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Striae distensae (SD) are a common condition, which can appear differently across skin colors and for which effective treatments remain limited. SD have several risk factors, including pregnancy, obesity, growth spurts, and several pathologic conditions. Few studies have examined whether there are skin color differences regarding SD in their clinical presentation, risk factors, and associated comorbidities. To evaluate the clinical features, risk factors, and associated comorbidities of SD among Black and White women. This was a two-part study involving a telephone questionnaire followed by an in-person clinical assessment with standardized photographs. One hundred forty-three women (75 Black, 68 White) completed the survey, and 66 women (33 Black, 33 White) completed the in-person clinical assessment. Black and White women in the study were found to be similar in age, SD duration, parity, pregnancy-associated weight gain, and family history. Black women, on average, had a greater number of SD than White women (118 versus 76, p  = 0.01). Striae were typically white and skin-colored among Black women, but white and violaceous among White women ( p  = 0.02). Black women were more likely to have involvement of the lower legs ( p  = 0.04), axilla ( p  = 0.05), and buttocks ( p  = 0.002) than White women. Compared to Black women, urinary incontinence was more commonly reported among White women, though this did not reach statistical significance ( p  = 0.07). There was a significant association between smoking and SD in White women ( p  = 0.003), but not in Black women. Additionally, Black women were more likely to use creams to diminish the appearance of their striae. While the etiology, prevalence, and risk factors of SD may be similar between Black and White women, there may be important skin color differences in SD clinical features and medical comorbidities. Larger studies are needed to further characterize the relationship between SD and medical comorbidities such as urinary incontinence and pelvic floor dysfunction. The study of this relationship may advance understanding of SD pathogenesis and provide pathways for targeted therapies. More studies are needed to determine the role of SD evaluation as a screening tool to help predict the risk of the development of pelvic floor dysfunction.

Introduction 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). This study investigates the synergistic effect of nanofat and platelet-rich plasma (PRP) injections on collagen production in fibroblasts derived from SA (SAF). Material and Methods A prospective, randomized single-blind study was conducted in fifty women presenting with SA in the abdominal region who had voluntarily sought a conventional abdominoplasty procedure and accepted to test an autologous treatment for their SDs. SA were treated using: PrP 10 ml; PrP 2ml (20%) + nanofat 8ml (80%); nanofat 10ml. Following the abdominal dermolipectomy, biopsies from treated and untreated SDs were taken and analyzed for type I collagen quantification. Results were processed through statistical analysis models using the Student’s t test. Results Collagen concentration in untreated SA biopsies was significantly lower than in healthy skin. Both PRP and nanofat treatments significantly increased collagen biosynthesis compared to controls, with the combined PRP-nanofat treatment showing the highest increase in collagen levels ( p  < 0.0001). A superior clinical improvement was observed in the areas that received the combined treatment of PRP and nanofat ( p   =  0.001). Conclusion Our findings indicate that both PRP and nanofat treatments effectively enhance collagen production in SA, with the combined PRP-nanofat treatment showing a synergistic effect. This combined therapy holds promise for effectively treating SA, providing a new potential treatment avenue for SMs and similar skin conditions. Further studies are needed to validate these results and explore clinical applications. Level of Evidence I 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 .

Striae distensae (SD), commonly known as stretch marks, are a common dermatological condition with challenging therapeutic interventions and varying outcomes. The current study aims to compare the clinical response, efficacy, side effects, and safety of microneedling (MN) with autologous platelet-rich fibrin (PRF) versus MN with autologous platelet-rich plasma (PRP) in treating abdominal stretch marks. Thirty patients (27 females and 3 males) with bilateral abdominal SD were underwent both MN with PRP and MN with PRF in a randomized split-abdomen design, with session performed every month for a total of three sessions. Clinical efficacy was assessed by two independent dermatologists using the Davey score, the Global Aesthetic Improvement Scale (GAIS), measurement of the width of widest striae, and patient satisfaction score. Blinded evaluation was conducted by comparing pre- and post-treatment photographs. 3-mm punch biopsy specimens were taken from the same lesion sites pre-treatment and one month after the last session and were stained by hematoxylin and eosin (H&E) to subjectively assess histopathological changes and treatment efficacy. Both treatment modalities induced significant clinical improvement with PRF sides demonstrating superior results. However, when comparing both methods, no statistically significant difference was observed between them regarding Davey score, width of the widest striae, GAIS, and patient satisfaction. In conclusion: The combination of MN with PRF appears to be a promising therapeutic modality with better patient satisfaction compared to MN with PRP in the treatment of SD. Moreover, PRF is inexpensive, simple to produce and is made naturally without the need of biochemical additives.

