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1.
Lasers Med Sci ; 34(7): 1295-1304, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31044363

RESUMO

Striae distensae (SD) cause a cosmetic problem to many patients. Recently, fractional micro-needle radiofrequency (FMR) device has been introduced in treatment of SD. Also, fractional CO2 laser has been used as a resurfacing laser technique in the treatment of SD. The aim of our study was to assess and compare between the efficacy of FMR and fractional CO2 laser in treatment of SD. Seventeen female patients with SD were enrolled in this study. Detailed history was taken and dermatological examination was done to determine the type of striae, the location, and measurement of the width of the largest striae on each side. In each patient, one side was randomly assigned to treatment by FMR (area A), and the other side to treatment by fractional CO2 laser (area B). Our results showed that both techniques were effective. A slight better efficacy was encountered with FMR, but the difference was not statistically significant (p = 0.716). The current study concluded that FMR and fractional CO2 laser are almost equally effective in the treatment of SD (rubra and alba). Development of post inflammatory hyper-pigmentation (PIH) was evident with fractional CO2 in contrast with FMR, and the difference was statistically significant (p = 0.001).


Assuntos
Lasers de Gás , Agulhas , Terapia por Radiofrequência , Estrias de Distensão/cirurgia , Adulto , Terapia Combinada , Feminino , Humanos , Satisfação do Paciente , Estrias de Distensão/terapia , Resultado do Tratamento
2.
Dermatol Surg ; 45(10): 1245-1252, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30893166

RESUMO

BACKGROUND: Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date. OBJECTIVE: To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum. MATERIALS AND METHODS: Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study. RESULTS: Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts. CONCLUSION: The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.


Assuntos
Ceratolíticos/administração & dosagem , Complicações na Gravidez/terapia , Terapia por Radiofrequência/métodos , Estrias de Distensão/terapia , Tretinoína/administração & dosagem , Adulto , Eritema/diagnóstico , Eritema/etiologia , Feminino , Humanos , Ceratolíticos/efeitos adversos , Pessoa de Meia-Idade , Dor/diagnóstico , Dor/etiologia , Medição da Dor , Satisfação do Paciente , Projetos Piloto , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Terapia por Radiofrequência/efeitos adversos , Terapia por Radiofrequência/instrumentação , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Creme para a Pele/administração & dosagem , Creme para a Pele/efeitos adversos , Estrias de Distensão/diagnóstico por imagem , Resultado do Tratamento , Tretinoína/efeitos adversos , Ultrassonografia
3.
Am J Clin Dermatol ; 20(2): 277-287, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30618025

RESUMO

BACKGROUND: Striae distensae (SD), an unsightly cutaneous condition characterized by epidermal atrophy, can affect the quality of life of women. OBJECTIVES: The aim of our study was to compare the efficacy of a neodymium:yttrium-aluminum-perovskite 1340 nm non-ablative fractional laser (NAFL) and the microneedling (MN) technique to treat striae alba (SA). MATERIALS AND METHODS: NAFL and MN were used to treat striae on the longitudinally divided abdominal surface of 20 women classified as Fitzpatrick skin type III or IV (five sessions at monthly intervals). Photographs and skin biopsies were obtained during pretreatment and after the third and fifth treatment sessions for all patients. Patients and two independent evaluators assessed the clinical response using the Global Aesthetic Improvement Scale. RESULTS: Patient-reported evaluation showed improvement of striae using both modalities, with no statistically significant difference between the groups. Collagen and elastic fibers were significantly increased (p < 0.01) after the third and fifth treatment sessions, with no significant difference between the modalities. In addition, Dermatology Life Quality Index scores showed significant improvement (p < 0.001) after the third and fifth treatment sessions compared with pretreatment values, with average values of 8.4 (standard error [SE] ± 1.21), 3.17 (SE ± 0.55), and 2.64 (SE ± 0.60), respectively. The mean pain score using the Visual Analog Scale in the MN group versus the NAFL group was 5.23 (SE ± 0.31) versus 2.39 (SE ± 0.22) [p < 0.001], and the mean duration of adverse events in the NAFL group versus the MN group was 4.03 days (SE ± 0.45) versus 3 days (SE ± 0.37) [p = 0.02]. CONCLUSION: NAFL and MN are safe for treating SD, particularly in individuals classified as phototype III or IV. MN is a useful non-technology-dependent, low-cost alternative therapy for SA. CLINICAL TRIAL REGISTRATION NUMBER: NCT03390439.


