Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO2 Fractional Laser: A Randomized Controlled Trial

Background: Striae distensae are atrophic dermal scars with overlying epidermal atrophy causing significant cosmetic concern. Although a variety of laser and light sources have been used for the treatment of striae distensae, to date no definite 'gold standard' treatment modality has been determined. Objective: To assess and compare the efficacy and safety of nonablative fractional photothermolysis and ablative CO2 fractional laser resurfacing in the treatment of striae distensae. Methods: Twenty-four ethnic South Korean patients with varying degrees of atrophic striae alba in the abdomen were enrolled in a randomized blind split study. The patients were treated with 1,550 nm fractional Er:Glass laser and ablative fractional CO2 laser resurfacing. Each half of the abdominal lesion was randomly selected and treated three times at intervals of 4-weeks using the same parameters. Digital photography was conducted and skin elasticity and the width of the widest striae in each subject were measured at the baseline and 4 weeks after the final treatment. Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs by two blinded physicians and participant satisfaction rates were evaluated. Skin biopsies were taken from three participants. All adverse effects were reported during the study. Results: Although they do not statistically differ, both treatments with nonablative fractional laser and ablative CO2 fractional laser showed a significant clinical and histopathologic improvement of striae distensae over pretreatment sites. Conclusion: These results support the use of nonablative fractional laser and ablative CO2 fractional laser as effective and safe treatment modalities for striae distensae of Asian skin. However, neither treatment showed any greater clinical improvement than the other treatment. (Ann Dermatol 23(4) 481 similar to 489, 2011)