Fractional Photothermolysis For The Treatment Of Striae Distensae

BackgroundStriae Distensae (SD) is a type of atrophic scar that occurs in body areas with more tension. Finding a safe and efficient treatment is the main direction and purpose of this research.ObjectivesTo assess the efficacy of using FP for the treatment of SD, as well as to establish the optimum treatment parameters for Chinese while minimizing adverse reactions.Methods60 patients (43 female and 17 male) were enrolled in this study and randomized into 3 groups:control group, ActiveFX group and DeepFX group. Patients received approximately 1 to 3 treatments. Assessments and digital photo comparisons were performed by 3 other clinical dermatologist doctors before the first treatment, prior to each treatment and during each follow up visit. Treatment efficacy, adverse reactions, and patients-satisfactory assessments were also recorded. Patients were also examined with Reflectance confocal microscopy (RCM) at each visit. Biopsy was performed on 2 patients for staining and immunochemistry testing.ResultsAll 60 patients completed treatments and follow ups. Based on the assessment results, the t test comparisons in between groups indicated that the efficacy rate, skin roughness, satisfactory assessment, pigmentation, and pain assessment in the treatment groups had much better results than the control group (P<0.01). DeepFX showed great differences in the comparison of skin depth with the control group (P<0.01). When ActiveFX and DeepFX groups were compared for efficacy, it was indicated that there were great statistics significances for both skin roughness and skin depth (P<0.01). Different SD phenotypes indicated the differences between each type showed statistic significances (P<0.05), typeâ…  andâ…¥SD both showed good clinical improvement. Patients who received 3 treatments showed best prognosis results compared to those who received 1 and 2 treatments. Treatment groups showe greater pigmentation when compared to the control group (P<0.01). Pain assessment evaluation indicated that DeepFX treatment induced higher pain intensity than ActiveFX treatment. RCM indicated that a week after treatment, telangiectasia and edema were observed. After the inflammation has subsided, collagens were mesh-shape aligned. Histopathologic findings showed increase in epidermal thickness, telangiectasia and edema after the SD were treated. Collagenâ… and Collagenâ…¢showed positive results in immunochemistry staining after treatment.ConclusionsAt the end of all treatments, both treatment groups ActiveFX and DeepFX showed better results than the control group and the DeepFX group showed better overall results than ActiveFX group. FP treatment showed apparent clinical improvement with typeâ… and typeâ…¥SD. Patients who received 3 treatments showed best prognosis results. Both ActiveFX and DeepFX showed mild pigmentation and DeepFX treatment indicated higher pain intensity than ActiveFX treatment. FP can safely and effectively treat SD.