Assuntos
Técnicas Cosméticas , Lasers de Estado Sólido/uso terapêutico , Agulhas , Estrias de Distensão/terapia , Adulto , Biópsia , Colágeno/metabolismo , Feminino , Humanos , Qualidade de Vida , Estrias de Distensão/patologia , Resultado do Tratamento
4.
J Cosmet Laser Ther ; 21(5): 270-277, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30321078

RESUMO

Background: Fractional photothermolysis is creation of microscopic thermal zones of controlled depth, width and density. Microneedling is a simple treatment modality to reduce striae distensae. Objective: Evaluate and compare the efficacy of fractional carbon dioxide laser and microneedling as a treatment of striae distensae. Methods: Individuals with striae distensae received three split-body treatments at four-week intervals. The right side of the body was treated with fractional CO2 laser, while the other side with microneedling. Assessment was done by comparing photographs before and after treatments by two blinded physicians using a quartile grading scale. Evaluation also included patient satisfaction score and histopathological examination. Results: In total 33 subjects were enrolled and 30 completed the study. By quartile grading score, we recorded 55% moderate-excellent improvement of striae in the dermaroller-treated side but with fractional CO2 laser-treated side, we recorded 76% of patients had moderate-excellent improvement. Patients were more satisfied with fractional CO2 laser than the microneedling. Post-inflammatory hyperpigmentation, as a complication of fractional CO2 laser, appeared in 11 patients. Conclusion: Fractional CO2 laser is more effective in treating striae with acceptable side effects but still microneedling can be afforded as an effective, safe and cheap method.


Assuntos
Técnicas Cosméticas/instrumentação , Lasers de Gás/uso terapêutico , Agulhas , Estrias de Distensão/terapia , Administração Cutânea , Adulto , Feminino , Humanos , Masculino , Satisfação do Paciente , Resultado do Tratamento
5.
J Cosmet Laser Ther ; 21(1): 49-57, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29451986

RESUMO

Striae distensae (SD), otherwise known as "stretchmarks," are a common presenting complaint, particularly in young healthy women. SD are hypothesized to form in a patient when the cross-linked collagen is "overstretched" and rupture of this collagen matrix causes the striae. Thus, many treatments work by increasing collagen synthesis. This review critically appraises the evidence to date for the treatment of SD, including both energy-based devices and topical treatments.


Assuntos
Estrias de Distensão/terapia , Dermabrasão/métodos , Medicina Baseada em Evidências , Feminino , Humanos , Ceratolíticos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Fototerapia/métodos , Tretinoína/uso terapêutico
6.
J Cosmet Laser Ther ; 21(1): 39-43, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29547019

RESUMO

OBJECTIVE: To assess the effects of galvano-puncture (GG) and dermabrasion (DG) in reducing striae distensae in the gluteal region of women. METHODS: This randomized, controlled, single-blind clinical trial was conducted at the UNIFAL-MG. Participants were 48 female who had striae distensae alba in the gluteal region. They were randomly divided in GG; DG; and Control Group (CG). The length and width of the largest striae were measured (in millimeters) using a caliper. The same striae were assessed before and after treatment. Infrared thermography was performed in the gluteal region to assess local microcirculation. RESULTS: Intragroup analysis showed a significant reduction in the dimension of the striae between baseline and treatment session 10 in the GG and DG groups. Between-group analysis revealed a reduction in the width and length of the striae for both the GG and DG groups, but there were no significant differences between the two groups. When compared to the CG and the DG group, the GG group had significant improvements, as shown by thermography. CONCLUSION: Both GG and DG are effective in reducing striae length and width. However, only the thermography results showed significant differences between GG and control, and between GG and DG.


