Introduction: Stretch marks, or striae distensae (SD), are the lesions of the dermis caused by its linear atrophy at the sites of stretching. They occur in more than 70% of pregnant women and adolescents as a result of cutaneous stretching. This study aimed at evaluating and comparing the clinical and histological efficacy of the fractional CO2 laser versus the long pulsed (LP) Nd: YAG laser in the treatment of striae alba. Methods: Thirty female subjects having bilateral symmetrical stretch marks were managed by the LP Nd: YAG laser on the right side and the fractional CO2 laser on the left side. The laser treatment course consisted of 3 sessions with an interval of 3 weeks. The patient satisfaction score and the Global Aesthetic Improvement Scale (GAIS) were employed in the study in order to assess the improvement 3 months after therapy. Punch biopsies measuring 4 mm were extracted from one lesion on each side at baseline and after the last treatment session by 3 months to evaluate the thickness of both collagen and epidermis Results: Clinical improvement was more significant in the lesions treated by the LP Nd:YAG laser than those treated with the fractional CO2 laser. The patient satisfaction score and the GAIS were higher with a statistically significant value in the side treated by the LP Nd:YAG laser. Collagen and epidermal thickness increased more in the LP Nd: YAG laser-treated lesions in comparison to their thickness in the fractional CO2 laser-managed lesions, but this difference did not have a statistical significance. Conclusion: The clinical efficacy of the LP Nd-YAG laser exceeded that of the fractional CO2 laser in the treatment of striae alba without severe side effects in spite of the insignificant histological difference between the two lasers.

Striae distensae (SD) are common skin conditions that have posed a significant challenge regarding their assessment and treatment. The present study aimed to evaluate the efficacy of microneedling in comparison to fractional CO2 laser therapy. Similar striae were selected and photographed. Each side was randomly assigned to be treated with CO2 fractional laser or microneedling four times at monthly intervals and followed up for 10 months. Outcome measures including the length and width of the largest striae, dermatologist assessed improvement, patients\' satisfaction, and visual analog scale (VAS) were assessed. Wilcoxon signed-rank test and Mann-Whitney U test were used to assess the efficacy of treatments. Forty patients with a mean age of 28.1 years were included. The median cross-section of the largest striae decreased significantly in both groups (P-value <0.001), without statistically significant differences between the two groups before and 6 months after treatment. VAS also improved significantly in both groups, and there were no statistically significant differences between the two treatments in all visits. No clinically significant adverse effects were observed. Fractional CO2 laser and microneedling are both efficient treatments to resolve SD. A new light should be shed on the microneedling modality as it is more economical than the other treatment options.

Authors present a study about the contraction forces observed in striae distensae fibroblasts (SMF) in a collagen scaffold. Collagen lattices were used to study the mechanical behavior of SDF within the collagen matrix compared to the lattices produced using the healthy skin derived fibroblasts (NSF). A Forcebox device was used to measure the contractile forces. Striae Rubrae fibroblast\'s contractile force was by 28% greater than that generated by the NSF and striae albae fibroblasts (P<0.05). Anomalies and especially differences in forces generated by SMF were observed through all our experiments. These findings complete and corroborate the results and information published in our previous studies. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

UNASSIGNED: Stretch marks (SM) are nowadays the most common aesthetic pathology of the body; in the XX century, it mainly affected pregnant women, while today it also affects teenagers during puberty, boys and girls without distinction. The aim of this study was to evaluate possible variations in the histological structure of the skin-in terms of quality/quantity of the extracellular matrix and of the collagen and elastic fibers-following the electromagnetic fields and negative pressure (V-EMF) treatment as regards hypotonia and SMs.
UNASSIGNED: For the current study, 60 women, aged between 25 and 45, were examined. All of them presented deep, white or pearly white colored SMs having had them for between 12 and 25 years. These were documented, asking patients their level of satisfaction, through pictures and biopsies. All patients underwent a cycle of 6 or 8 weekly sessions; everyone was highly satisfied with the results obtained.
UNASSIGNED: Biopsies proved that the tissue was reorganized and restored to the original volume, characterized by the production of new, high-quality collagen and elastin molecules, by the reorganization of the basement membrane and by the correct positioning of the melanocytes. No side effects were observed during the treatments. This synergy stands as the most suitable treatment of striae rubra and alba.
UNASSIGNED: V-EMF enhances the keratinocyte migration base, melanocytes, and promotes neoangiogenesis with the result of improvement in the SM.

