Efficacy of green tea ( Camellia sinensis Linn) 3% extract cream on improvement of striae distensae.

Background: Striae distensae (SD) is a skin condition that frequently causes dermatological consultations and although asymptomatic, it may can cause itch and burning sensation. Green tea extract contains polyphenol, including flavanol, flavandiol, flavonoid, phenolic acid, amino acids and minerals which play a role in the repair of stretch marks through anti-inflammatory mechanism, increase collagen production, fibroblast proliferation, and skin hydration. Objective: To determine the efficacy of green tea extract cream on striae distensae. Methods: This is a pre-experimental clinical trial with a pretest-posttest design on 36 subjects with striae distensae. Diagnosis establishes through history taking and clinical evaluation. Imam Nelva Alviera (INA) score was used as SD severity before and after the application of the 3% green tea extract cream carried out at weeks 0, 2, 4, 6, and 8. Side effects and subjects' satisfaction were also recorded. Cochran test was carried out to see the difference before and after treatment, with a p-value <0.05 considered significant. Results: Majority of study subjects were 18-25 years (77.8%), had history of pregnancy (75%), had a history of menarche at the age of 12 years (27.8%) and all subjects had striae alba. There was significant decrement in INA score for striae distensae (p<0.001) after eight weeks administration of 3% green tea extract cream. Clinical improvement and no side effects were also noted. All subjects were satisfied. Conclusions: The use of 3% green tea extract cream can improve the appearance of SD.

Split body comparative clinical and radiological study of fractional CO2 laser versus carboxytherapy in treatment of striae distensae.

Striae Distensae (SD) are quite common complaint in dermatology practice. They are linear lesions of variable length and width according to the site and the causative condition. Several treatment modalities have been tried. To achieve satisfactory results, a combination therapy is often needed. To evaluate the efficacy and safety of fractional CO2 laser versus carboxytherapy in the treatment of Striae Distensae clinically and radiologically. Thirty Egyptian patients with striae distensae, received a split body therapy: the left side was treated by fractional CO2 laser and the right side was treated by carboxytherapy in the same session. Six sessions were done with 4 weeks apart. Clinical evaluation by measurement of the width of widest striae on both sides, global aesthetic improvement scale (GAIS), and Likert satisfaction scale. Radiological evaluation by measurement of cutaneous thickness of widest striae on both sides by ultrasonography. There was a highly statistically significant decrease in the median width of the widest striae distensae on both sides after the last session (P < 0.01). Regarding GAIS, satisfaction scale and ultrasound, there was highly statistically significant improvement on laser side than carboxytherapy side (P < 0.01) after last session. Both fractional CO2 laser and carboxytherapy may be considered as safe and effective lines of treatment for striae distensae, but fractional CO2 laser showed excellent improvement clinically, radiologically when compared with carboxytherapy which made it a promising module in treatment of striae distensae.

Carboxytherapy in dermatology: A systematic review.

INTRODUCTION: The overall effects of Carboxytherapy, defined as the administration of carbon dioxide, have been studied for many years. It has been suggested that by improving oxygenation, interacting with the tissue perfusion regulators, and disrupting the adipose cell membranes, the method can lead to notable improvements in different esthetic and pathological conditions. Therefore, we aimed to systematically review the available studies evaluating the potential benefits of carboxytherapy in dermatological conditions and how it objectively stands against scientific scrutiny. METHODS: We searched the PubMed, Scopus, Embase, and Web of Science databases, including the studies exploring the method's efficacy in managing any dermatological condition. RESULTS: A total 27 of studies were identified (with a pooled sample of over 700 cases), most of which were clinical trials. Facial wrinkles, periorbital hyperpigmentation, skin laxity deficiency, scars, striae distensae, localized lipolysis and cellulite, alopecia, chronic diabetic wounds, and psoriatic plaques comprised the package of the dermatological conditions that were studied. Except for a few studies, the method mainly demonstrated significant improvements on all of the mentioned conditions. The inter- and post-operational adverse events were mild and transient, including erythema, pain, crepitus, and ecchymoses. DISCUSSION: Carboxytherapy can provide those practicing in the field with sustainably favorable results. However, the numbers of cases on whom the fat-reducing capabilities of the method were studied and experienced varying degrees of recurrence caught our eye. In addition, we observed a notable disparity between the outcome measures utilized in the studies. The modest sample size in each condition also added to the injury, as the conditions on which the method was evaluated are pretty common in the general population. Therefore, for a definite conclusion, more randomized controlled trials with the shortcomings mentioned well addressed need to be conducted.

