Treatment of striae albae with combination of fractional radiofrequency and topical tretinoin: A randomized controlled trial.

Mature striae distensae, called striae albae, are common but treatment-resistant dermal scars. Fractional radiofrequency (FRF) can potentially act as transdermal permeation enhancer for topical tretinoin (TT). This study investigated FRF and TT as a combination treatment for striae albae. Twenty patients were included, each with four anatomically comparable areas that were randomized to (i) TT (ii) FRF (iii) combination FRF + TT and (iv) untreated control. Three treatment sessions were performed one month apart, and TT was also applied in-between. The change in striae from baseline to 20-week follow-up (Δ) was assessed using the Patient Observer Scar Assessment Scale (POSAS, SUM: 6-60). At baseline, patients assessed the striae as moderate-severe (POSAS-PT: SUM medians 24-25) and at follow-up, they reported an improvement (POSAS-PT: ΔSUM 5-10 points), but only the combination treatment improved significantly better (FRF + TT vs. control p = 0.029). A blinded dermatologist confirmed a tendency towards treatment improvement (POSAS-OBS: ΔSUM: 0-2 point, all treatments vs control p≥0.269). A subtle tendency was observed in objective measures with 3D photographs. Combination treatment with FRF and TT was tolerable and improved patient-reported striae compared to control. Striae albae remain challenging, but the findings highlight a potential for future combination treatment approaches.Trial registration number: NCT05461755Date of registration: 15.07.2022.