A pilot study of treatment of striae distensae with variable square pulse Erbium: YAG laser resurfacing.

BACKGROUND: Striae distensae (SD) are a frequent skin condition for which treatment remains a challenge. Various laser treatments have been employed to remove the epidermis and cause dermal wound and heating with subsequent dermal collagen remodeling.

OBJECTIVE: To determine the efficacy and safety of a variable square pulse Erbium: YAG (VSP Er:YAG) laser for the treatment of striae in skin phototypes III-IV.

METHODS: Twenty-one women with SD were treated monthly for 2 months with VSP Er:YAG laser resurfacing using a 7-mm spot size. One side of their striae was randomly treated with one pass of 400 mJ in short pulse (SP) mode with 50% overlapping and one pass of 2.2 J/cm2 in smooth (SM) mode with nonoverlapping. The other side of their striae was treated with two passes of 400 mJ in SP mode with 50% overlapping. Objective and subjective assessments were obtained at baseline and 1-, 3-, and 6-month after treatment.

RESULTS: In both SP&SM and SP only group, volume of SD measured by Visioscan VC98 reduced significantly at 6-month follow-up visit (P=.017 and P=.034, respectively). There were no statistically significant differences in skin roughness (SER), skin smoothness (SESM), and surface measured by Visioscan VC98. Transient postinflammatory hyperpigmentation (PIH) is the common side effect found in patients with darker skin tone even in nonsun exposure areas and can last as long as 6 months.

CONCLUSIONS: VSP Er:YAG laser resurfacing is a promising treatment option for SD. Lower fluence should be used in patients with darker skin phototype to avoid the risk of PIH. In addition, pre- and post-treatment with topical preparations for PIH prevention may be needed.