Topical oil formulation of plant extracts and vitamins as effective treatment for stretch marks and xerosis-An observational longitudinal study.

BACKGROUND: Stretch marks are linear scars that result from elastic fiber destruction. They usually occur as the consequence of rapid change in the body mass (weight gain and loss, pregnancy, weightlifting), long-term steroid use, or endocrinopathies. Treatment is challenging and mainly based on topical and procedural therapies, although the standard of care is still under debate. PURPOSE: To evaluate the efficacy and tolerance of a topical oil formulation of plant extracts and vitamins on the aesthetic improvement of stretch marks and xerosis. MATERIALS AND METHODS: Fifty male and female patients, aged between 14 and 45 years, with stretch marks referring at the University Hospital Federico II, Naples, were enrolled between March and November 2019. Topical application of plant extracts and vitamin-rich oil was performed twice daily on affected skin for 4 months. Patients were monitored at baseline (T0), and at two-month (T1) and 4-month (T2) follow-ups, through clinical and dermoscopic assessment, confocal microscopy, cutaneous ultrasound, MoistureMeterEpiD, and X-Rite spectrocolorimeter. Primary endpoints were as follows: 70% clinical improvement of stretch marks and 3-point decrease in clinical score from baseline to T2. Secondary endpoints were as follows: change in the T0 parallel pattern of collagen fibers at confocal microscopy, cutaneous thickness increase at ultrasounds, cutaneous hydration increase at MoistureMeterEpiD, erythema reduction at X-Rite spectrocolorimeter, and safety and adverse events (AEs). RESULTS: At 4-month follow-up, stretch marks improved objectively and subjectively in all patients (p < 0.001). In detail, there was a 29% and 71% improvement in clinical appearance of stretch marks at T1 and T2, respectively, as documented dermoscopically and by the 3-point reduction in the assessor's mean clinical score at each follow-up visits [from 8.1±0.7 at baseline to 5.7±1.0 at T1 and 2.3 ±0.5 at T2 (p < 0.001)]. Erythema decreased by 15% and 30% and in parallel hydration increased by 25% and 71%, at T1 and T2, respectively (p < 0.001). At T2 confocal microscopy of stretch marks, dermal collagenous fibers assumed casual disposition with reticular pattern and refractivity, as signs of collagen remodeling and neocollagenesis, and also the T2 cutaneous ultrasound revealed increased epidermal thickness and decreased dermal hypoechogenicity as for a higher skin hydration. CONCLUSION: Our study showed that a topical oil formulation rich in plant extracts and vitamins appears to be effective and safe in treating stretch marks and xerosis.

Striae Distensae: In Vitro Study and Assessment of Combined Treatment With Sodium Ascorbate and Platelet-Rich Plasma on Fibroblasts.

