McDaniel D H, Ash K, Zukowski M
Laser Center of Virginia, Eastern Virginia Medical School, Virginia Beach, USA.
Dermatol Surg. 1996 Apr;22(4):332-7. doi: 10.1111/j.1524-4725.1996.tb00326.x.
Striae, or stretch marks, are very common skin disorders that do not impair bodily function, but are of considerable cosmetic concern to many patients. Traditionally, treatment options have been very limited. This study examines the results of treating striae using the 585-nm pulsed dye laser. Stimulation of a variety of wound healing processes has been attributed to low energy laser therapy. Clinically, improvement of hypertrophic and erythematous scars with the 585-nm pulsed dye laser at energy densities of 6-7 J/cm2 is well established. Since striae are dermal scars, evaluation of this same therapy to treat striae was undertaken.
To evaluate the effectiveness of the 585-nm flashlamp-pumped pulse dye laser in treating cutaneous striae.
Thirty-nine striae were treated with four treatment protocols. These treated striae were compared with untreated striae controls in the same patient. The patients ages ranged from 23 to 52 years, with an average age of 36 years. The average age of the treated striae prior to initial treatment was 14 years (range, 8 months to 32 years). Treatment parameters included spot sizes of 7 and 10 mm and fluences of 2.0, 2.5, 3.0, and 4.0 J/cm2. Response to therapy was evaluated through clinical grading, sequential photography, and optical profilometry at a blinded laboratory. Skin biopsies were also examined with light microscopy from two of the 39 striae that were treated.
Subjectively, striae appeared to return toward the appearance of normal skin with all protocols. However, the protocol with 10-mm spot size using 3.0 J/cm2 fluence improved the appearance of striae better than the other treatment protocols. Objectively, shadow profilometry revealed that all treatment protocols reduced skin shadowing in striae. This result corresponds with surface patterns of striae returning to that closely resembling adjacent normal skin surface patterns. Histologically, using hematoxylin and eosin stains as well as elastin strains, striae treated with a low fluence pulsed dye laser treatment protocol regained normal appearing elastin content when compared with normal (non-striae) skin adjacent to the treated striae.
Treatment with the 585-nm pulsed dye laser at low energy densities was shown to improve the appearance of striae. Apparent increased dermal elastin was also observed 8 weeks posttherapy and possibly contributed to the improvement seen in the study patients.
萎缩纹，即妊娠纹，是非常常见的皮肤疾病，虽不损害身体功能，但许多患者对其外观极为关注。传统上，治疗选择非常有限。本研究探讨了使用585纳米脉冲染料激光治疗萎缩纹的效果。低能量激光疗法被认为可刺激多种伤口愈合过程。临床上，使用能量密度为6 - 7焦/平方厘米的585纳米脉冲染料激光治疗增生性和红斑性瘢痕的效果已得到充分证实。由于萎缩纹是真皮瘢痕，因此对相同疗法治疗萎缩纹进行了评估。
评估585纳米闪光灯泵浦脉冲染料激光治疗皮肤萎缩纹的有效性。
采用四种治疗方案对39条萎缩纹进行治疗。将这些接受治疗的萎缩纹与同一患者未治疗的萎缩纹对照进行比较。患者年龄在23至52岁之间，平均年龄为36岁。初始治疗前，接受治疗的萎缩纹平均年龄为14岁（范围为8个月至32岁）。治疗参数包括光斑尺寸为7毫米和10毫米，能量密度为2.0、2.5、3.0和4.0焦/平方厘米。通过临床分级、连续摄影以及在盲法实验室进行光学轮廓测量来评估治疗反应。还对39条接受治疗的萎缩纹中的两条进行了皮肤活检，并进行光镜检查。
主观上，所有治疗方案的萎缩纹外观似乎都恢复到接近正常皮肤。然而，使用光斑尺寸为10毫米、能量密度为3.0焦/平方厘米的治疗方案比其他治疗方案能更好地改善萎缩纹外观。客观上，阴影轮廓测量显示所有治疗方案均减少了萎缩纹处的皮肤阴影。这一结果与萎缩纹的表面图案恢复到与相邻正常皮肤表面图案非常相似的情况相符。组织学上，使用苏木精和伊红染色以及弹性蛋白染色，与接受治疗的萎缩纹相邻的正常（非萎缩纹）皮肤相比，采用低能量密度脉冲染料激光治疗方案治疗的萎缩纹恢复了外观正常的弹性蛋白含量。
低能量密度的585纳米脉冲染料激光治疗可改善萎缩纹外观。治疗后8周还观察到真皮弹性蛋白明显增加，这可能有助于本研究患者所观察到的改善效果。
