![]() ![]() Histological comparison between normal skin and striae distensae ( SD) skin H+E stains (magnification ×8.0). 11 Striae albae have been described as appearing similar to mature and flattened, or stretched dermal scars. 6, 10 Conversely, striae albae have less vascularity and tend to be very pale in colour. 9 Additionally, in striae rubrae, collagen fibres become thicker, more densely packed, are arranged in a parallel pattern and show a reduction in elastic fibres. 7 Vascular changes occur which contribute to the red and erythematous appearance of striae rubrae. 6, 7, 8 Gradual atrophy of the epidermis has been noted including loss of rete ridges. 5 Other observations include perivascular lymphocytic cuffing, increased glycosaminoglycan, sporadic presence of lymphocytes and oedema in the dermis. Elastolysis of the mid‐dermis is evident due to mast cell degranulation and stimulation of macrophages. ![]() There are a number of pathological and histological changes which occur when SD are formed (Fig. (c) An illustration of striae albae on the abdomen. They also do not recur but are permanent striae. ![]() Striae albae are atrophic, wrinkled and pale. They do not recur and are classified as temporary striae. Striae rubrae are considered as an early form of SD, which are erythematous, red and sometimes slightly raised linear lesions. (b) A diagram to demonstrate the difference in characteristics between striae rubrae and striae albae. (a) An illustration of striae rubrae on the abdomen. Randomized controlled trials are necessary to assess the efficacy of topical products for treatment and prevention of different stages of SD.Ĭomparisons between striae albae and striae rubrae. A structured approach in identification and targeted management of symptoms and signs with the appropriate topical is required. In conclusion, there is no topical formulation, which is shown to be most effective in eradicating or improving SD. later stages of SD (striae rubrae compared to striae albae) and their role in both prevention and treatment. The majority of topicals failed to mention their effect on early vs. Overall, there is a distinct lack of evidence for each topical formulation. Additionally, tretinoin used therapeutically showed varying results whilst cocoa butter and olive oil did not demonstrate any effect. Trofolastin and Alphastria creams demonstrated level‐2 evidence of positive results for their prophylactic use in SD. The results showed that there are few studies ( n = 11) which investigate the efficacy of topicals in management of SD. A systematic search of published literature and manufacturer website information for topicals in SD was carried out. The aim here was to assess the evidence for the use of topicals in SD and to propose a structured approach in managing SD. Even though there are many commercially available topical products, not all have sufficient level of evidence to support their continued use in SD. ![]() The most common therapy is the application of topicals used both therapeutically and prophylactically. Many therapeutic modalities are available but none can completely eradicate SD. Striae distensae ( SD) are common dermal lesions, with significant physical and psychological impact. ![]()
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