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). Fibroblasts seem to play a key role in the pathogenesis of stretch marks. This study was aimed at describing and analyzing stretch marks-derived fibroblasts (SMF), the differences between SR- and SA-derived fibroblasts (SRF, SAF), testing two treatments in vitro (sodium ascorbate and PrP) on SAF. MATERIAL AND METHODS: To characterize the SMF, the expression of alpha smooth muscle actin (alpha SMA) was investigated. Type I collagen expression was measured in SAF, before and after adding different PrP concentrations and sodium ascorbate in the culture medium. Results were processed through statistical analysis models using the Student's t-test. RESULTS: A significant increase in alpha SMA (P <0.001) was observed in SRF. SAF treated with PrP and sodium ascorbate showed a resumption of their metabolic activity by an increase in collagen type I production and cell proliferation. After 24 h of incubation with PrP 1% and PrP 5% + sodium ascorbate, cell viability was increased by 140% and 151% and by 156 and 178% after 48 h, respectively, compared to the control. CONCLUSION: Our study shows that a biologically mediated improvement in SMF metabolic activity is possible. Our promising results require further trials to be able to confirm the reproducibility of this combined treatment, particularly in vivo. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable.

Carboxytherapy for striae distensae: A promising modality.

BACKGROUND: Striae distensae (SD) is a very common skin problem. Although a lot of treatment modalities have been proposed, few of them are effective. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many indications of cosmetic dermatology such as SD. OBJECTIVES: To objectively evaluate the use and effectiveness of CDT for treatment of SD. PATIENTS AND METHODS: Twenty patients were subjected to 8 sessions of CDT injection at 2-week intervals using carboxy-gun. Patients were photographed, and skin specimens were obtained from the treated area before and after 4 months of treatment. Using a computerized 3D camera, skin topography was objectively analyzed before and after treatment. Evaluation of collagen and elastic fibers by special histopathological staining, in addition to histometric analysis, was also done to evaluate treatment efficacy. RESULTS: Clinically, SD was statistically significantly improved after CDT injection compared with baseline (mean percentage of improvement of length and width, 59.8 ± 15.9; P < .05). Meanwhile, the improvement observed by the 3D camera correlated with the clinical improvement. Histometric analysis showed an increase in epidermal thickness (P < .0001) in association with re-appearance of rete ridges following treatment. Histochemical evaluation of changes in elastic and collagen fibers after treatment showed better organization of curled and fragmented elastic fibers, which was accompanied by an increase in collagen content that became denser, arranged in bundles and parallel to the epidermis. CONCLUSIONS: CDT is an effective, promising, and simple minimally invasive procedure for improving SD with few side effects and low downtime.

Postpartum stretchmarks: repairing activity of an oral Centella asiatica supplementation (Centellicum®).

BACKGROUND: This registry study evaluates the effects of oral Centellicum®, a new preparation of Centella asiatica (CA) on cutaneous stretchmarks (SMs) on the lower abdominal wall in comparison with the topical treatment with a specific antistretch cream. This cream is used for pregnancy SMs. The aim of the management was to give back to the structurally damaged skin areas (apparent as SMs) a normal elasticity and resistance and improving the local microcirculation. METHODS: We selected 78 healthy women with SMs at least 6 months postpartum available to follow the registry plan. The subjects were evaluated in three treatment groups: Clarins, stretch mark minimizer, the hydrating control cream and Centellicum® 3X225 mg/day for 6 weeks. RESULTS: The three registry groups of otherwise healthy subjects were comparable at inclusion and 6 weeks: 25 women used the SMs cream 1 (mean age 34.4;3.2); 28 control women (age 35.2;2) used the hydrating control cream. The third group (25 women; mean age 35.3;1.5) used the hydrating control cream and oral Centellicum® as a supplementary management. Standard management was used in all groups. As for the safety issue, no allergy, no side effects and no tolerability problems were observed. The compliance was very good and there were no drop outs. No other drug or treatment was used during the registry period. Skin thickness (ultrasound, measuring at the edge of at the largest visible stretchmark) increased significantly more at 6 weeks with Centellicum® in comparison with both controls (P<0.05). Skin thickness at the center of the SM (skin was less dense at this level) was also increased more with the supplement in comparison with the other managements (P<0.05). The grey scale median improved more (increased) with Centellicum at 6 weeks (P<0.05). The skin included more collagen components and become whiter or denser at ultrasound. Skin perfusion measured by laser Doppler showed a higher improvement with Centellicum® (P<0.05). Skin temperature, considered a function of nutritional and thermoregulatory dermal perfusion, improved more with the supplement (P<0.05). Elasticity (measured by elastosonography) was improved more with the supplement (P<0.05). The subjective evaluation with an analogue score resulted better (the SMs were less visible and the score decreased) with Centellicum® (P<0.05). The number of visible SMs was decreased more with Centellicum® (P<0.05). CONCLUSIONS: Oral supplementation with Centellicum® appears to improve SMs in a relatively short period of time. Larger studies are needed to evaluate the protective and repairing potentials of CA.