Striae distensae (SD) are visible linear scars developing in areas of dermal damage. Insulin is a peptide hormone that can potentially help restore the integrity of damaged skin and promote the reformation of granulation tissue. Hyaluronic Acid is commonly used in aesthetic medicine. To evaluate the clinical response and efficacy of microneedling and topical insulin against microneedling and topical hyaluronic acid in treating stretch marks. The study was conducted on 30 patients suffering from striae distensae in the abdomen. The patients were treated by microneedling followed by hyaluronic acid on the right side. The second group was treated by microneedling followed by topical insulin on the left side of the abdomen. At the end of the study the improvement with hyaluronic acid was 23.3% of patients with excellent improvement and 30.0% of patients with marked improvement. The improvement with topical insulin was 30.0% of patients with excellent improvement and 20.0% of patients with marked improvement. Microneedling followed by hyaluronic acid or topical insulin can be an effective and safe therapeutic option for the treatment of Stretch marks with no significant side effects.

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. Discussion 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. Trial registration ISRCTN Registry, ISRCTN76992326 . Registered on 14 July 2017.

Introduction and Hypothesis The high prevalence of pelvic organ prolapse (POP) and related complications shows the necessity of early identification of risk factors. It is considered that striae and POP share a similar physiopathology. However, the link between the two is still inconclusive and requires further investigation. We conducted this study to evaluate the association between striae and POP. Methods Databases such as PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched to find relevant literature from inception up to May 2023. Full-text articles published in English or other languages and observational studies were included. The statistical analysis was performed using STATA 14.2. The random effects model was performed and heterogeneity was ≥ 50%. Statistical tools such as the Chi-squared test and the I 2 index were used to calculate the level of heterogeneity among studies. Additionally, we utilized Funnel plots and Egger tests to assess the presence of publication bias. Results Seven studies were selected for meta-analysis, yielding a total of 605 patients and 660 control subjects, to assess the link between striae and POP. The overall pooled odds ratio (OR) was 2.08 (95% confidence interval 1.04–4.19, I 2  = 80.40%). Our analysis revealed a strong relationship between POP and striae ( p  < 0.001). Conclusions This study recommends that stretch marks may be used as a helpful indicator of the risk for POP. Evaluation of striae as a risk factor and screening tool for detecting women at risk for the development of POP should be addressed in future well-designed studies. However, there is a need for high-quality studies in this field owing to the low quality of evidence.

Background Despite numerous treatment modalities for striae distensae (SD), a definitive gold standard therapy remains unidentified. Aims This study aims to evaluate and compare the efficacy of injectable poly‐L‐lactic acid (PLLA) with a 1565‐nm non‐ablative fractional laser (NAFL) in treating SD located in the abdominal area. Methods 40 women with SD were randomly assigned to one of four treatment groups: (1) control, (2) PLLA, (3) 1565‐nm NAFL, and (4) a combination of PLLA and 1565‐nm NAFL. Participants, except those in the control group, underwent three treatment sessions at monthly intervals. Antera 3D imaging was used to collect data at baseline (T0) and 3 months post‐treatment (T4). Collagen fibers were analyzed via immunohistochemical staining, while elastic fibers were assessed using picrosirius red and Masson staining at both T0 and T4. Results The overall efficacy scores for the PLLA, 1565‐nm NAFL, and PLLA + 1565‐nm NAFL groups were 5.70 ± 1.25, 3.60 ± 2.12, and 6.70 ± 2.21, respectively. Post‐treatment evaluations demonstrated substantial decreases in SD volume from T0 to T4, with reductions of −1.96 ± 1.53 in the PLLA group, −0.70 ± 0.67 in the 1565‐nm NAFL group, and −1.48 ± 1.35 in the PLLA + 1565‐nm NAFL group. The combined and PLLA groups exhibited significant reductions in area compared to the 1565‐nm NAFL and control groups. Histological analysis confirmed the presence of PLLA particles in the treated area without inflammatory reactions 1 month post‐final injection. Conclusions PLLA injections are more effective than 1565‐nm NAFL in SD treatment, enhancing collagen production without inducing inflammation in treated skin. Trial Registration Clinicaltrials.gov: NCT05827913