Assuntos
Técnicas Cosméticas , Dermabrasão/métodos , Punções/métodos , Estrias de Distensão/terapia , Adulto , Terapia Combinada , Dermabrasão/efeitos adversos , Feminino , Humanos , Microcirculação , Punções/efeitos adversos , Método Simples-Cego , Termografia , Adulto Jovem
7.
J Dermatolog Treat ; 30(3): 294-302, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30049244

RESUMO

BACKGROUND: Striae distensae are caused by rapid stretching of the skin. They are often secondary to obesity or pregnancy and can lead to significant cosmetic disfigurement. AIM: To determine the efficacy, indications, and side effects of commonly used energy devices in the treatment of striae. METHODS: A comprehensive literature search was performed using the PubMed and Medline databases. RESULTS: A total of 41 relevant articles were identified. Radiofrequency (RF) was the commonest employed modality (11 studies), followed by the CO2, and pulsed dye lasers (10 and 5 studies, respectively). The best results against striae alba were seen with a combination of RF, platelet-rich plasma and ultrasound (either excellent or very good results in 71.9%), followed by intense pulsed light in isolation (very good results in 40%). The response of SR was assessed by fewer studies. The best outcomes were seen after treatment with either the Nd:YAG (excellent results in 40% and good in 40%) or Er:Glass lasers (excellent results in 10% and good in 20%). CONCLUSIONS: The therapeutic measures for striae are multiple and no current treatment offers consistent and complete resolution. However, energy devices are a safe and potentially effective modality in the treatment of striae.


Assuntos
Terapia a Laser/métodos , Terapia por Radiofrequência/métodos , Estrias de Distensão/terapia , Terapia por Ultrassom/métodos , Terapia Combinada , Feminino , Humanos , Plasma Rico em Plaquetas , Pele/efeitos da radiação
8.
J Cosmet Laser Ther ; 21(4): 213-216, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30130428

RESUMO

Striae distensae or stretch marks are dermal scars characterized by flattening and atrophy of the epidermis. They develop particularly during adolescence but they can also appear in other situations such as pregnancy, the use of prolonged therapies with topical or systemic corticosteroids, Cushing's syndrome, Marfan's syndrome, prolonged use of lightening creams, cachexia, rapid weight loss or the use of androgenic and anabolic substances. Treatment options often take a long time, and the results are often disappointing, causing significant psychological distress in patients. We propose a completely innovative approach, combining the skinbooster technique with the microneedling technique. These minivasive methods work by inducing tissue remodeling and stimulating the synthesis of new collagen. Confocal microscopy can show and follow the skin changes made by these therapies, thus becoming an important and valid therapeutic monitoring tool for aesthetic dermatology.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Microscopia Confocal , Agulhas , Estrias de Distensão/terapia , Estética , Feminino , Humanos , Fotografação , Estrias de Distensão/patologia , Adulto Jovem
9.
J Cosmet Dermatol ; 18(3): 788-797, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29921041