Is carboxytherapy a good alternative method in the removal of various skin defects?

Carbon dioxide is a physiologic compound present in our body, mainly as a result of cellular metabolism. The frequency of carboxytherapy use by dermatologists and cosmetologists increased significantly in the second half of the 20th century due to the fact that it improves blood circulation within skin tissues. This article focuses on the use of carboxytherapy in case of various skin problems, such as stretch marks, scars, loss of elasticity, redundancy of fatty tissue, cellulite, morphea, and alopecia. The review of sparse studies that are available indicate increasing interest in this method.

Molecular Docking for Prediction and Interpretation of Adverse Drug Reactions.

AIM AND OBJECTIVE: Adverse drug reactions (ADRs) present a major burden for patients and the healthcare industry. Various computational methods have been developed to predict ADRs for drug molecules. However, many of these methods require experimental or surveillance data and cannot be used when only structural information is available. MATERIALS AND METHODS: We collected 1,231 small molecule drugs and 600 human proteins and utilized molecular docking to generate binding features among them. We developed machine learning models that use these docking features to make predictions for 1,533 ADRs. RESULTS: These models obtain an overall area under the receiver operating characteristic curve (AUROC) of 0.843 and an overall area under the precision-recall curve (AUPR) of 0.395, outperforming seven structural fingerprint-based prediction models. Using the method, we predicted skin striae for fluticasone propionate, dermatitis acneiform for mometasone, and decreased libido for irinotecan, as demonstrations. Furthermore, we analyzed the top binding proteins associated with some of the ADRs, which can help to understand and/or generate hypotheses for underlying mechanisms of ADRs. CONCLUSION: Machine learning combined with molecular docking can help to predict ADRs for drug molecules and provide possible explanations for the ADR mechanisms.

Cutometric assessment of elasticity of skin with striae distensae following carboxytherapy.

OBJECTIVE: The aim of the study was to evaluate the effectiveness of carboxytherapy in the treatment of striae distensae. Additionally, discomfort and side effects associated with the treatment were assessed. MATERIALS AND METHODS: This study involved 15 women aged 22-40 years. They underwent 3 sessions of carboxytherapy at one-week intervals. Treatment was performed in skin area within stretch marks located on stomach, buttocks, and thighs. Cutometric probe was used to evaluate skin elasticity. Four measurements were performed-immediately before each treatment and one month after the last session. Photographic documentation was made before and after a series of treatment to perform clinical evaluation of changes in skin condition. RESULTS: Statistical analysis of results obtained with the use of Cutometer (R2 and R8 parameters) demonstrated that carboxytherapy significantly improved skin elasticity within stretch marks (P < .05). The analysis of photographic documentation revealed 58% improvement in stretch mark visibility. The width and length of stretch marks decreased, and their color became more like the natural color of the skin. Carboxytherapy is associated with moderate pain/discomfort. The occurrence of hematoma is the main side effect of this procedure. CONCLUSIONS: Carboxytherapy seems to be an effective method of reducing stretch marks. This procedure is safe, and it can be performed without the risk of complications. Moreover, it does not require special postoperative convalescence. Photographic documentation is a method of assessment of aesthetic procedures effectiveness, which is complementary to other objective methods (eg, the use of MPA probes).

The effect of Aloe vera gel and sweet almond oil on striae gravidarum in nulliparous women.

