scholar 

  18. Park KY, Kim HK, Kim SE, Kim BJ, Kim MN. Treatment of striae distensae using needling therapy: a pilot study. Dermatol Surg. 2012;38(11):1823–8.

    Article  CAS  Google Scholar 

  19. Mazzella C, Cantelli M, Nappa P, Annunziata MC, Delfino M, Fabbrocini G. Confocal microscopy can assess the efficacy of combined microneedling and skinbooster for striae rubrae. J Cosmet Laser Ther. 2018. https://doi.org/10.1080/14764172.2018.1511913 (Epub 21 Aug 2018).

    Article  PubMed  Google Scholar 

  20. Lima EV, Lima MA, Takano M, Takano D. Microagulhamento: estudo experimental e classificação da injúria provocada. Surg Cosmet Dermatol. 2013;5(2):110–4.

    Google Scholar 

  21. Glass JS, Hardy CL, Meeks NM, Carroll BT. Acute pain management in dermatology: risk assessment and treatment. J Am Acad Dermatol. 2015;73(4):543–60.

    Article  Google Scholar 

  22. Martins GA, Arruda L, Mugnaini AS. Validação de questionários de avaliação da qualidade de vida em pacientes de psoríase. An Bras Dermatol. 2004;79(5):521–35.

    Article  Google Scholar 

  23. Hexsel D, Soirefmann M, Porto MD, Schilling-Souza J, Siega C, Dal’Forno T. Superficial dermabrasion versus topical tretinoin on early striae distensae: a randomized, pilot study. Dermatol Surg. 2014;40(5):537–44.

    Article  CAS  Google Scholar 

  24. Sardana K, Manjhi M, Garg VK, Sagar V. Which type of atrophic acne scar (ice-pick, boxcar, or rolling) responds to nonablative fractional laser therapy? Dermatol Surg. 2014;40(3):288–300.

    Article  CAS  Google Scholar 

  25. Guida S, Galimberti MG, Bencini M, Pellacani G, Bencini PL. Treatment of striae distensae with non-ablative fractional laser: clinical and in vivo microscopic documentation of treatment efficacy. Lasers Med Sci. 2018;33(1):75–8.

    Article  Google Scholar 

  26. Bertin C, Lopes-Dacunha A, Nkengne A, Roure R, Stamatas GN. Striae distensae are characterized by distinct microstructural features as measured by non-invasive methods in vivo. Ski Res Technol. 2014;20(1):81–6.

    Article  CAS  Google Scholar 

  27. Yamaguchi K, Suganuma N, Ohashi K. Quality of life evaluation in Japanese pregnant women with striae gravidarum: a cross-sectional study. BMC Res Notes. 2012;5:450.

    Article  Google Scholar 

  28. Paula HR, Dini GM, Haddad A, Ferreira LM, Weiss MA. Tradução, adaptação cultural e validação do questionário de qualidade de vida norte-americano Skindex-29. An Bras Dermatol. 2014;89(4):600–7.

    Article  Google Scholar 

  29. Kim BJ, Lee DH, Kim MN, Song KY, Cho WI, Lee CK, et al. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol. 2008;9(1):33–7.

    Article  CAS  Google Scholar 

  30. Zeitter S, Sikora Z, Jahn S, Stahl F, Strauß S, Lazaridis A, et al. Microneedling: matching the results of medical needling and repetitive treatments to maximize potential for skin regeneration. Burns. 2014;40(5):966–73.

    Article  CAS  Google Scholar 

  31. El-Domyati M, Barakat M, Awad S, Medhat W, El-Fakahany H, Farag H. Microneedling therapy for atrophic acne scars an objective evaluation. J Clin Aesthet Dermatol. 2015;8(7):36–42.

    PubMed  PubMed Central  Google Scholar 

  32. Aust MC, Fernandes D, Kolokythas P, Kaplan HM, Vogt PM. Percutaneous collagen induction therapy: an alternative treatment for scars, wrinkles, and skin laxity. Plast Reconstr Surg. 2008;121(4):1421–9.

    Article  CAS  Google Scholar 

  33. Dogra S, Yadav S, Sarangal R. Microneedling for acne scars in Asian skin type: an effective low cost treatment modality. J Cosmet Dermatol. 2014;13(3):180–7.

    Article  Google Scholar 

Download references

Acknowledgements

Evaluation assistance was provided by Clarissa Prieto Herman Reinehr, MD, Master in Medical Sciences, and Juliano Peruzzo, MD, Master in Medical Sciences.

Author information

Authors and Affiliations

  1. Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Ana Paula Naspolini & Tania Ferreira Cestari

  2. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Juliana Catucci Boza

  3. Barretos Cancer Hospital, Barretos, Brazil

    Vinicius Duval da Silva

Authors
  1. Ana Paula Naspolini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juliana Catucci Boza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vinicius Duval da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tania Ferreira Cestari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana Paula Naspolini.

Ethics declarations

Conflicts of interest

Ana Paula Naspolini, Juliana Catucci Boza, Vinicius Duval da Silva, and Tania Ferreira Cestari have no conflicts of interest to declare.

Funding

The research for this paper was financially supported by the Research and Events Incentive Fund (FIPE), HCPA, Brazil. In addition, this study received financial support from Aché Laboratory (Guarulhos, Brazil), Dr. Roller, MTO Importadora e Distribuidora (São Leopoldo, Brazil), and Vydence Medical Company (São Carlos, Brazil), who provided the anesthetics and devices used in this study.

Research involving human participants and/or animals

This study was performed in accordance with the ethical standards of the Declaration of Helsinki, and was approved by the Ethics Committee of the Clinical Hospital of Porto Alegre (CAAE: 47639415.1.0000.5327).

Informed consent

All patients were provided complete information regarding the procedures, and subsequently signed informed consent forms.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 378 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Naspolini, A.P., Boza, J.C., da Silva, V.D. et al. Efficacy of Microneedling Versus Fractional Non-ablative Laser to Treat Striae Alba: A Randomized Study. Am J Clin Dermatol 20, 277–287 (2019). https://doi.org/10.1007/s40257-018-0415-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40257-018-0415-0

Search

Navigation