RESUMO
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.