暂无摘要。

BACKGROUND: Stretch marks are linear scars that result from elastic fiber destruction. They usually occur as the consequence of rapid change in the body mass (weight gain and loss, pregnancy, weightlifting), long-term steroid use, or endocrinopathies. Treatment is challenging and mainly based on topical and procedural therapies, although the standard of care is still under debate.
OBJECTIVE: To evaluate the efficacy and tolerance of a topical oil formulation of plant extracts and vitamins on the aesthetic improvement of stretch marks and xerosis.
METHODS: Fifty male and female patients, aged between 14 and 45 years, with stretch marks referring at the University Hospital Federico II, Naples, were enrolled between March and November 2019. Topical application of plant extracts and vitamin-rich oil was performed twice daily on affected skin for 4 months. Patients were monitored at baseline (T0), and at two-month (T1) and 4-month (T2) follow-ups, through clinical and dermoscopic assessment, confocal microscopy, cutaneous ultrasound, MoistureMeterEpiD, and X-Rite spectrocolorimeter. Primary endpoints were as follows: 70% clinical improvement of stretch marks and 3-point decrease in clinical score from baseline to T2. Secondary endpoints were as follows: change in the T0 parallel pattern of collagen fibers at confocal microscopy, cutaneous thickness increase at ultrasounds, cutaneous hydration increase at MoistureMeterEpiD, erythema reduction at X-Rite spectrocolorimeter, and safety and adverse events (AEs).
RESULTS: At 4-month follow-up, stretch marks improved objectively and subjectively in all patients (p < 0.001). In detail, there was a 29% and 71% improvement in clinical appearance of stretch marks at T1 and T2, respectively, as documented dermoscopically and by the 3-point reduction in the assessor\'s mean clinical score at each follow-up visits [from 8.1±0.7 at baseline to 5.7±1.0 at T1 and 2.3 ±0.5 at T2 (p < 0.001)]. Erythema decreased by 15% and 30% and in parallel hydration increased by 25% and 71%, at T1 and T2, respectively (p < 0.001). At T2 confocal microscopy of stretch marks, dermal collagenous fibers assumed casual disposition with reticular pattern and refractivity, as signs of collagen remodeling and neocollagenesis, and also the T2 cutaneous ultrasound revealed increased epidermal thickness and decreased dermal hypoechogenicity as for a higher skin hydration.
CONCLUSIONS: Our study showed that a topical oil formulation rich in plant extracts and vitamins appears to be effective and safe in treating stretch marks and xerosis.

Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called \"striae rubrae\" (SR) and a chronic phase in which they are called striae albae (SA). Fibroblasts seem to play a key role in the pathogenesis of stretch marks. This study was aimed at describing and analyzing stretch marks-derived fibroblasts (SMF), the differences between SR- and SA-derived fibroblasts (SRF, SAF), testing two treatments in vitro (sodium ascorbate and PrP) on SAF.
To characterize the SMF, the expression of alpha smooth muscle actin (alpha SMA) was investigated. Type I collagen expression was measured in SAF, before and after adding different PrP concentrations and sodium ascorbate in the culture medium. Results were processed through statistical analysis models using the Student\'s t-test.
A significant increase in alpha SMA (P <0.001) was observed in SRF. SAF treated with PrP and sodium ascorbate showed a resumption of their metabolic activity by an increase in collagen type I production and cell proliferation. After 24 h of incubation with PrP 1% and PrP 5% + sodium ascorbate, cell viability was increased by 140% and 151% and by 156 and 178% after 48 h, respectively, compared to the control.
Our study shows that a biologically mediated improvement in SMF metabolic activity is possible. Our promising results require further trials to be able to confirm the reproducibility of this combined treatment, particularly in vivo.
This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable.