RESUMO

BACKGROUND: Striae distensae are very common cutaneous disorders that produce great psychological stress for women. OBJECTIVE: measure and compare between efficacy and tolerability of three modalities for treatment of striae distensae. PATIENTS AND METHODS: Forty-five female patients with striae distensae were randomly selected from the outpatient dermatology clinics of Al-Zahra university Hospital within 6 months period. Patients divided into three groups according to the therapeutic modalities were used. Group A: treated with carboxytherapy using carbon dioxide (CO2) injection, Group B: where patients were treated with intradermal injection of autologous platelet-rich plasma (PRP), and Group C: where we used tripolar radiofrequency (RF) for treatment. RESULTS: All treated groups showed overall clinical improvement as regards the width, texture, and overall improvement after treatment (P > .05), with no statistically significant differences between the three groups. Patient's satisfaction was statistically significantly better in both group C (93.33%) and group A (80%) while group B (53.33%) was less with minimal side effects such as pain and ecchymosis, which were more frequent in group B than the other two groups; but with no statistically significance differences both groups A and C were effective with no significant differences in both types of striae and in any site of the body but group B is significantly more effective on striae rubra on trunk, with better improvement of lesions texture. CONCLUSION: The three modalities of treatments proved to be effective clinically and histopathologically in treating both types of striae, which were well tolerated by the patients with minimal, transient side effects and our study results gave us guidelines for their clinical application.


Assuntos
Dióxido de Carbono/administração & dosagem , Técnicas Cosméticas/efeitos adversos , Plasma Rico em Plaquetas , Terapia por Radiofrequência , Estrias de Distensão/terapia , Adulto , Dióxido de Carbono/efeitos adversos , Equimose/epidemiologia , Equimose/etiologia , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Dor/epidemiologia , Dor/etiologia , Satisfação do Paciente , Ondas de Rádio/efeitos adversos , Resultado do Tratamento , Adulto Jovem
10.
Harefuah ; 157(12): 787-790, 2018 Dec.
Artigo em Hebraico | MEDLINE | ID: mdl-30582313

RESUMO

INTRODUCTION: Striae gravidarum is the second most prevalent skin manifestation after skin pigmentation during pregnancy. Its etiology is uncertain, but it is assumed that changes in the structure of collagen, mediated by hormonal changes during pregnancy, are the causative factor. These marks normally appear during the third trimester of pregnancy and disappear several months after delivery. Striae gravidarum have no adverse health implications though they have negative psychological effects on the affected gravid women. Several treatments for this coetaneous affliction have been tested but only skin rubbing of almond oil as well as extracts from the Centella tree have proved to be of limited therapeutic value. Nevertheless, it has been proven that the mere application of various creams for this coetaneous problem during pregnancy is effective in improving the feeling of the users.


Assuntos
Complicações na Gravidez , Estrias de Distensão , Feminino , Humanos , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/terapia , Terceiro Trimestre da Gravidez , Prevalência , Pele , Estrias de Distensão/etiologia , Estrias de Distensão/terapia
11.
Rev. bras. cir. plást ; 33(4): 580-585, out.-dez. 2018.
Artigo em Inglês, Português | LILACS | ID: biblio-980166

RESUMO

Estrias de distensão são cicatrizes na derme que constrangem os pacientes e oferecem desafios ao tratamento clínico. Resultam do rápido estiramento da pele, frequentemente presente em adolescentes, gestantes, obesos e indivíduos com rápida mudança de peso. Apresentam-se inicialmente como placas eritematosas e edemaciadas (estrias rubras) e, conforme amadurecem, tornam-se esbranquiçadas e atróficas (estrias albas), devido à degradação e reorganização de fibras de elastina e de colágeno. Atualmente, lasers representam modalidade terapêutica não invasiva emergente, que já demonstrou sucesso na redução da vascularização excessiva das estrias rubras, e no estímulo à produção de colágeno e elastina nas albas. Foi realizada revisão da literatura no PubMed referente ao tratamento de estrias atróficas com laser de janeiro de 2000 até dezembro de 2016. Os autores encontraram 28 artigos que se enquadraram nos critérios de inclusão. Existem poucos estudos clínicos randomizados avaliando a eficácia ao longo prazo e a segurança de aparelhos à base de energia. Baseado em casos clínicos e revisões sistemáticas, ambos os lasers - ablativo e não ablativo - fracionados demonstraram melhora modesta do aspecto das estrias distensas. Há tendência a sugestão do laser não ablativo fracionado de 1.540 nanômetro como sendo opção de primeira escolha para tratamento das estrias distensas. Porém, estudos futuros devem focar em desenhos de pesquisa com duração mais longa, medidas objetivas e padronizadas da avaliação dos resultados como biópsias e estudos moleculares, que demonstrem aumento nas fibras elásticas e fibras de colágeno, que correlacionem com a melhora do aspecto clínico das estrias após aplicação de lasers com parâmetros sistematizados.


