Tretinoin Treatment of Early Striae

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Summary and Comment

Tretinoin Treatment of Early Striae

Past studies of the treatment of striae with tretinoin have shown mixed results. In this double-blind, randomized, placebo-controlled study, 22 patients applied either 0.1% tretinoin cream (10 patients) or vehicle (12 patients) daily for six months to individual early red or violaceous striae. Patients were evaluated monthly by self-assessment questionnaires and skin examinations that included assessments of striae severity on a 10-point scale and measurements of striae length and width. In addition, biopsies were taken before and after treatment for histologic assessment and immunohistologic analysis of dermal elastin and collagen content.

Tretinoin-treated patients showed statistically significant improvements in severity scores after two months of treatment. After six months, 80% of the tretinoin-treated patients had definite or marked improvement of striae, with statistically significant decreases in mean length and width of 14% and 8%, respectively. There were no significant differences in elastic and collagen fibers in striae after tretinoin treatment as compared with before. Moderate or severe erythema and scaling developed in 55% of the tretinoin-treated patients early in the course of treatment but gradually resolved.

Comment: In this very thorough study, early and prolonged tretinoin treatment was effective in improving the appearance of red striae. However, the histologic component of this study does not shed any light on the possible mechanism for the clinical changes observed. Other studies have shown that white striae usually fail to respond to tretinoin treatment but may be amenable to pulsed dye (585-nm) laser therapy, as described below. This study was supported in part by a drug company that makes tretinoin.

— GJ Hruza

Published in Journal Watch Dermatology June 1, 1996