Comparative study between dermaroller and dermaroller with platelet rich plasma in the treatment of striae alba

Abstract

SUMMARY S triae distensae are dermal atrophic scars with overlying epidermal flattening and atrophy, that occurs after tissue tearing due to overstretching or rapid growth. They are a common skin condition that rarely causes any significant medical problems, but are often a significant source of distress for those affected. Although SD are common, satisfactory therapeutic interventions have been disappointing. Skin needling has been used since 1995 to achieve PCI. It is an effective method for treating scars; post-acne scars, surgical scars, and stretch marks. The technique involves puncturing the skin multiple times with a small needle to induce collagen growth. It is presumed that this technique promotes removal of damaged collagen found in the scar tissue and induces new collagen formation. Platelet rich plasma is a generic term used to describe a plasma suspension obtained from whole blood, prepared so as to contain platelet concentrations higher than those normally found in circulating blood. The mechanism of action of PRP is based on the fact that platelets contain many growth factors in their alpha granules. These factors have a well-known role in the process of tissue repair. They act on the mesenchymal stem cells, osteoblasts, endothelial cells, epidermal cells, and fibroblasts, promoting new collagen synthesis. In the present study, we compared the efficacy of dermaroller alone Vs dermaroller and PRP in the treatment of striae alba, both clinically and histopathologically. Ten patients with striae alba in their abdomen were enrolled in our study. On the right side of the abdomen microneedling with dermaroller was done, and on the left side dermaroller followed by PRP injection was done. Each patient underwent 3 sessions at 1 month interval. Skin biopsies were taken from both sides at baseline and 3 months after the last session. Clinical improvement was assessed by comparing pre and post-treatment photographs, using the quartile grading scale. Histopathological evaluation was done by comparing epidermal thickness, collagen bundles thickness, and elastic fibers number in pre and post-treatment biopsies, stained with H&E, MT, and orcein stains. There was statistically significant clinical improvement in both sides, yet there was no statistical significant difference between both sides. Collagen thickness and elastic fibers were markedly increased in both sides, with significant higher difference in the side treated with dermaroller and PRP. Epidermal thickness was mildly improved in both sides with no statistical difference between them.