Stretch marks are scars on the dermis that cause patients to be self-conscious and that pose challenges in clinical treatment. They result from rapid stretching of the skin and often observed in adolescents, pregnant women, obese individuals, and people experiencing rapid change in weight. They initially appear as erythematous and edematous plaques (red striae), and as they mature, they become whitish and atrophic (striae alba) due to the degradation and reorganization of elastin and collagen fibers. Currently, laser treatment is an emerging noninvasive therapeutic modality that is successful in reducing the excessive vascularization of red striae and in stimulating the production of collagen and elastin in the alba. In the present literature review, PubMed was searched for articles on the treatment of atrophic striations with laser that were published from January 2000 to December 2016. The authors have found 28 articles that met the inclusion criteria. Only few randomized clinical trials have evaluated the long-term efficacy and safety of energybased treatments. Based on clinical cases and systematic reviews, both ablative and non-ablative fractional lasers caused moderate improvement in the appearance of distending striae. The 1540-nm non-ablative fractional laser is more likely to be considered the first-line treatment for stretch marks. However, future studies should focus on research with longer duration, studies with objective and standardized measures for the evaluation of results, such as biopsy results, and molecular studies showing an increase in elastic and collagen fibers that correlate to the improvement in the clinical appearance of the striae after using lasers with systematized parameters.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Terapêutica/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Dermatologia/métodos , Terapia a Laser/métodos , Estrias de Distensão/cirurgia , Estrias de Distensão/prevenção & controle , Estrias de Distensão/terapia
13.
Dermatol Surg ; 44(10): 1311-1316, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29746426

RESUMO

BACKGROUND: Few effective treatments exist for striae alba, which are the mature stage of stretch marks. OBJECTIVE: To evaluate the efficacy of the nonablative fractional 1,565-nm Erbium-glass (Er:glass) and the picosecond fractional 1,064/532-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers in the treatment of striae alba. MATERIALS AND METHODS: Twenty subjects with striae alba on the bilateral abdomen were treated with either the nonablative fractional 1565-nm Er:glass or the picosecond fractional 1,064/532-nm Nd:YAG laser, with a total of 3 treatments 3 weeks apart. RESULTS: A 31% (1.25/4) texture improvement was noted for both the fractional 1,565-nm Er:glass laser and the picosecond fractional 1,064/532-nm Nd:YAG laser. The degree of atrophy was improved by 30% (1.19/4) with the 1,565-nm Er:glass laser and 35% (1.38/4) with the picosecond 1,064/532-nm Nd:YAG laser. A 48% (1.9/4) subject overall assessment of improvement was noted with the fractional 1565-nm Er:glass laser and 45% (1.8/4) improvement with the picosecond fractional 1,064/532-nm Nd:YAG laser. There was no significant change in striae density with either laser. The picosecond laser was rated as less painful during all 3 sessions (p = .002) and had a shorter healing time (p = .035). The nonablative fractional 1,565-nm Er:glass and the picosecond fractional 1,064/532-nm Nd:YAG lasers were equally efficacious in improving striae alba.


