tretinoin and Striae-Distensae

Striae distensae (SD) are common and aesthetically undesirable dermal lesions. The aim of this study is to comprehensively evaluate the effectiveness of different therapies in treating striae distensae using network meta-analysis.. A systematic search of electronic databases up to December 1, 2019 was conducted. Randomized controlled trails (RCTs) examining the effectiveness of different methods in treating striae distensae were included. The primary outcomes are clinical effective rate and patient's satisfaction degree. Risk of bias was assessed by the Cochrane risk of bias tool. Network meta-analysis was based on Bayesian framework.. Fourteen trails that met the criteria with 651 subjects were included. The results of the network meta-analysis show that topical tretinoin combined bipolar radiofrequency showed the highest probability of being the best method to improve the clinical effectiveness and patient satisfaction rate of treating SD (84.5% and 95.7% respectively), closely followed by bipolar radiofrequency (75.3% and 84.3% respectively). Among laser treatment, CO2 fractional laser is superior to other lasers in the clinical effectiveness and patient satisfaction (72.0% and 58.1% respectively). Statistics showed the topical tretinoin was the worst-performing option in improving the clinical effectiveness and patient satisfaction rate of SD treatment (5.4% and 5.1% respectively).. Based on the results of network meta-analysis, we recommend treating striae distensae with bipolar radio frequency combined topical tretinoin. The commonly used CO2 fractional laser can be considered as alternative treatment candidate. Additional large-scale RCTs are necessary to obtain more precise estimates of their relative efficacy.

Topics: Administration, Topical; Adolescent; Adult; Female; Humans; Keratolytic Agents; Lasers, Gas; Male; Patient Satisfaction; Radiofrequency Ablation; Randomized Controlled Trials as Topic; Striae Distensae; Tretinoin; Young Adult

Striae distensae (SD), otherwise known as "stretchmarks," are a common presenting complaint, particularly in young healthy women. SD are hypothesized to form in a patient when the cross-linked collagen is "overstretched" and rupture of this collagen matrix causes the striae. Thus, many treatments work by increasing collagen synthesis. This review critically appraises the evidence to date for the treatment of SD, including both energy-based devices and topical treatments.

Topics: Dermabrasion; Evidence-Based Medicine; Female; Humans; Keratolytic Agents; Low-Level Light Therapy; Phototherapy; Striae Distensae; Tretinoin

Striae gravidarum (SG), or stretch marks developing during pregnancy, affect up to 90% of women. While not medically dangerous, SG can be disfiguring, causing emotional and psychological distress. However, studies specifically addressing the prevention of SG, especially during pregnancy, are sparse. Furthermore, the molecular pathogenesis of SG is unclear and may differ from that of striae from other causes. Considering these factors, we review topical modalities that have been used specifically for preventing SG during pregnancy. We identify two major strategies (end points) addressed by these modalities, namely (i) preventing the de novo development of SG and (ii) reducing the severity of SG that have recently developed. We also identify risk factors for the development of SG and suggest that pregnant women with these risk factors are an appropriate target population for prevention. In reviewing the literature, we find that there is limited evidence that centella, and possibly massage with bitter almond oil, may prevent SG and/or reduce their severity. There is weak evidence that hyaluronic acid prevents SG. Tretinoin holds promise for reducing the severity of new-onset SG, but its use is limited by its pregnancy category. Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce. Furthermore, available topical modalities generally lack strong evidence from rigorous, well-designed, randomized controlled trials with ample numbers of subjects. Thus, further research is necessary to elucidate SG pathogenesis, which may lead to effective prevention modalities.

Topics: Administration, Cutaneous; Dermatologic Agents; Dietary Fats; Female; Humans; Hyaluronic Acid; Massage; Ointments; Olive Oil; Plant Oils; Pregnancy; Pregnancy Complications; Risk Factors; Risk Reduction Behavior; Striae Distensae; Tretinoin

Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments available, no consistently effective therapies have been established. In this systematic review, we evaluate 8 randomized controlled trials (RCTs) to assess the efficacy and safety of currently available therapies for the treatment of stretch marks. Due to the limited number of patients and high or unclear risk of bias in the studies included in this assessment, the evidence from this review is insufficient to provide clear guidelines for practice. Therefore, more high-quality RCTs are needed.