BACKGROUND: The leaves of Tasmannia lanceolata mainly contain polygodial that is known to exhibit a range of biological functions including anti-inflammatory effects.
OBJECTIVE: These studies aimed to assess the effects of Tasmannia lanceolata extract (TLE) on skin and more particularly on stretch marks in women.
METHODS: A double-blind, randomized, placebo-controlled clinical study was carried out on 29 women, aged from 25 to 60 years, to investigate the effects of TLE on stabilized stretch marks. TLE and placebo products were topically applied daily for 8 weeks. Skin roughness and firmness of stretch marks were assessed by 2D and 3D photograph processing and analyses. Dermal density and thickness were evaluated using ultrasound, while stretch mark conditions (length, color, and depth) were determined by clinical scoring. Matricial proteins (pro-collagen I and elastin) and pro-matricial factors, like TGF-β concentrations, were quantified from cultures of human skin explants presenting stretch marks, treated with TLE or vehicle control.
RESULTS: Skin roughness of stretch marks was significantly reduced in the TLE group after 8 weeks of treatment. Skin firmness of stretch marks was significantly increased in the TLE group after 4 weeks of treatment, and this improved effect was maintained until the end of the study. Dermal density and thickness were significantly increased in the TLE group compared to the placebo group. Furthermore, TLE restored the dermal condition of the stretch mark skin, up to normal skin levels. In addition, pro-collagen I and elastin concentrations were found to be higher in the TLE-treated stretch mark skin explants compared to the untreated ones, associated with higher quantities of TGF-β production.
CONCLUSIONS: These results revealed that TLE could help improve the aspect of stabilized stretch marks in women by restoring the matricial environment.

Striae distensae (SD) are cutaneous lesions that often occur on the breasts, abdomen, hips, and thighs. The aim of this study is to evaluate the effectiveness of a new technique using a non-invasive Er:YAG laser combined with Spatially Modulated Ablation (SMA) module for the treatment of SD.
This prospective pilot clinical study included 20 patients with skin phototypes I to IV who are affected by SD. The Er:YAG 2940 nm laser with SMA module was used in scanning mode with fluences of 2.3 J/cm2 , frequency of 3 Hz, and pulse duration of 0.3 milliseconds. The laser beam is split into several microspots and penetrates only by 50 μm in the epidermis thickness. This technology induces also the generation of acoustic waves to stimulate tissue regeneration. Each patient underwent six laser sessions. An objective and subjective assessment of SD were used. All adverse events were reported.
Most patients reported good improvement and expressed their satisfaction with the treatment. Cutometric analysis showed significant improvement in skin elasticity at the end of study. Moreover, ultrasound analysis revealed an increase in dermal thickness (P < 0.01). POSAS scores decreased significantly at 3 and 6 months, reflecting improved skin quality. The average recovery time was 5 days, with no adverse effects reported.
Using Er:YAG laser (2,940 nm) with SMA technology to treat SD resulted in improved volume and textural appearance without side effects. The elasticity and thickness of the dermis also improved. The Er:YAG laser with SMA module may be considered as a novel and effective technique to treat SD lesions with minimal time recovery. Lasers Surg. Med. 51:230-238, 2019. © 2018 Wiley Periodicals, Inc.

BACKGROUND: Striae gravidarum (stretch marks) are considered the most common connective tissue/skin change in pregnancy. Though not a health issue they can affect women in different ways, for example, cause stress or be an aesthetic or cosmetic concern. Many women use one or more of the commercially available products to try and prevent their development during pregnancy despite the fact that that there is a lack of high-quality evidence to support their use. There is a dearth of studies on the prevention of striae gravidarum and large, robust trials are lacking. Until such time as more products are investigated, much of the knowledge remains anecdotal. This pilot study will evaluate the feasibility of conducting a study to evaluate the effectiveness of a commercially available moisturising oil compared to no treatment for the prevention and reduction in severity of striae gravidarum.
METHODS: The definitive study will be a randomised controlled trial to evaluate the effectiveness of a moisturising oil (commercially available moisturising oil) compared to no treatment for the prevention and reduction in severity of striae gravidarum. This protocol is for a pilot randomised trial to evaluate the feasibility of conducting such a study. The pilot study will be a two-arm, unblinded, pragmatic parallel randomised trial with a 1:1 randomisation ratio between control and intervention groups. Women in the intervention group will be asked to apply a moisturising oil to their abdomen during pregnancy, while women in the control group will not use any treatment. It is proposed to recruit 20 primigravida, who are 12-16 weeks pregnant from an Irish Maternity Hospital, in each arm to assess the feasibility of running such a trial.
CONCLUSIONS: This pilot trial will evaluate the feasibility of conducting the main study to evaluate the effectiveness of a moisturising oil (commercially available moisturising oil) compared to no treatment for the prevention and reduction in severity of striae gravidarum. It will potentially initiate the generation of high-quality evidence to guide women in their choice of anti-stretch mark product.
BACKGROUND: ISRCTN Registry, ISRCTN76992326 . Registered on 14 July 2017.