Striae distensae: A comprehensive review and evidence-based evaluation of prophylaxis and treatment

Abstract

Striae distensae are an extremely common, therapeutically challenging form of dermal scarring. Risk factors have been reported but much remains to be understood about their epidemiology, diagnosis and treatment. Up-to-date knowledge of the scientific research and the evidence behind both preventative and therapeutic agents are vital in order to understand striae and to offer patients the best therapeutic alternatives. We present a clinical review of the current literature concerning striae distensae and their prevention and treatment. A systematic review of the literature was undertaken using Medline, Embase and Google Scholar. Articles in English, Spanish, Portuguese, Turkish and French were included. Striae distensae occur in pregnancy, puberty and obesity as well as in numerous medical conditions and following therapeutic interventions. Proposed aetiological mechanisms relate to hormones, physical stretch and structural alterations to the integument. Assessment methods include subjective visual scoring and various imaging modalities. Treatments that we have evaluated include topical agents, used prophylactically or therapeutically, as well as light and laser therapies, which have shown improvements in the appearance of striae. Few high level evidence based medicine randomized controlled trials evaluating treatments for striae distensae exist. Topical therapeutic agents appear to lack efficacy in the prevention of striae distensae. What's already known about this topic? Striae distensae are extremely common and pose a significant psychological burden for patients. They commonly occur during pregnancy and adolescence. Topical, laser and light therapies can be used as treatment. What does this study add? We provide an up-to-date review of the literature regarding striae distensae, their epidemiology, histopathology and assessment. We also provide an evidence-based evaluation of topical, laser and light therapies used to treat striae distensae. © 2013 British Association of Dermatologists.