BACKGROUND AND OBJECTIVE: Striae are linear depressions of the skin and causes psychological and sexual problems in person. Different methods are used to prevent and treat them but there is no definitive method. We compared the effect of Aloe vera gel and sweet almond oil on striae gravidarum. MATERIALS AND METHODS: In this double-blind clinical trial, 160 nulliparous women were enrolled and randomly divided into three case groups and one control group. The four groups were given 700 g Aloe vera, sweet almond oil, and base cream to use topically on the abdominal skin and forth group don't receive any medication as control group in five steps, they were examined study's variables (itching, erythema, and spread of striae) using statistical tests in SPSS. RESULT: The findings showed that Aloe vera and sweet almond oil creams are more effective than the base cream and the control group to decrease itching and erythema and to prevent the spread of striae on the surface of abdomen (p < .05); however, all three creams had a similar effect on the diameter and the number of striae (p > .05). CONCLUSIONS: Aloe vera and sweet almond oil creams reduce the itching of striae and prevent their progression.

Improvement of skin condition in striae distensae: development, characterization and clinical efficacy of a cosmetic product containing Punica granatum seed oil and Croton lechleri resin extract.

Striae distensae are a frequent skin condition associated with pregnancy, weight change or lack of skin elasticity. The aim of this research was to obtain a topical product containing herbal active ingredients with documented antioxidant and anti-inflammatory activity (Punica granatum seed oil and Croton lechleri resin extract) and demonstrate its positive effect on prevention and treatment of striae distensae. First, the cream base formulation was optimized through experimental design. Secondly, the cream containing the two active ingredients was investigated in an interventional nonrandomized clinical trial. The clinical outcome was assessed through biophysical parameters and ultrasonographic evaluation. The state of the skin was evaluated by biophysical measurements and ultrasonography at the beginning of the study and after 3 and 6 weeks. The experimental design was successfully used to set the best ranges for the technological and formulation factors to obtain a cosmetic formulation with optimal characteristics. The study of clinical efficacy on the optimal formulation revealed an increase in the dermis thickness, hydration and elasticity values in both groups after 6 weeks of cream application. The new oil-in-water cream containing P. granatum seed oil and C. lechleri resin extract can be helpful in the prevention or improving of skin changes associated with striae.

The Comparative Study of Topical Therapy on Striae Alba between a Herbal Extract Cream and 0.1% Tretinoin Cream in Adolescence.

Background: Striae are commonly developed in adolescence as a result of active growth spurt. Although they create little physical health issue, they are cosmetic concerns to the patients. Effective striae treatment can help improve their mental health and personality. Objective: To compare the effects of a herbal extract cream and 0.1% tretinoin cream in the treatment of striae alba. Material and Method: Forty eight participants aged between 10 - 19 years old, with striae alba at their thighs were randomized into two groups. Each group was separately treated with 0.1% tretinoin and herbal extract for 16 weeks. The width, length and surface roughness of the lesions were assessed including histological evaluation and participants' satisfaction. Results: Thirty nine participants completed the study after 16 weeks. Compared to initial lesions, the striae width was reduced by 9.01% (p = 0.002) in tretinoin group and 13.09% (p<0.001) in herbal extract group. The length was reduced by 9.54% in tretinoin group (p<0.001) and 8.73% in herbal extract group (p<0.001). The surface roughness assessed by Visioscan VC98 was reduced by 13.70% in tretinoin group (p = 0.036) and 17.24% in herbal extract group (p<0.001). From H&E staining, the mean difference of epidermal thickness was 4.79±7.15 microns in tretinoin group and 14.22±16.98 microns in herbal extract group. The mean difference of collagen amount was 13.75±6.02 units in tretinoin group and 6.60±4.92 units in herbal extract group. From Masson trichrome staining, the mean difference of collagen amount was 6.75±3.50 units in tretinoin group and 12.20±7.73 units in herbal extract group. From Verhoff van Gieson staining, the mean difference of elastin amount was 2.25±3.30 units in tretinoin group and 5.40±4.16 units in herbal extract group. There was no statistical significant difference between two groups in histological evaluation. The herbal extract caused irritant contact dermatitis only 4.55% in contrast to 72.73% from the tretinoin group. Most participants from both groups had moderate to high satisfaction according to the efficacy of their treatments. Conclusion: The herbal extract cream is as effective as 0.1% tretinoin cream in the treatment of striae alba. As tretinoin can cause skin irritation, the herbal extract can be a better alternative treatment.