Assuntos
Terapia a Laser , Lasers de Estado Sólido/uso terapêutico , Estrias de Distensão/terapia , Abdome , Adulto , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Resultado do Tratamento
14.
Dermatol Surg ; 44(5): 697-704, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29701622

RESUMO

BACKGROUND: Striae distensae (SD) are dermal scars associated with atrophy of the epidermis. OBJECTIVE: To evaluate the effect and safety of intralesional injection of platelet-rich plasma (PRP) versus topical tretinoin 0.05% in treatment of SD. METHODS: Thirty patients (27 females and 3 males) had bilateral striae distensae were enrolled in this study. In every patient, half of the selected striae were treated with PRP intralesional injection. The other half was treated by topical tretinoin. Skin biopsies were taken from both sides before and after the treatment. Digital photographs were taken at the baseline and at the end of follow-up period. Clinical improvement was evaluated by 2 blind dermatologists in addition to the patient's satisfaction rating. RESULTS: There was statistically significant improvement in the SD treated with PRP and topical tretinoin cream. The improvement was more in the SD treated with PRP injections (p = .015). Patient's satisfaction showed that the improvement was more in the PRP-treated side (p = .003). Collagen and elastic fibers in the dermis were increased in all biopsies after treatment. CONCLUSION: PRP injection and topical tretinoin are safe for the treatment of SD, but PRP is more effective and it gives better therapeutic response than tretinoin.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Ceratolíticos/administração & dosagem , Satisfação do Paciente , Plasma Rico em Plaquetas , Estrias de Distensão/terapia , Tretinoína/administração & dosagem , Abdome/patologia , Administração Cutânea , Adolescente , Adulto , Feminino , Humanos , Injeções Intralesionais/métodos , Masculino , Pessoa de Meia-Idade , Estrias de Distensão/patologia , Coxa da Perna/patologia , Fatores de Tempo , Resultado do Tratamento , Gravação em Vídeo
15.
Aesthet Surg J ; 38(9): 990-997, 2018 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-29596639

RESUMO

Background: Stretch marks are common permanent dermal lesions that can cause psychosocial distress. A number of treatment modalities are available, with the majority targeted towards collagen production. Objectives: To develop and field test a new BODY-Q scale to measure appearance of stretch marks in order to provide a means to incorporate the patient perspective into future treatment studies. Methods: We previously described the development of the BODY-Q conceptual framework, which involved a literature review, 63 patient interviews, 22 cognitive interviews and input from 9 experts, and the international field-test study that involved 403 weight loss and 331 body contouring patients. To develop the Stretch Marks scale, we reexamined appearance codes from the original interviews. The scale was field tested in an international study. Rasch measurement theory (RMT) analysis was used to refine the scale and examine measurement properties. Results: The Stretch Marks scale was completed by 630 participants, who provided 774 assessments. After dropping 3 items, the data fit the Rasch model (P = 0.56). Items (eg, length, width, amount, location, up close) mapped out a well-targeted clinical hierarchy. All items had ordered thresholds and good item fit. There was no evidence of differential item functioning (bias) by gender, age group or language (English vs Danish). The scale evidenced high reliability (ie, person separation index = 0.94, Cronbach's alpha = 0.97). For construct validity, the mean score correlated with the total number of body areas with stretch marks, higher BMI before bariatric surgery, and other BODY-Q scales. Conclusions: This scale could be used to measure the impact of innovative treatments for stretch marks.


Assuntos
Contorno Corporal/métodos , Avaliação de Resultados da Assistência ao Paciente , Estrias de Distensão/diagnóstico , Inquéritos e Questionários , Adulto , Idoso , Cirurgia Bariátrica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/cirurgia , Satisfação do Paciente , Psicometria , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Estrias de Distensão/etiologia , Estrias de Distensão/psicologia , Estrias de Distensão/terapia , Perda de Peso , Adulto Jovem
16.
J Cosmet Dermatol ; 17(6): 1008-1015, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29316152

