Author |
Device evaluated |
Striae type |
Fitzpatrick skin type |
Wavelength and regimen |
No. of subjects (T/C) |
Outcome |
Adverse effects |
Study design |
Level of evidence |
McDaniel et al.106 |
PDL |
Albae 38, rubrae 1 |
Not stated |
585-nm. Four protocols (spot diameter, fluence): 1 = 10 mm, 2·5 J cm−2; 2 = 10 mm, 3·0 J cm−2; 3 = 7 mm, 2·0 J cm−2; 4 = 7 mm, 4·0 J cm−2 |
39 |
The 10-mm spot size with 3·0 J cm−2 improved the SD better than other treatment protocols. Significant reduction in skin shadowing in SD with all protocols (shadow profilometry). Normal-appearing elastin in SD treated with low-fluence PDL |
Mild transient purpura or slight erythema |
Nonrandomized controlled trial |
3 |
Jimenez et al.113 |
PDL |
Albae 11, rubrae 9 |
II–IV |
585-nm, two treatments at baseline and at week 6 |
20 |
No significant difference between control and treated SD after 12 weeks.13/20 and 9/20 subjects had decreased area of striae in treated and nontreated areas, respectively. None of the striae albae had a change in colour. Four of nine striae rubrae showed improvement |
PIH in one patient |
Nonrandomized controlled trial |
3 |
Nehal et al.114 |
PDL |
Albae |
Not stated |
585-nm, 10 mm spot size and fluence of 4·25 J cm−2. Treated at 2-month intervals for 1–2 years |
5 |
Subjectively reported slightly improved appearance of SD. No pre- or post-treatment photographic improvement. Histologically no significant changes reported following treatment |
PIH in darker skin types |
Case series |
4 |
Suh et al.105 |
PDL/RF |
Albae 36, rubrae 1 |
III–IV |
585-nm, three treatments at baseline, Thermage RF device used with fluences 53–97 J cm−2 (dial setting 10·5–13·5) with 2–3 passes. (PDL/RF), week 4 (PDL), week 8 (PDL) |
37 |
Subjective assessment showed 89% of patients had 'good and very good' overall improvement in SD while 59% in were graded 'good and very good' in elasticity. No control and no randomization in this study |
Transient purpura (16%) and PIH (3%) |
Case series |
4 |
Goldman et al.36 |
Nd:YAG laser |
Rubrae |
II–IV |
1064-nm, average number of treatment sessions was 3·45 with an interval of 3–6 weeks |
20 |
Results considered as excellent by 55% and 40% of patients and doctors, respectively. No control and no randomization in this study |
Minimal oedema and erythema |
Case series |
4 |
Tay et al.107 |
Nonablative diode laser |
Albae 9, rubrae 2 |
IV–VI |
1450-nm, three treatments at 6-week intervals |
11 |
No patients showed any noticeable improvement compared with control areas (one side of the body was treated with other side acting as control). Not all outcomes are reported in the results |
Transient erythema, PIH (64%, n = 7) |
RCT |
2 |
de Angelis et al.32 |
Er:glass fractional nonablative laser |
All types |
II–IV |
1540-nm, 2–3 passes, 2–4 total treatments at 6-week intervals |
51 |
50% or greater overall improvement at 6 months (unblinded assessment), 51–75% improvement (blinded assessment). No control in this study |
Transient oedema, erythema, PIH |
Case series |
4 |
Stotland et al.115 |
Er:glass fractional nonablative laser |
Albae 13, rubrae 1 |
I–IV |
1550-nm, 8–12 passes with fluences of 12–18 J cm−2, six treatments in total |
14 |
Overall improvement of 26–50% in 63% of patients (n = 5), < 25% improvement in dyschromia in 50% of patients (n = 4), improved texture of 26–50% in 50% of patients (n = 4). Untreated striae acted as controls. |
Post-treatment oedema, erythema and papules |
RCT |
2 |
Guimarães et al.116 |
Er:glass fractional nonablative laser |
Rubrae |
Not stated |
1540-nm, eight sessions in total |
10 |
Post-breast augmentation SD. Three patients completed eight treatments. One month after the last treatment, all patients showed a marked improvement in the striae. No controls or randomization |
Post-laser erythema, PIH in 10% (n = 1) |
Case series |
4 |
Yang and Lee117 |
Er:glass fractional nonablative laser vs. ablative fractional CO2 laser |
Albae |
IV |
Er:glass 1550-nm at a pulse of 50 mJ and spot density 100 spots cm−2. CO2 pulse energy 40–50 mJ and spot density 75–100 spots cm−2. Three treatments at 4-week intervals |
22 |
Abdomen split into two halves and each half randomized to one of the two treatments. No statistical difference between the two lasers but significant clinical and histological improvement comparing pre- and post-treatment. No control used |
PIH (36%) |
Comparative study |
4 |
Goldberg et al.110 |