Estrías rojo vinosas / Red striae

No disponible

Ex vivo evaluation of the effect of photodynamic therapy on skin scars and striae distensae.

BACKGROUND: Skin scars and striae distensae (SD) are common dermal disorders with ill-defined treatment options. There is emerging clinical evidence for use of photodynamic therapy (PDT) in treating skin fibrosis. Therefore, the aim here was to investigate the effect of PDT on skin scars and SD in an ex vivo model of human skin scarring. METHODS: Photodynamic therapy, with 5ALA or MALA in addition to illumination with 40 J/cm(2) of red light, was applied to striae alba, fine line, hypertrophic and keloid scars ex vivo (n = 18). General morphology was assessed by H&E, Herovici's and Weigert's differential staining. Apoptosis, proliferation, metalloproteinase 3 and tropoelastin expression were quantified immunohistochemically, and differential gene expression of proliferating cell nuclear antigen (PCNA), collagen (COL) type I and type III, matrix metalloproteinase 3 (MMP3) and tropoelastin (ELN) was assessed by real-time quantitative reverse transcription polymerase chain reaction. RESULTS: Apoptosis increased, which correlated with decreased proliferation and PCNA gene expression. Post-PDT, matrix components were found to be re-organised in both hypertrophic and keloid scars. COLI and COLIII gene expression levels decreased, whilst MMP3 and ELN increased significantly post-PDT compared to normal skin and untreated controls (P < 0.05). However, no significant difference between 5ALA and MALA-PDT treatments was observed. CONCLUSION: Using our unique ex vivo model, we show for the first time morphological and cellular effect of application of PDT, which correlates with the degree and severity of dermal fibrosis. In view of this, PDT may be ideal in targeting treatment of abnormal skin scarring.

Interventions for the treatment of stretch marks: a systematic review.

Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments available, no consistently effective therapies have been established. In this systematic review, we evaluate 8 randomized controlled trials (RCTs) to assess the efficacy and safety of currently available therapies for the treatment of stretch marks. Due to the limited number of patients and high or unclear risk of bias in the studies included in this assessment, the evidence from this review is insufficient to provide clear guidelines for practice. Therefore, more high-quality RCTs are needed.

Sodium L-ascorbate enhances elastic fibers deposition by fibroblasts from normal and pathologic human skin.

BACKGROUND: Vitamin C (L-ascorbic acid), a known enhancer of collagen deposition, has also been identified as an inhibitor of elastogenesis. OBJECTIVE: Present studies explored whether and how the L-ascorbic acid derivative (+) sodium L-ascorbate (SA) would affect production of collagen and elastic fibers in cultures of fibroblasts derived from normal human skin and dermal fat, as well as in explants of normal human skin, stretch-marked skin and keloids. METHODS: Effects of SA on the extracellular matrix production were assessed quantitatively by PCR analyses, western blots, biochemical assay of insoluble elastin and by immuno-histochemistry. We also evaluated effects of SA on production of the reactive oxygen species (ROS) and phosphorylation of IGF-I and insulin receptors. RESULTS: SA, applied in 50-200 µM concentrations, stimulates production of both collagen and elastic fibers in all tested cultures. Moreover, combination of SA with a proline hydroxylase inhibitor induces a beneficial remodelling in explants of dermal scars, resulting in the inhibition of collagen deposition and induction of new elastogenesis. Importantly, we revealed that SA stimulates elastogenesis only after intracellular influx of non-oxidized ascorbate anions (facilitated by the sodium-dependent ascorbate transporter), that causes reduction of intracellular ROS, activation of c-Src tyrosine kinase and the enhancement of IGF-1-induced phosphorylation of the IGF-1 receptor that ultimately triggers elastogenic signalling pathway. CONCLUSION: Our results endorse the use of this potent stimulator of collagen and elastin production in the treatment of wrinkled and stretch-marked skin. They also encourage inclusion of SA into therapeutic combinations with collagenogenesis inhibitors to prevent formation of dermal scars and keloids.

