title: Evaluation of Various Therapeutic Measures in Striae Rubra.
abstract: BACKGROUND
  Striae are linear atrophic depressions that form in areas of dermal damage in the skin. As on date, no consensus or protocol exists for the treatment of stria rubra. Topical retinoids, chemical peels, microdermabrasion, radiofrequency, photothermolysis, intense pulsed light and lasers are some of the modalities used.
  
  
  OBJECTIVE
  To compare the efficacy of various therapeutic modalities in striae rubra.
  
  
  METHODS
  This prospective cohort study comprised of a total of fifty patients from August-2012 to October-2013 in a tertiary care center in Western India, Gujarat having striae rubra. They were randomly divided into five groups of ten patients each. Patients were evaluated on the basis of visual assessment, both by doctor as well as the patient. Group I was given topical tretinoin (0.1% w/w) gel applied once at night, Group II-microdermabrasion (MDA) combined with trichloroacetic acid (TCA) (30%) peel, Group III-mesotherapy, Group IV-Q-switched Nd: YAG laser, and Group V-combination treatment of microdermabrasion, salicylic acid peel and retinol (yellow) peel. Patients were treated at an interval of 15 days for 2 months and then at monthly intervals. Objective assessment was done at 2(nd) month, 6(th) month, and at the end of 1(st) year.
  
  
  RESULTS
  Patients in Group I treated with topical tretinoin showed the least response with 80% (8) of them showing minimal clinical improvement (0-25%) as compared to patients in Group V in which 60% (6) patients showed moderate clinical improvement (50-75%). While majority of the patients in Group II, III, and IV showed mild clinical improvement (25-50%).
  
  
  CONCLUSIONS
  Striae rubra is a common cause of concern for adolescent population. Combination treatment with microdermabrasion, salicylic acid and retinol yellow peel gave superior results as compared to other therapeutic options. Mild to moderate improvement was seen with Nd: YAG laser, mesotherapy and MDA + TCA whereas minimal improvement were seen with topical tretinoin.
authors.affiliation: Department of Dermatology, B.J. Medical College, Ahmedabad, Gujarat, India.
authors.forename: Umesh Karsandas
authors.initials: UK
authors.lastname: Karia
authors.affiliation: Department of Dermatology, GMERS Medical College, Gandhinagar, Gujarat, India.
authors.forename: Bela Bhemabhai
authors.initials: BB
authors.lastname: Padhiar
authors.affiliation: Department of Dermatology, B.J. Medical College, Ahmedabad, Gujarat, India.
authors.forename: Bela Jaswantbhai
authors.initials: BJ
authors.lastname: Shah
keywords: Mesotherapy; Q-switched Nd: YAG laser; microdermabrasion; retinol yellow peel; striae rubra; topical tretinoin