XeCl excimer UVB laser vs. UVB light device |
Albae |
II–IV |
Up to 10 treatments, XeCl 308-nm, UVB 290–320-nm |
10 |
Increased melanin, hypertrophy and increased number of melanocytes in all treated SD. Maintained at 6 months. No control and no randomization in this study |
Not stated |
Comparative study |
4 |
Goldberg et al.118 |
XeCl excimer laser |
Albae |
II–IV |
308-nm, treatments continued until 15 completed or > 75% increase in pigmentation |
75 |
Clinically evident improvement in striae reported in 80% of subjects. Average of 8·4 treatments. For the first 10 patients, half the area of trunk/extremity acted as a control. In the remaining 65, both sides were treated |
Erythema (100%) |
Case series |
4 |
Ostovari et al.119 |
XeCl excimer laser |
Albae |
I–IV |
308-nm, weekly until 10 treatments completed or until 100% repigmentation |
10 |
80% of patients had a poor or moderate result based on photographs and 70% based on patients' self-assessment. |
PIH |
Nonrandomized controlled trial |
3 |
Alexiades-Armenakas et al.120 |
XeCl excimer laser |
Albae |
Not stated |
308-nm, every 2 weeks until maximum of 10 treatments, 75% or 100% increase in colorimetric or visual pigment correction, respectively |
9 |
68% improvement in mean pigmentation relative to normal skin control. Mean percentage pigmentation 102% compared with control. Overall excellent pigment correction maintained to 2 months follow-up |
Transient erythema |
RCT |
2 |
Longo et al.104 |
Copper bromide laser |
Not stated |
II–III |
577-nm, 1–5 sessions 1 month apart |
15 |
Five out of 15 subjects experienced complete disappearance of striae, other subjects: 50–90% improvement of dimensions. In 13/15 results were maintained after 1 year. No control and no randomization in this study |
Erythema |
Case Series |
4 |
Al-Dhalimi and Abo Nasyria121 |
IPL 650-nm vs. 590-nm |
Rubrae |
III–IV |
Two cut-off filters used 590-nm on left and 650-nm on right, starting fluence 13 J cm−2 increased to 15·5 J cm−2. Five sessions at 2-week intervals |
20 |
Significant reduction in total number of SD on right from 256 to 240. Significant reduction in SD on left from 251 to 228. Also decreased sum of lengths and maximum widths. No control and no randomization in this study |
Severe erythema (60%, n = 6) |
Comparative study |
4 |
Hernández-Pérez et al.100 |
IPL |
Albae |
80% IV, 20% III |
515–1200-nm, five sessions once every 2 weeks |
15 |
Sum of the total length of striae reduced from 375to 239 cm. Reduced number of striae from a total of 117 to 94. Significant difference in post-treatment dermal thickness. No control and no randomization in this study |
PIH (40%) |
Case Series |
4 |
Sadick et al.108 |
UVA/UVB light therapy (MulticlearTM) |
Albae |
II–IV |
UVB 296–315-nm, UVA1 360–370-nm, twice weekly for maximum of 10 treatments |
9 |
Five subjects had completely repigmented striae, three had 76–100% improvement and one had 51–75% improvement. Improvement only short term. No randomization in this study |
PIH (> 50%) |
Nonrandomized controlled trial |
3 |
Trelles et al.109 |
Infrared light system (NovaPlus) |
Albae |
II–IV |
Three passes per session over four sessions, 15 days apart |
10 |
Four patients reported results as 'fair', two as 'better' and four as 'same'. 3D optical skin imaging showed improvement of 25–50% in depth corresponding to SD. Histology showed improvements compared with specimens at baseline. No control and no randomization in this study |
Minimal erythema for 24 h |
Case series |
4 |
Manuskiatti et al.111 |
RF device |
Albae 16, rubrae 1 |
IV–V |
Six, weekly treatments. TriPollar RF device (3 electrodes) used at range of 40–50 W and frequency range 1 MHz |
17 |
38% and 12% of subjects had 25–50% and 51–75% improvement in striae, respectively, on assessment. 12%, 23% and 65% of subjects rated their contentment as slightly satisfied, satisfied and very satisfied, respectively. No control and no randomization in this study |
None reported |
Case series |
4 |
Suh et al.122 |
Plasma fractional RF and platelet-rich plasma and ultrasound |
Not stated |
III–V |
Fortnightly for total of four sessions |
18 |
Two blinded reviewers rated 'excellent' results (75–100% improvement) in 33% (n = 6) of subjects, 'very good' (50–74% improvement) in 38·9% (n = 7), 'good' (25–49% improvement) in 22·4% (n = 4) and 'mild' (1–24% improvement) in 5·6% (n = 1). No control and no randomization in this study |
PIH (11%) |