The effect of olive oil and the Saj® cream in prevention of striae gravidarum: A randomized controlled clinical trial.

OBJECTIVE: To compare the clinical efficacy of olive oil and the Saj(®) cream on the occurrence and severity of striae gravidarum. DESIGN: Parallel randomized controlled clinical trial. SETTING: West Health Centre, Lolagar and Akbarabadi Hospitals, Tehran, Iran. INTERVENTIONS: 360 Nulliparous women at their second trimester of pregnancy randomly (simple randomization) allocated into three groups of olive oil, the Saj(®) cream, and control that finally 150 of them (50 subjects in each group) completed the study. Control group did not receive any medication/intervention. At gestational age of 38-40 weeks the participants were evaluated regarding the occurrence of striae on abdominal skin and its severity that were primary outcome of the study. RESULTS: In the olive oil group, striae occurred in 72% of the participants, which were mild, moderate, and severe in 32%, 26%, and 6% of the cases, respectively. In those who received Saj(®) cream, striae occurred in 64% of the cases, which were mild, moderate and severe in 16%, 34%, and 14% of the cases, respectively. With regard to the control group, striae occurred in 60% of the participants, among which striae were mild, moderate, and severe in 22%, 24%, and 14% of the cases, respectively. There were no statistically significant differences among the three studied groups regarding the incidence or severity of striae. CONCLUSION: Neither olive oil nor the Saj(®) cream were effective in preventing the occurrence of striae gravidarum or affecting its severity. Further studies to examine the effect of other herbal/chemical preparations on occurrence of striae gravidarum are recommended.

A double-blind controlled clinical trial assessing the effect of topical gels on striae distensae (stretch marks): a non-invasive imaging, morphological and immunohistochemical study.

Striae distensae (SD) are cutaneous lesions often presenting post-pregnancy with atrophy and flattening of the epidermis. SD is poorly understood and treatment remains ill-defined. Our aim was to assess the effect of topical application of silicone gel compared with placebo on SD using non-invasive devices and by immunohistochemical analysis of sequential tissue biopsies in a double-blind controlled trial. Twenty volunteers massaged silicone and placebo gels into separate sides of the abdomen, daily for 6 weeks. Objective non-invasive imaging plus subjective self-assessment of SD were performed on days 0, 21, 42, 90, in addition to tissue biopsies on days 0 and 42. Non-invasive imaging demonstrated an increase in melanin and a decrease in haemoglobin, collagen and pliability over the 6-week period on both sides. Additionally, collagen levels in SD were significantly higher (p value = 0.001) and melanin levels lower (p value = 0.048) with silicone gel compared with placebo. Histological analysis revealed epidermal flattening with a reduction of rete ridges in SD on both sides. Vascular count significantly decreased with placebo gel (p = 0.002). Corroborating the clinical results, melanin levels increased, whilst collagen type 1 and elastin decreased on both sides. Non-invasive techniques showed that the application of silicone gel increased collagen levels and reduced pigmentation compared with placebo. However, both clinical and histological data revealed that melanin increased whilst collagen, elastin and pliability decreased over the 6-week period with both gels. Furthermore, vascularity significantly decreased with placebo gel. These findings provide preliminary evidence of the utility of topical gels in the clinical management of SD.