RESUMO

BACKGROUND: Striae distensae are dermal scars with a linear atrophic depression. The exact origin of striae distensae remains unrevealed, but low expression of collagen and fibronectin genes in the affected tissue was found. Several treatment modalities have been proposed, yet no consistent modality is available. AIM OF THE WORK: To evaluate and compare the efficacy and safety of carboxytherapy vs platelet-rich plasma (PRP) in treatment of stretch marks. PATIENTS AND METHODS: This study included 20 patients with striae alba. Every patient received treatment in the form of PRP injection in their right side (group A) and carboxytherapy session in their left side (group B) every 3-4 weeks for 4 sessions. Skin biopsies were taken before and after treatment, and they were subjected to fibronectin immunohistochemical stain. RESULTS: There was a significant improvement in striae alba in both groups after than before treatment. There was no significant difference between both groups as regards either percentage of improvement, response (grading scale), or patient satisfaction. The fibronectin-stained area was significantly higher in both groups after than before treatment, and it was significantly higher after treatment in group (B) than group (A). CONCLUSIONS: Both methods were safe and effective with minimal side effects. There was no significant difference between both methods of treatments. This was confirmed histopathologically by fibronectin expression which is found to be low in striae and increased significantly after treatment. But fibronectin expression was higher in group (B) than (A).


Assuntos
Dióxido de Carbono/uso terapêutico , Plasma Rico em Plaquetas , Estrias de Distensão/patologia , Estrias de Distensão/terapia , Adolescente , Adulto , Biópsia , Dióxido de Carbono/administração & dosagem , Dióxido de Carbono/efeitos adversos , Feminino , Fibronectinas/metabolismo , Humanos , Imuno-Histoquímica , Injeções Intradérmicas , Masculino , Satisfação do Paciente , Pele/patologia , Estrias de Distensão/metabolismo , Resultado do Tratamento , Adulto Jovem
17.
Int J Cosmet Sci ; 40(1): 81-86, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29094366

RESUMO

OBJECTIVE: The normal process of skin tissue repair following injury invariably results in visual scarring. It is known that topical treatment with hydrophobic cosmetics rich in silicone and mineral oil content can improve the appearance of scars and striae. Given lifestyle preferences of many cosmetic consumers towards so-called natural treatments, the objective of this controlled randomized study was to investigate the efficacy of a plant body oil rich in oleic and linoleic acids (Bio Skin Oil® ) for improving the appearance of scars and striae. METHODS: A panel of 80 volunteers with non-hypertrophic scars (40) or stretch marks (40) not older than 3 years applied a cosmetic face and body oil for 8 weeks. Compared to an untreated scar/stretch mark region, a blinded investigator as well as volunteer assessments with given observed parameters demonstrated the efficacy of the oil under test. RESULTS: On the Observer Scar Assessment Scale (OSAS), the mean score was reduced on the product-treated area by approximately 5% (P = 0.006). The untreated area remained unchanged. Observed effects by volunteers were more pronounced - Patient Scar Assessment Scale (PSAS) giving a reduction of approximately 20% on the treated area, and on the control untreated area a reduction of approximately 6%. The overall product effect of 14% was shown to be clearly significant (P = 0.001). All statements relating to product traits achieved higher frequencies of agreements than of non-agreements and were therefore assessed positively by the volunteers. Highest frequencies of agreements occurred in statements that the test product provides a long-lasting, soft and supple skin feeling (93%); caring effect (87%); and quick absorbance (84%). Agreement was also found for statements that the product improves the skin appearance (61%) and that scars/striae appear less pronounced (51%). Only 17% of volunteers felt the oil had no benefit to the appearance of their scars/striae. CONCLUSIONS: The oil blend under test is effective in improving the appearance of non-keloid scars and striae. Further work is required to understand the mechanisms of how plant oil fatty acids ameliorate scar and striae appearance.


