A double-blind controlled clinical trial assessing the effect of topical gels on striae distensae (stretch marks): a non-invasive imaging, morphological and immunohistochemical study

Abstract

Striae distensae (SD) are cutaneous lesions often presenting post-pregnancy with atrophy and flattening of the epidermis. SD is poorly understood and treatment remains ill-defined. Our aim was to assess the effect of topical application of silicone gel compared with placebo on SD using non-invasive devices and by immunohistochemical analysis of sequential tissue biopsies in a double-blind controlled trial. Twenty volunteers massaged silicone and placebo gels into separate sides of the abdomen, daily for 6 weeks. Objective non-invasive imaging plus subjective self-assessment of SD were performed on days 0, 21, 42, 90, in addition to tissue biopsies on days 0 and 42. Non-invasive imaging demonstrated an increase in melanin and a decrease in haemoglobin, collagen and pliability over the 6-week period on both sides. Additionally, collagen levels in SD were significantly higher (p value = 0.001) and melanin levels lower (p value = 0.048) with silicone gel compared with placebo. Histological analysis revealed epidermal flattening with a reduction of rete ridges in SD on both sides. Vascular count significantly decreased with placebo gel (p = 0.002). Corroborating the clinical results, melanin levels increased, whilst collagen type 1 and elastin decreased on both sides. Non-invasive techniques showed that the application of silicone gel increased collagen levels and reduced pigmentation compared with placebo. However, both clinical and histological data revealed that melanin increased whilst collagen, elastin and pliability decreased over the 6-week period with both gels. Furthermore, vascularity significantly decreased with placebo gel. These findings provide preliminary evidence of the utility of topical gels in the clinical management of SD.

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Abbreviations

ACTH:

Adrenocorticotropic hormone

EvG:

Elastic van Gieson stain

FLPI:

Full-field Laser Perfusion Imaging

H + E:

Haematoxylin and Eosin stain

MF:

Mason Fontana stain

SIAscopy:

Spectrophotometric Intracutaneous Analysis

SD:

Striae distensae

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Conflict of interest

Partial funding of this project was provided by Sinclair Pharmaceuticals Ltd.

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Correspondence to Ardeshir Bayat.

Additional information

This paper has been given as a podium presentation at the Symposium of Advanced Wound Care in conjunction with the Wound Healing Society in Atlanta, Georgia, USA, April 2012.

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Ud-Din, S., McAnelly, SL., Bowring, A. et al. A double-blind controlled clinical trial assessing the effect of topical gels on striae distensae (stretch marks): a non-invasive imaging, morphological and immunohistochemical study. Arch Dermatol Res 305, 603–617 (2013). https://doi.org/10.1007/s00403-013-1336-7

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Keywords

  • Striae distensae
  • Silicone gel
  • Massage
  • Skin scarring
  • Histological analysis