Case series |
4 |
Kim et al.123 |
Intradermal RF and autologous platelet-rich plasma |
Not stated |
IV |
Three sessions once every 4 weeks, RF device frequency of 1134 kHz |
19 |
Objective assessment demonstrated 5% of patients with excellent improvement (n = 1), 37% with marked improvement (n = 7), 32% with moderate improvement (n = 6) and 26% with mild improvement (n = 5). No control and no randomization in this study |
Transient bruising lasting 3–7 days (100%) |
Case series |
4 |
Ryu et al.124 |
Fractionated microneedle RF vs. fractional CO2 laser |
Not stated |
IV |
Three treatment groups: fractional CO2 laser (n = 10), microneedle RF (n = 10), and both (n = 10) |
30 |
Improvement evaluated on a visual analogue scale 1–4 (1 = minimal improvement or steady state, 4 = near total improvement), was 2·2 in the fractional CO2 laser-treated group, 1·8 in the microneedle RF-treated group and 3·4 in the combination group. A thickened epidermis and increase in collagen fibres observed in the combination-treated sites. No control and no randomization in this study |
Transient PIH, pain and pruritus |
Comparative study |
4 |
Lee et al.79 |
Short-pulsed CO2 laser |
Albae |
IV |
10 600-nm |
27 |
Results showed that 7% (n = 2) had > 75% improvement, 52% (n = 14) had 51–75% improvement, 33% (n = 9) had 26–50% improvement and 7% (n = 2) had 0–25% improvement. No control and no randomization in this study |
Short-term erythema (100%) 4 weeks and mild PIH resolving within 4 weeks |
Case series |
4 |
Nouri et al.125 |
Short-pulsed CO2 laser vs. control vs. PDL |
Not stated |
IV–VI |
CO2 10 600-nm, two passes then saline wash. PDL 585-nm |
4 |
At 20-week follow-up, type IV skin showed no improvement with PDL, type VI showed hyperpigmentation. The short pulsed CO2 showed persistent erythema and marked hyperpigmentation in types IV and VI skin respectively |
Persistent erythema and PIH in skin types IV and VI with CO2 laser |
Nonrandomized controlled trial |
3 |
Bak et al.112 |
Fractional photothermolysis (Fraxel SR 1500) |
Rubrae 16, albae 6 |
Not stated |
1500-nm, two sessions of eight passes at 4-week intervals |
22 |
27% (n = 6) of patients showed marked improvement of SD while 63% (n = 16) showed mild improvement. Significant increase in average epidermal and dermal thickness from baseline. No control and no randomization in this study |
Erythema, mild pigmentation, PIH (9%) |
Case series |
4 |
Abdel-Latif and Albendary103 |
Microdermabrasion |
Rubrae 12, albae 8 |
II–IV |
Five treatments at weekly intervals |
20 |
Other half of body acted as control. 'Good to excellent' improvement in striae in 50% of subjects. Remaining 50% had 'mild to moderate' improvement. Most improvement in striae rubrae. Significantly increased type I procollagen α1 mRNA in treatment compared with controls. No randomization |
Transient erythema (25%, n = 5) and PIH (20%, n = 4) |
Nonrandomized controlled trial |
3 |
Shin et al.126 |
Group A (3 areas) = laser/laser and collagen/collagen. Group B (3 areas) = laser/laser and placebo/placebo |
Albae |
III–IV |
Succinylated atelocollagen and ablative fractional resurfacing laser, three laser treatments at 4-week intervals |
12 |
Clinical improvement scores evaluated by two doctors found a significant difference between atelocollagen and placebo sites after laser treatment and also between atelocollagen and placebo. No randomization |
Erythema (100%) for 2–3 days, PIH (75%), one patient developed psoriasis |
Nonrandomized controlled trial |
3 |
Aust et al.127 |
Percutaneous collagen induction therapy |
Not stated |
Not stated |
Single 30-min procedure |
22 |
At 6 months follow-up improved skin texture, skin tightening, dermal neovascularization and no change in pigmentation. Increased collagen I and elastin on biopsy. No control and no randomization in this study |
None reported |
Case series |
4 |
Park et al.128 |
Needling therapy |
Albae 11, rubrae 5 |
III–IV |
Three treatments at 4-week intervals |
16 |
Results reported were that 37% (n = 6) of patients were highly satisfied, 50% (n = 8) were somewhat satisfied and 13% (n = 2) were unsatisfied. Increased collagen was found in the dermis post-treatment and the fragmented dermal elastin fibres normalized post-treatment. No control and no randomization in this study |
Pain, erythema, spotty bleeding and pruritus |
Case series |
4 |
Total studies: 30 |
LOE-1: 0; LOE-2: 3; LOE-3: 7; LOE-4: 20 |