COMPARISON OF TOPICAL THERAPY FOR STRIAE ALBA (20-PERCENT GLYCOLIC ACID 0.05-PERCENT TRETINOIN VERSUS 20-PERCENT GLYCOLIC ACID 10-PERCENT L-ASCORBIC-ACID)

BACKGROUND. Topical treatment of striae rubra with 0.1% tretinoin and laser treatment of striae rubra and alba with the 585-nm pulsed dye la ser are proven therapeutic options. However, little efficacy has been shown for treatment of striae alba topically, and the laser is current ly not a suitable treatment option for darker ethnic skin types. OBJEC TIVE. The purpose of this study was to demonstrate that selected comme rcial topical agents can improve the appearance of striae alba. METHOD S. Ten patients of varying skin types (I-V) having striae distensae al ba on the abdomen or thighs were selected to evaluate the effectivenes s of two topical treatment regimens. Patients were placed on daily top ical application of 20% glycolic acid (MD Forte) to the entire treatme nt area. In addition, the patients applied 10% L-ascorbic acid, 2% zin c sulfate, and 0.5% tyrosine to half to the treatment area and 0.05% t retinoin emollient cream (Renova) to the other half of the treatment a rea. The creams were applied on a daily basis for 12 weeks. Improvemen t teas evaluated at 4 and 12 weeks in an objective unblinded fashion a t the follow-up visits, a objective blinded fashion by visual grading at the conclusion of the study, and in an objective blinded fashion wi th profilometry. Additionally, histopathologic analysis was performed. RESULTS. Analysis of these data reveals: 1) both regimens can improve the appearance of stretch marks; 2) these topical therapy regimens ar e safe and effective in study patients with minimal irritation; 3) ela stin content within the reticular and papillary dermis can increase wi th topical 20% glycolic acid combined with 0.05% tretinoin emollient c ream therapy; 4) both regimens increased epidermal thickness and decre ased papillary dermal thickness in treated stretch marks when compared with untreated stretch marks; 5) combined epidermal and papillary der mal thickness in stretch marks treated with either topical regimen app roaches that of normal skin; and 6) profilometry can objectively measu re differences in skin texture associated with striae treatments when compared to controls, however, it is not sensitive enough to justify c omparison or quantitative improvements between similarly effective tre atments. (C) 1998 by the American Society for Dermatologic Surgery, In c. Dermatol Surg 1998;24:849-856.