Topics: Glycolates; Humans; Keratolytic Agents; Laser Therapy; Ointments; Randomized Controlled Trials as Topic; Striae Distensae; Treatment Outcome; Tretinoin

Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date.. To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum.. Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study.. Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts.. The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.

Topics: Adult; Erythema; Female; Humans; Keratolytic Agents; Middle Aged; Pain; Pain Measurement; Patient Satisfaction; Pilot Projects; Pregnancy; Pregnancy Complications; Radiofrequency Therapy; Skin; Skin Cream; Striae Distensae; Treatment Outcome; Tretinoin; Ultrasonography

Striae are commonly developed in adolescence as a result of active growth spurt. Although they create little physical health issue, they are cosmetic concerns to the patients. Effective striae treatment can help improve their mental health and personality.. To compare the effects of a herbal extract cream and 0.1% tretinoin cream in the treatment of striae alba.. Forty eight participants aged between 10 - 19 years old, with striae alba at their thighs were randomized into two groups. Each group was separately treated with 0.1% tretinoin and herbal extract for 16 weeks. The width, length and surface roughness of the lesions were assessed including histological evaluation and participants’ satisfaction.. Thirty nine participants completed the study after 16 weeks. Compared to initial lesions, the striae width was reduced by 9.01% (p = 0.002) in tretinoin group and 13.09% (p<0.001) in herbal extract group. The length was reduced by 9.54% in tretinoin group (p<0.001) and 8.73% in herbal extract group (p<0.001). The surface roughness assessed by Visioscan VC98 was reduced by 13.70% in tretinoin group (p = 0.036) and 17.24% in herbal extract group (p<0.001). From H&E staining, the mean difference of epidermal thickness was 4.79±7.15 microns in tretinoin group and 14.22±16.98 microns in herbal extract group. The mean difference of collagen amount was 13.75±6.02 units in tretinoin group and 6.60±4.92 units in herbal extract group. From Masson trichrome staining, the mean difference of collagen amount was 6.75±3.50 units in tretinoin group and 12.20±7.73 units in herbal extract group. From Verhoff van Gieson staining, the mean difference of elastin amount was 2.25±3.30 units in tretinoin group and 5.40±4.16 units in herbal extract group. There was no statistical significant difference between two groups in histological evaluation. The herbal extract caused irritant contact dermatitis only 4.55% in contrast to 72.73% from the tretinoin group. Most participants from both groups had moderate to high satisfaction according to the efficacy of their treatments.. The herbal extract cream is as effective as 0.1% tretinoin cream in the treatment of striae alba. As tretinoin can cause skin irritation, the herbal extract can be a better alternative treatment.

Topics: Administration, Topical; Adolescent; Adult; Child; Double-Blind Method; Female; Humans; Keratolytic Agents; Male; Ointments; Plant Extracts; Plants, Medicinal; Striae Distensae; Thigh; Treatment Outcome; Tretinoin; Young Adult

Striae distensae (SD) is a common skin condition, with a prevalence ranging from 40% to 90%, depending on the population studied.. To evaluate the efficacy of superficial dermabrasion and compare it with that of topical tretinoin cream in the treatment of narrow and early SD.. Prospective, single-center, randomized, open-label study. Thirty-two women presenting with early, untreated SD (striae rubra) were included in this study. One group received 16 weekly sessions of superficial and localized dermabrasion, and the other used 0.05% tretinoin cream daily. Striae width and length were measured and compared between groups and over time. Global Aesthetic Improvement Scale scores and subject satisfaction were also assessed. Biopsies were performed for subjects who agreed to undergo this procedure, followed by histologic analyses of the skin samples.. Both treatments were efficacious, with significant improvement in early SD from baseline, but there was no significant difference between the two treatments. Histologic assessment showed improvement in epidermal and dermal layers for the dermabrasion treatment group.. Both treatments had similar efficacy, but superficial dermabrasion had a lower frequency of side effects and better adherence of the patients.

