TREATMENT OF STRETCH MARKS WITH THE 585-NM FLASHMAP-PUMPED PULSED DYE-LASER

BACKGROUND. Striae, or stretch marks, are very common skin disorders t hat do not impair bodily function, but are of considerable cosmetic co ncern to many patients. Traditionally, treatment options have been ver y limited. This study examines the results of treating striae using th e 585-nm pulsed dye laser. Stimulation of a variety of wound healing p rocesses has been attributed to low energy laser therapy. Clinically, improvement of hypertrophic and erythematous scars with the 585-nm pul sed dye laser at energy densities of 6-7 J/cm(2) is well established. Since striae are dermal sears, evaluation of this same therapy to trea t striae was undertaken. OBJECTIVE. TO evaluate the effectiveness of t he 585-nm flashlamp-pumped pulse dye laser in treating cutaneous stria e. METHODS. Thirty-nine striae were treated with four treatment protoc ols. These treated striae were compared with untreated striae controls in the same patient. The patients ages ranged from 23 to 52 years, wi th an average age of 36 years. The average age of-the treated striae p rior to initial treatment was 14 years (range, 8 months to 32 years). Treatment parameters included spot sizes of 7 and 10 mm and fluences o f 2.0, 2.5, 3.0, and 4.0 J/cm(2). Response to therapy was evaluated th rough clinical grading, sequential photography, and optical profilomet ry at a blinded laboratory. Skin biopsies were also examined with ligh t microscopy from two of the 39 striae that were treated. RESULTS. Sub jectively, striae appeared to return toward the appearance of normal s kin With all protocols. However, the protocol with 10-mm spot size usi ng 3.0 J/cm(2) fluence improved the appearance of striae better than t he other treatment protocols. Objectively, shadow profilometry reveale d that all treatment protocols reduced skin shadowing in striae. This result corresponds with surface patterns of striae returning to that c losely resembling adjacent normal skin surface patterns. Histologicall y, using hematoxylin and eosin stains as well as elastin strains, stri ae treated with a low fluence pulsed dye laser treatment protocol rega ined normal appearing elastin content when compared with normal (non-s triae) skin adjacent to the treated striae. CONCLUSION. Treatment with the 585-nm pulsed dye laser at low energy densities was shown to impr ove the appearance of striae. Apparent increased dermal elastin teas a lso observed 8 weeks posttherapy and possibly contributed to the impro vement seen in the study patients.