Synergistic effect of platelet-rich plasma in combination with fractional carbon dioxide laser versus its combination with pulsed dye laser in striae distensae: A comparative study

Abstract

Background: Striae distensae (SD) are very common atrophic cutaneous scarring that are therapeutically challenging. Various kinds of laser had been suggested as effective treatment modalities for SD. In addition, platelet-rich plasma (PRP) was recently recommended for its therapy.

Objective: To evaluate the synergistic role of PRP injection as a combined modality to fractional CO₂ laser (Fr CO₂ ) versus its combination with pulsed dye laser (PDL) in SD.

Patients and methods: Thirty SD patients were included in this study and treated by intradermal injection of autologous PRP on both sides, followed by laser therapy (Fr CO₂ laser on right side and PDL on left side). They received 3 treatment sessions at 6 weeks interval.

Results: Both treatment sides reported significant clinical improvements of SD lesions, evidenced by significant reduction of width of striae lesions and significant improvement of skin texture. Furthermore, significantly higher degree of clinical improvements were observed in response to treatment sessions by combined PRP with Fr CO₂ laser rather than combined PRP with PDL. Generally, post-inflammatory hyperpigmentation (PIH) were mild in all patients. Histopathologically, SD lesions showed improvement of epidermal thickness, and more homogenization and regular orientation of dermal collagen fibers in both treatment sides, with more significant improvement on the side treated by combined PRP with Fr CO₂ laser sessions rather than the other side.

Conclusions: PRP injection in combination with Fr CO₂ laser or PDL is considered safe and effective therapeutic regimens for SD. However, its combination with Fr CO₂ laser is more promising with better outcome and fewer side effects.

Keywords: carbon dioxide laser; platelet-rich plasma; pulse dye laser; striae distensae.