Risk Factors and associations with acquiring

striae distensae

Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9 th ed). New York: McGraw-Hill Education. p1197
Ud-Din S, McGeorge D, Bayat A. (2016). Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae, Journal of the European Academy of Dermatology and
Venereology, 30, 211–222.
The Form of Striae Distensae

Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9 th ed). New York: McGraw-Hill Education. p1197
Ud-Din S, McGeorge D, Bayat A. (2016). Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae, Journal of the European Academy of Dermatology and
Venereology, 30, 211–222.
Distribution / clinical Feature

Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9th ed). New York: McGraw-Hill Education. p1197
Trozak, D.J. Tennenhouse, and J.J. Russell. Current Clinical Practice: Dermatology Skills for Primary Care: An Illustrated Guide. 2006. P 223-9
Treatment
Early stage striae

Combination of
Combination of
Tretinoin 0,1% 10% L-ascorbic
0.05% tretinoin + Procedure
cream acid+20%
20% glycolic acid
glycolic acid.3

S. Alba : ractionated
S.Rubra : 585-nm
Aim of treatments: microneedle
pulsed-dye laser
radiofrequency in
Increase collagen production combination with frac-
Reduce erythema (vascularity) tional carbon dioxide
laser.
 in striae rubra
Increase pigmentation (melanin)
 in striae alba
Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9th ed). New York: McGraw-Hill Education. p1197
MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Treatment – summarizing the studies available for topical treatment for striae distensae

James R.T, Elston D.M ,James W.D, et al. (2019). Andrews Diseases of the Skin Clinical Dermatology-Elsevier. p512-3
Ud-Din S, McGeorge D, Bayat A. (2016). Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae, Journal of the European Academy of Dermatology and Venereology, 30, 211–222.
 Pulsed Dye Laser Treatment

Every 4-6 Discontinued Skin Type

1 line
st weeks, pulse NO evidence of IV-VI (avoid)
Striae Rubra duration 6-10 response after 3 Dyspigment
ms treatment
ation

Improve Side Effect

erythema and
Continue Purpura, Skin Type
exert beneficial until progressive
PIH, IV-VI Treat
effects on dermal improvement
collagen cases Blistering, with
Scarring Microneedling

James R.T, Elston D.M ,James W.D, et al. (2019). Andrews Diseases of the Skin Clinical Dermatology-Elsevier. p512-3
Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9th ed). New York: McGraw-Hill Education. p1197
MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Topical Tretinoin Treatment

If the skin Irritated

Stimulate Change to tretinoin 0.05%
Continue
Collagen Until satisfactory response
emollient cream, tretinoin
0.05% lotion, adapalene 0.1%
Synthesis gel or cream, or adapalene
0.3% gel

Tretinoin 0,1% Discontinue

cream Once No Improvement after 3-6
month
nightly
Not Recommended
During Pregnancy
See the Side Effect
improvement Erythema, Scaling, PIH
(in skin type IV-VI)
in 1-2 month
James R.T, Elston D.M ,James W.D, et al. (2019). Andrews Diseases of the Skin Clinical Dermatology-Elsevier. p512-3
Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9th ed). New York: McGraw-Hill Education. p1197
MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Fractional Lasers Treatment

Fractional Lasers
Improvements in dyspigmentation and the texture of
skin

Nonablative Ablative

Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9th ed). New York: McGraw-Hill Education. p1197
MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Nonablative Fractional Lasers Treatment

For skin type

1550 nm Comfort by: IV-VI
Once Topical ↓ Energy &
monthly (3- anesthesia density
6month) & air cooling setting

Clinical
Erythema,
improve- Sun
edema,
ment 3-6 protective –
rough
month after ↓dyspig-
desquama-
last mentation
tion, PIH
treatment

MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Ablative Fractional Lasers Treatment

10,600 nm fractional Comfort by:

Skin type IV-VI
CO2 lasers Topical anesthesia,
Controversial
Once at 4-6months systemic narcotic pain

Complication Nonfacial site

Prolonged erythema, Serosanguineous 1-3 treatment is sufficient
infection, PIH, and discharge & crusting;
scarring desquamation; Erythema

MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Radiofrequency Microneedling Treatment

Clinical
Once at 4+ improvement
Neo-
weeks, 3-6 Few weeks
collagenesis sessions after last
treatment

Adverse effect
Min. Pain, erythema,
Combine
Epidermal edena, crusting,
injury RF energy
bruising, pinpoint
bleeding.

MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
Treatment – summarizing the studies available for
procedural treatment for striae distensae

Lokhande AJ, Mysore V. Striae distensae treatment review and update. Indian Dermatology Online J 2019;10:380-95
Treatment – summarizing the studies available for
procedural treatment for striae distensae

Lokhande AJ, Mysore V. Striae distensae treatment review and update. Indian Dermatol Online J 2019;10:380-95
Treatment – summarizing the studies available for
procedural treatment for striae distensae

Lokhande AJ, Mysore V. Striae distensae treatment review and update. Indian Dermatol Online J 2019;10:380-95
,
Combined microneedling with topical application of platelet-rich
plasma versus microneedling alone in the treatment of stria distensae:
clinicopathological analysis

the use of (MN) before (PRP) 40 Patient

application - for deeper
penetration and therefore, Group 1 – MN
augment the efficacy Group 2 – MN+PRP

Conclusion: Result:
MN-PRP MN-PRP
Excellent improvement
The combined MN-PRP is more
Collagen & elastic fibers
effective than MN alone for
Proliferative activity
the treatment of the lesions of
Caspase-3 protein expression
SD.
 Clinical
improvement of
STRIAE RUBRA
lesions following
combined
microneedling
with topical
application of
platelet-rich
plasma versus the
use of
microneedling
alone.
 Clinical
improvement of
STRIAE ALBA
lesions following
combined
microneedling
with topical
application of
platelet-rich
plasma versus the
use of
microneedling
alone.
Therapeutic targets in the management of striae distensae: A
systematic review

The method is to review of
evaluate and summarize the different the literature was
treatment methods for striae distensae performed with no limits
placed on publication date.
Conclusion:
Result:
Further randomized,
The majority of treatments controlled trials;
aim to increase collagen
production; reduce focus on creating
erythema in SR; increasing standardized outcome
melanin in SA measures and treatment
protocols
Hague A, Bayat A. (2017). Therapeutic targets in the management of striae distensae: A systematic review, Journal of the American Academy of Dermatology, 77:559-68.
Hague A, Bayat A. (2017). Therapeutic targets in the management of striae distensae: A systematic review, Journal of the American Academy of Dermatology, 77:559-68.
 References
• Kang S, Amagai M, Bruckner AL, et al. (2019). Fitzpatrick’s dermatology (9 th ed). New York: McGraw-Hill Education.
• Hirt P.A, Castilo D.E, et al. (2019). Skin change in obese patient. Journal of the American Academy of Dermatology. 1037-57
• Ud-Din S, McGeorge D, Bayat A. (2016). Topical management of striae distensae (stretch marks): prevention and therapy of striae
rubrae and albae, Journal of the European Academy of Dermatology and Venereology, 30, 211–222.
• Atwal GS, Manku LK, Griffiths CE et al. Striae gravidarum in primiparae. Br J Dermatol 2006; 155: 965–969. British Journal of Medical
Practitioners, September 2016, Volume 9, 913-9
• Trozak, D.J. Tennenhouse, and J.J. Russell. Current Clinical Practice: Dermatology Skills for Primary Care: An Illustrated Guide. 2006.
P 223-9
• MacGregor JL, Wesley NO. (2019). Striae distensae (stretch marks). Uptodate.
• James R.T, Elston D.M ,James W.D, et al. (2019). Andrews Diseases of the Skin Clinical Dermatology-Elsevier. p512-3
• Al-Himdani, S., Ud-Din, S., Gilmore, S., & Bayat, A. (2014). Striae distensae: a comprehensive review and evidence-based evaluation
of prophylaxis and treatment. British Journal of Dermatology, 170(3),
• Hengge, U. R., Ruzicka, T., Schwartz, R. A., & Cork, M. J. (2006). Adverse effects of topical glucocorticosteroids. Journal of the
American Academy of Dermatology, 54(1), 1–15. doi:10.1016/j.jaad.2005.01.010 
• Amira A.M, Zedan H, Mostafa M.M, et al (2020) Combined microneedling with topical application of platelet-rich plasma versus
microneedling alone in the treatment of stria distensae: clinicopathological analysis, Journal of Dermatological Treatment, DOI: 
10.1080/09546634.2020.1782323
• Hague A, Bayat A. (2017). Therapeutic targets in the management of striae distensae: A systematic review, Journal of the American
Academy of Dermatology, 77:559-68.
THANK YOU