Madegowda Shashikumar Basavapura, Rajegowda Harish Muddanahalli, Kalegowda Deepadarshan, Nagaraju Phani Halevoor, Naidu Hemalatha Mullagura
Department of Dermatology, Mandya Institute of Medical Sciences (MIMS), Mandya, Karnataka, India.
J Cutan Aesthet Surg. 2023 Jul-Sep;16(3):178-185. doi: 10.4103/JCAS.JCAS_65_22.
Striae distensae are atrophic scars that are often cosmetically distressing. The efficacy of fractional carbon dioxide (CO) laser and platelet-rich plasma (PRP) in treating striae individually has been evaluated previously. However, not many studies described the combined efficacy of both.
The aim of this study was to compare the efficacy and safety of fractional CO laser alone and in combination with PRP.
Twenty-four patients with striae presenting bilaterally in the abdomen, upper limbs, and lower limbs were included. PRP was prepared by double-spin method and cell count was done to ensure at least fourfold concentration of platelets. The patients were treated CO laser on both sides and PRP on the left side along with laser, every month for three sessions. Digital photography and dermoscopy were done at baseline, every treatment session, and 6 months after treatment. Clinical improvement was assessed by comparing photographs and patient satisfaction before and after treatment.
All patients showed improvement on both sides. In CO-laser-treated patients, responses in 6 patients (25%) were moderate, 14 (56%) were good, and 4 (16.6%) were excellent. In CO-laser and PRP-treated patients, responses in 5 patients (20.8%) were moderate, 11 (45.8%) were good, and 8 (33.3%) were excellent. Hyperpigmentation was the most common side-effect seen (19 patients) on both sides, which resolved spontaneously by 6 months.
These results support the use of ablative CO fractional laser as effective and safe treatment modalities for striae. However, slightly better efficacy was noted with the addition of PRP.
膨胀纹是萎缩性瘢痕,常令人在外观上苦恼。先前已评估了分次二氧化碳(CO)激光和富血小板血浆(PRP)单独治疗膨胀纹的疗效。然而,描述两者联合疗效的研究并不多。
本研究旨在比较单纯分次CO激光与联合PRP治疗的疗效和安全性。
纳入24例腹部、上肢和下肢双侧出现膨胀纹的患者。采用双离心法制备PRP,并进行细胞计数以确保血小板浓度至少为四倍。患者双侧接受CO激光治疗,左侧在激光治疗的同时联合PRP治疗,每月治疗一次,共三次。在基线、每次治疗时以及治疗后6个月进行数码摄影和皮肤镜检查。通过比较治疗前后的照片和患者满意度来评估临床改善情况。
所有患者双侧均有改善。在接受CO激光治疗的患者中,6例(25%)反应中等,14例(56%)反应良好,4例(16.6%)反应极佳。在接受CO激光和PRP治疗的患者中,5例(20.8%)反应中等,11例(45.8%)反应良好,8例(33.3%)反应极佳。色素沉着是双侧最常见的副作用(19例患者),6个月时可自行消退。
这些结果支持将剥脱性CO分次激光作为治疗膨胀纹的有效且安全的治疗方式。然而,添加PRP后疗效略有提高。