Clinical Efficacy Comparisons Between Poly-L-Lactic Acid Injections and Non-Ablative 1565-nm Fractional Laser for Treatment of Striae Distensae-A Randomized Trial.

BACKGROUND

Despite numerous treatment modalities for striae distensae (SD), a definitive gold standard therapy remains unidentified.

AIMS: This study aims to evaluate and compare the efficacy of injectable poly-L-lactic acid (PLLA) with a 1565-nm non-ablative fractional laser (NAFL) in treating SD located in the abdominal area.

METHODS

40 women with SD were randomly assigned to one of four treatment groups: (1) control, (2) PLLA, (3) 1565-nm NAFL, and (4) a combination of PLLA and 1565-nm NAFL. Participants, except those in the control group, underwent three treatment sessions at monthly intervals. Antera 3D imaging was used to collect data at baseline (T0) and 3 months post-treatment (T4). Collagen fibers were analyzed via immunohistochemical staining, while elastic fibers were assessed using picrosirius red and Masson staining at both T0 and T4.

RESULTS

The overall efficacy scores for the PLLA, 1565-nm NAFL, and PLLA + 1565-nm NAFL groups were 5.70 ± 1.25, 3.60 ± 2.12, and 6.70 ± 2.21, respectively. Post-treatment evaluations demonstrated substantial decreases in SD volume from T0 to T4, with reductions of -1.96 ± 1.53 in the PLLA group, -0.70 ± 0.67 in the 1565-nm NAFL group, and -1.48 ± 1.35 in the PLLA + 1565-nm NAFL group. The combined and PLLA groups exhibited significant reductions in area compared to the 1565-nm NAFL and control groups. Histological analysis confirmed the presence of PLLA particles in the treated area without inflammatory reactions 1 month post-final injection.

CONCLUSIONS

PLLA injections are more effective than 1565-nm NAFL in SD treatment, enhancing collagen production without inducing inflammation in treated skin.

TRIAL REGISTRATION: Clinicaltrials.gov: NCT05827913.