title: Striae Distensae: Preventative and Therapeutic Modalities to Improve Aesthetic Appearance.
abstract: BACKGROUND
  Striae distensae (SD) are aesthetically troublesome to patients and therapeutically challenging.
  
  
  OBJECTIVE
  Herein, the authors comprehensively review the literature pertaining to the history, pathogenesis, clinical presentation, clinical rating scales, and laboratory, imaging, and histologic features of SD.
  
  
  METHODS
  A review of PubMed, MEDLINE, Scopus, Embase, and Google scholar was conducted, including literature published from 1773 to August 6, 2016.
  
  
  RESULTS
  The authors identified 68 articles that met inclusion and exclusion criteria.
  
  
  CONCLUSIONS
  There are few randomized controlled trials evaluating the long-term efficacy and safety of various topical and energy-based devices. Based on clinical and anecdotal experience, both nonablative and ablative fractionated lasers have shown modest SD improvement compared with other treatment modalities (including Excimer laser, CuBr laser, pulsed dye laser, and 1,064-nm Nd:YAG laser). In the authors' experience, 1,540-nm nonablative fractionated laser is a worthy first-line modality for the treatment of SD. Future researchers may consider greater focus on enhanced study design, including larger, long-term split-body, or split-SD head-to-head randomized comparative trials with objective outcome measures and end points, such as biopsy and molecular studies demonstrating increased collagen and elastic fibers that correlate to clinical improvement.
authors.affiliation: *Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; †Dermatology Service, Sacramento VA Medical Center, Mather, California; ‡Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York; §Department of Internal Medicine, California Pacific Medical Center, San Francisco, California; ¶Department of Dermatology, UC Davis Medical Center, Sacramento, California.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Ross
authors.forename: Derek
authors.initials: D
authors.lastname: Ho
authors.forename: Juliya
authors.initials: J
authors.lastname: Fisher
authors.forename: Andrew
authors.initials: A
authors.lastname: Mamalis
authors.forename: Edward
authors.initials: E
authors.lastname: Heilman
authors.forename: Nazanin
authors.initials: N
authors.lastname: Saedi
authors.forename: Jared
authors.initials: J
authors.lastname: Jagdeo
mesh_terms: D004954:Esthetics; D006801:Humans; D053685:Laser Therapy; D057896:Striae Distensae / Q000209:etiology / Q000473:pathology / Q000517:prevention & control* / Q000628:therapy*