Assuntos
Cicatriz/terapia , Cosméticos , Óleos Vegetais/uso terapêutico , Estrias de Distensão/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Azeite de Oliva/administração & dosagem , Azeite de Oliva/uso terapêutico , Óleos Vegetais/administração & dosagem , Óleo de Açafrão/administração & dosagem , Óleo de Açafrão/uso terapêutico , Adulto Jovem
18.
J Cosmet Dermatol ; 17(2): 176-183, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28755402

RESUMO

BACKGROUND: Striae distensae (SD) are a common dermatologic problem that plagues many people. Although there are many therapeutic modalities have been used to treat SD, effective method has been disappointing for striae Alba. AIMS: To evaluate the clinical and histopathologic efficacy and safety of the 2940-nm erbium yttrium aluminum garnet (Er:YAG) ablative fractional laser (AFL) with recombinant bovine basic fibroblast growth factor (rb-bFGF) and light-emitting diode-red light (LED-RL) for the treatment of striae alba. PATIENTS AND METHODS: Thirty volunteers with striae distensae alba were enrolled. The subjects completed treatments with the 2940-nm Er:YAG AFL 6 times at 4-week intervals. Following this treatment, the subjects were required to spray rb-BFGF for 1 week at home. They then received LED-RL once every 7 days for three sessions between the two laser treatments. Two independent investigators evaluated clinical improvement at pretreatment and 1, 3, 6, and 12 months post-treatment, patients also provided self-assessments of clinical improvement. Two biopsies were obtained from two subjects, both of the same sites of striae alba, one before the first treatment and one 6 months after the last session. RESULTS: All 30 subjects demonstrated clinical improvement after treatment. Skin biopsies after treatment showed an increase in epidermal thickness, dermal thickness, and collagen and elastin density when compared to that at the baseline. CONCLUSIONS: The combination of the 2940-nm Er:YAG laser with rb-bFGF and LED-RL for the treatment of striae alba was a safe and effective approach for improving the appearance of striae alba.


Assuntos
Terapia pela Cor , Fator 2 de Crescimento de Fibroblastos/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Estrias de Distensão/patologia , Estrias de Distensão/terapia , Adulto , Animais , Bovinos , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Edema/etiologia , Eritema/etiologia , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Prospectivos , Proteínas Recombinantes/uso terapêutico , Adulto Jovem
19.
Semin Cutan Med Surg ; 36(4): 155-163, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29224032

RESUMO

Microneedling is a minimally invasive procedure wherein small holes are created across the stratum corneum while keeping the epidermis partially intact. This produces microchannels that increase skin permeability and simultaneously stimulate growth factor release. Since the epidermis is retained, microneedling has less risk of infection, postinflammatory hyperpigmentation, and scarring compared to other resurfacing modalities. This is a review of the literature on microneedling in the treatment of textural abnormalities, specifically rhytides, scars, and striae.


Assuntos
Cicatriz/terapia , Técnicas Cosméticas , Envelhecimento da Pele , Estrias de Distensão/terapia , Administração Cutânea , Técnicas Cosméticas/instrumentação , Humanos , Agulhas , Rejuvenescimento
20.
J Am Acad Dermatol ; 77(3): 559-568.e18, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28551068

RESUMO

BACKGROUND: Striae distensae are permanent dermal lesions that can cause significant psychosocial distress. A detailed understanding of the numerous treatment modalities available is essential to ensuring optimal patient outcomes. OBJECTIVE: Our objective was to evaluate and summarize the different treatment methods for striae distensae by linking their proposed modes of action with the histopathogenesis of the condition to guide patient treatment. METHODS: A systematic review of the literature was performed with no limits placed on publication date. Relevant studies were assigned a level of evidence by the authors. RESULTS: Ninety-two articles were identified, with 74 being eligible for quality assessment. The majority of treatments aim to increase collagen production. The use of vascular lasers can reduce erythema in striae rubrae by targeting hemoglobin, whereas increasing melanin through methods such as ultraviolet light is a major focus for treatment of striae albae. Despite some topical treatments being widely used, uncertainty regarding their mode of action remains. No treatment has proved to be completely effective. LIMITATIONS: Limitations of the study include low-quality evidence, small sample sizes, and varying treatment protocols and outcome measures, along with concerns regarding publication bias. CONCLUSIONS: Further randomized, controlled trials are needed before definitive conclusions and recommendations can be made.


Assuntos
Estrias de Distensão/terapia , Humanos
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