Topics: Administration, Cutaneous; Adolescent; Adult; Child; Dermabrasion; Female; Humans; Keratolytic Agents; Patient Satisfaction; Pilot Projects; Severity of Illness Index; Striae Distensae; Tretinoin; Young Adult

Striae distensae (SD) treatment still remains a therapeutic challenge to dermatologists. Ablative fractional laser and radiofrequency (RF) enhance skin-drug permeability for SD treatment.. To clinically evaluate the efficacy and safety as well as patient's satisfaction in relation to a method using ablative fractional RF associated with retinoic acid 0.05% cream and an acoustic pressure wave ultrasound (US) in patients with alba-type SD on the breast.. Eight patients with alba-type SD on the breast were treated with three step procedure: (1) fractional ablative RF for skin perforation; (2) topical application of retinoic acid 0.05% on the perforated skin; and (3) US was applied to enhance the retinoic acid penetration into the skin. Other eight patients with alba-type SD on the abdominal area were submitted to RF treatment isolated without retinoic acid or US. Three of them were submitted to skin biopsies.. Three patients with SD on the breast area improved from "severe" to "moderate;" two patients improved from "severe" to "mild;" two patients from "moderate" to "mild;" one patient from "marked" to "mild." Clinical assessment demonstrated significant improvement in the appearance of SD in all patients treated with RF associated with retinoic acid 0.05% cream and US (P = 0.008), with low incidence of side effects and high level of patient's satisfaction. Among the patients treated only with RF, two patients improved from "severe" to "marked;" one patient from "marked" to "moderate;" and one patient improved from "marked" to "mild." Four patients did not show any sort of improvement. Clinical assessment demonstrated no significant improvement in the appearance of SD treated with RF isolated with low incidence of side effects, but low-level of patient's satisfaction.. Ablative fractional RF and acoustic pressure US associated with retinoic acid 0.05% cream is safe and effective for alba-type SD treatment.

Topics: Administration, Cutaneous; Adolescent; Adult; Catheter Ablation; Combined Modality Therapy; Drug Delivery Systems; Female; Humans; Keratolytic Agents; Middle Aged; Patient Satisfaction; Prospective Studies; Severity of Illness Index; Single-Blind Method; Striae Distensae; Treatment Outcome; Tretinoin; Ultrasonic Therapy; Ultrasonography; Young Adult

Striae distensae (SD) are linear scar tissue in the dermis that arises from stretching the skin. There are two types of SD, striae rubrae and striae albae (SA) which is marked with a line hypopigmentation that cause a psychological problem, especially in the high skin type. The standard therapy is a 0.1% tretinoin cream, but it takes a long time to reach the collagen so it needs invasive measures to reach these targets. This study was comparing 0.1% tretinoin cream with combination therapy of fractional microneedle radiofrequency (FMR) and fractional CO

Topics: Carbon Dioxide; Humans; Indonesia; Lasers, Gas; Striae Distensae; Treatment Outcome; Tretinoin

Striae distensae (SD) are dermal scars associated with atrophy of the epidermis.. To evaluate the effect and safety of intralesional injection of platelet-rich plasma (PRP) versus topical tretinoin 0.05% in treatment of SD.. Thirty patients (27 females and 3 males) had bilateral striae distensae were enrolled in this study. In every patient, half of the selected striae were treated with PRP intralesional injection. The other half was treated by topical tretinoin. Skin biopsies were taken from both sides before and after the treatment. Digital photographs were taken at the baseline and at the end of follow-up period. Clinical improvement was evaluated by 2 blind dermatologists in addition to the patient's satisfaction rating.. There was statistically significant improvement in the SD treated with PRP and topical tretinoin cream. The improvement was more in the SD treated with PRP injections (p = .015). Patient's satisfaction showed that the improvement was more in the PRP-treated side (p = .003). Collagen and elastic fibers in the dermis were increased in all biopsies after treatment.. PRP injection and topical tretinoin are safe for the treatment of SD, but PRP is more effective and it gives better therapeutic response than tretinoin.

Topics: Abdomen; Administration, Cutaneous; Adolescent; Adult; Dermatologic Agents; Female; Humans; Injections, Intralesional; Keratolytic Agents; Male; Middle Aged; Patient Satisfaction; Platelet-Rich Plasma; Striae Distensae; Thigh; Time Factors; Treatment Outcome; Tretinoin; Video Recording