Striae alba, as an unsettling skin complication, has the potential to threaten the physical appearance and psychological health of individuals. So far, dermatologists’ endeavors have been futile in finding an ideal treatment. This study evaluated microneedling as a novel treatment modality for striae alba scars. Microneedling was implemented in 1–3 sessions in 2-week intervals among patients with striae alba lesions. The lesions were photographed before and 3 months after the treatment, while all side effects were recorded. Two non-involved dermatologists and a patient self-report based on a visual analog score scale were utilized to evaluate the clinical improvement of striae scars. The complication rate among the 32 patients was 25%, which consisted of seven (21.9%) cases of post-inflammatory hyperpigmentation and one case (3.1%) of skin infection. The average improvement score among the patients in our study based on their self-report was 5.3 ± 1.3. (Range 4–8), while based on physician evaluation was 5.6 ± 1.2 (range 3.5–8). There was a significant association between lower age and higher self-report scores. Also, the improvement of lesions was more significant in skin type 3 compared to 2, based on physician assessment. In this study, MN was effective in ameliorating SA scars and was observed to induce better clinical satisfaction in younger patients and breast lesions. The studies concerning the use of MN in treating SA have yielded much attention lately, and they have denoted the relatively low cost of MN, its capability to be utilized over vast treatment areas, and its safety in that regard. Further research regarding the comparison of MN’s efficacy in solo use versus implementing it as an adjuvant modality should be carried out.

Background Striae distensae is a disfiguring atrophic skin condition that impairs the body’s aesthetic image. Despite the variety of conducted studies, there is controversy regarding the best modalities. Human mesenchymal stem cells are considered a rich source for scar treatment. Skin needling is among the most efficient and safe aesthetic and therapeutic devices. This study aimed to evaluate the efficacy of the combination of needling and intradermal injection of mesenchymal stem cells compared to skin needling alone for treating striae distensae. Method This study was a randomized, double-blind clinical trial involving 10 women aged 18–60. Each striae lesion was divided into two parts, with one side receiving needling and intradermal injection of conditioned medium, while the other side received needling and intradermal injection of normal saline. This treatment was administered in three sessions with three-week intervals. Patients were evaluated before the first intervention and three months after the final session. Three months after the completion of the intervention, patients’ lesions were evaluated using biometric criteria, physician evaluation, and patient self-assessment. Results The results demonstrated a significant improvement in dermal and complete thickness and skin density in patients treated with microneedling. All skin ultrasound parameters improved significantly in patients receiving the combination of needling and conditioned medium. When comparing the two groups, significantly higher physician and patient satisfaction was observed in the combination group. However, the comparison of biometric indices improvement wasn’t significant between these groups. Conclusion The combination of human mesenchymal stem cells with microneedling could be considered a novel effective option for stretch marks.

The development of striae gravidarum (SG), stretch marks, is one of the most common skin changes during pregnancy. The number of studies conducted on the reduction or prevention of SG, especially on the effects of olive oil, is limited. The study intended to evaluate the clinical efficacy of olive oil in reducing the severity and preventing the progression of SG when used from the third trimester of pregnancy to the child's birth. The study was designed as a randomized controlled trial. The data was collected at the private Medipol Nisa Hospital. The trial registry number is NCT04489901. Participants were 156 Turkish women having their first pregnancies and in their third trimester. Participants were randomly assigned to either the intervention or the control group. Women in the intervention group applied olive oil to their abdomens twice a day, in the morning and evening. The control group used no intervention. The participants' striae levels were assessed using the Fitzpatrick Skin Type Scale and Davey's Severity Score. A statistically significant difference existed between the intervention and the control groups in terms of incidence and type of striae gravidarum, with the intervention group having a 50% incidence and 85.9% type 2 striae compared to the control group's 69.2% incidence and 35.9% type 4 striae. According to Davey's Severity Score, the severity of striae was significantly lower in the intervention group compared to the control group, with the scores being 2 and 4, respectively. Using olive oil was very effective in reducing the severity and preventing the progression of striae gravidarum.