Kang S, Kim K J, Griffiths C E, Wong T Y, Talwar H S, Fisher G J, Gordon D, Hamilton T A, Ellis C N, Voorhees J J
Department of Dermatology, University of Michigan Medical Center, Ann Arbor, USA.
Arch Dermatol. 1996 May;132(5):519-26.
Stretch marks are disfiguring lesions usually caused by excessive stretching of skin. We investigated the response of early, clinically active stretch marks to topical 0.1% tretinoin (retinoic acid) cream. In a double-blind, randomized, vehicle-controlled study, 22 patients applied either 0.1% tretinoin (n = 10) or vehicle (n = 12) daily for 6 months to the affected areas. Patients were evaluated by physical examination monthly and by analysis of biopsy specimens of stretch marks obtained before and at the end of therapy in comparison with untreated normal skin.
After 2 months, patients treated with tretinoin had significant improvements in severity scores of stretch marks compared with patients who received vehicle (P < .05). After 6 months, eight (80%) of the 10 tretinoin-treated patients had definite or marked improvement compared with one (8%) of the 12 vehicle-treated patients (P = .002). Targeted stretch marks in patients treated with tretinoin had a decrease in mean length and width of 14% and 8%, respectively, compared with an increase of 10% (P < .001) and 24% (P = .008), respectively, in patients who received vehicle. There were no significant differences in various measures of quality and quantity of dermal collagen and elastic fibers in stretch marks when tretinoin and vehicle treatments were compared.
Topical application of tretinoin significantly improves the clinical appearance of early, active stretch marks. The processes that are responsible for the clinical improvement remain unknown.
膨胀纹是通常由皮肤过度拉伸引起的毁容性损害。我们研究了早期临床活跃的膨胀纹对局部外用0.1%维甲酸（视黄酸）乳膏的反应。在一项双盲、随机、赋形剂对照研究中，22例患者每天将0.1%维甲酸（n = 10）或赋形剂（n = 12）应用于受累区域，持续6个月。每月通过体格检查对患者进行评估，并通过分析治疗前和治疗结束时获取的膨胀纹活检标本，并与未治疗的正常皮肤进行比较。
2个月后，与接受赋形剂治疗的患者相比，接受维甲酸治疗的患者膨胀纹严重程度评分有显著改善（P <.05）。6个月后，10例接受维甲酸治疗的患者中有8例（80%）有明确或明显改善，而12例接受赋形剂治疗的患者中有1例（8%）有改善（P =.002）。接受维甲酸治疗的患者中，目标膨胀纹的平均长度和宽度分别减少了14%和8%，而接受赋形剂治疗的患者中，平均长度和宽度分别增加了10%（P <.001）和24%（P =.008）。比较维甲酸和赋形剂治疗时，膨胀纹中真皮胶原蛋白和弹性纤维的各种质量和数量指标没有显著差异。
局部应用维甲酸可显著改善早期活跃膨胀纹的临床表现。导致临床改善的过程尚不清楚。
