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Microneedling Therapy for Striae Distensae: Systematic Review and Meta-Analysis

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Abstract

Introduction

Striae distensae (SD), linear scars of derma, caused by disproportionate skin stretching, which indicates a cosmetic problem and even endangers individuals’ psychosocial health. Microneedling, representing a relatively new procedural therapy, has shown brightening but diverse results in the remedy of SD. Our study systematically investigates and further evaluates the efficacy of microneedling for SD.

Method

This study was conducted following the PRISMA guidelines. According to the preplanned search strategy, four electronic databases were comprehensively searched for eligible clinical controlled studies. Standardized mean difference (SMD) and odd ratio (OR) with 95% confidence intervals were calculated for continuous data and dichotomous data, respectively.

Results

According to the predetermined criteria, eleven eligible articles of six RCTs and five non-RCTs were included. Concerning clinical improvement, a significant difference was observed in the microneedle radiofrequency treatment subgroup (SMD: 0.57, 95% CI 0.20−0.94, P = 0.003). The pooled result of the second subgroup revealed that microneedling and lasers producing almost comparable effectiveness for treating SD with no significant difference (P = 0.35). The analysis result of the third subgroup of microneedling versus non-laser therapy indicated significant difference at the 5% significance level (SMD:1.01, 95% CI 0.51−1.51, P < 0.0001). With regard to patient satisfaction, the pooled estimate concluded that participants’ satisfaction with therapeutic effect between MRF and laser group was comparable (P = 0.26), whereas microneedling exhibited significant superiority than both laser (P = 0.04) and non-laser treatments (SMD: 0.95, 95% CI 0.52–1.38, P < 0.0001). Occurrence of post-inflammatory hyperpigmentation (PIH) was not obvious in microneedling therapy compared to other treatments, and a statistically difference was observed (P = 0.0003). Microneedling treatment caused significant pain compared with laser therapy (P < 0.00001).

Conclusion

This systematic review and meta-analysis has provided initial evidence of the efficacy and safety of microneedling technology for SD.

Level of Evidence II

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References

  1. Al-Himdani S, Ud-Din S, Gilmore S, Bayat A (2014) Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol 170(3):527–547. https://doi.org/10.1111/bjd.12681

    Article  CAS  PubMed  Google Scholar 

  2. La Padula S, Hersant B, Pizza C, Chesne C, Jamin A, Ben Mosbah I, D’Andrea F, Persichetti P, Rega U, Pensato R, Meningaud JP (2023) The objective stretch marks photonumeric assessment scale: a new and complete method to assess striae distensae. Plast Reconstr Surg 151(2):307–313. https://doi.org/10.1097/PRS.0000000000009835

    Article  CAS  PubMed  Google Scholar 

  3. Borrelli MR, Griffin M, Chen K, Deleon Diaz NM, Adem S, Mascharak S, Shen AH, Ngaage LM, Lewis N, Longaker MT, Gurtner G, Wan DC, Lorenz HP (2022) Profibrotic signaling pathways and surface markers are up-regulated in fibroblasts of human striae distensae and in a mouse model system. Plast Reconstr Surg 150(2):327–338. https://doi.org/10.1097/PRS.0000000000009363

    Article  CAS  PubMed  Google Scholar 

  4. Lu H, Guo J, Hong X, Chen A, Zhang X, Shen S (2020) Comparative effectiveness of different therapies for treating striae distensae: a systematic review and network meta-analysis. Medicine (Baltimore) 99(39):e22256. https://doi.org/10.1097/md.0000000000022256

    Article  PubMed  Google Scholar 

  5. Meningaud JP, SidAhmed-Mezi M, Billon R, Rem K, La Padula S, Hersant B (2019) Clinical benefit of using a multifractional Er:YAG laser combined with a spatially modulated ablative (SMA) module for the treatment of striae distensae: a prospective pilot study in 20 patients. Lasers Surg Med 51(3):230–238. https://doi.org/10.1002/lsm.23042

    Article  PubMed  Google Scholar 

  6. Seirafianpour F, Sodagar S, Mozafarpoor S, Baradaran HR, Panahi P, Hassanlouei B, Goodarzi A (2021) Systematic review of single and combined treatments for different types of striae: a comparison of striae treatments. J Eur Acad Dermatol Venereol 35(11):2185–2198. https://doi.org/10.1111/jdv.17374

    Article  CAS  PubMed  Google Scholar 

  7. Borrelli MR, Griffin M, Ngaage LM, Longaker MT, Lorenz HP (2021) Striae distensae: scars without wounds. Plast Reconstr Surg 148(1):77–87. https://doi.org/10.1097/prs.0000000000008065

    Article  CAS  PubMed  Google Scholar 

  8. Ramaut L, Hoeksema H, Pirayesh A, Stillaert F, Monstrey S (2018) Microneedling: where do we stand now? A systematic review of the literature. J Plast Reconstr Aesthet Surg 71(1):1–14. https://doi.org/10.1016/j.bjps.2017.06.006

    Article  PubMed  Google Scholar 

  9. Ingrole RSJ, Azizoglu E, Dul M, Birchall JC, Gill HS, Prausnitz MR (2021) Trends of microneedle technology in the scientific literature, patents, clinical trials and internet activity. Biomaterials 267:120491. https://doi.org/10.1016/j.biomaterials.2020.120491

    Article  CAS  PubMed  Google Scholar 

  10. Tan MG, Jo CE, Chapas A, Khetarpal S, Dover JS (2021) Radiofrequency microneedling: a comprehensive and critical review. Dermatol Surg 47(6):755–761. https://doi.org/10.1097/dss.0000000000002972

    Article  CAS  PubMed  Google Scholar 

  11. Ryu H-W, Kim S-A, Jung HR, Ryoo Y-W, Lee K-S, Cho J-W (2013) Clinical improvement of striae distensae in Korean patients using a combination of fractionated microneedle radiofrequency and fractional carbon dioxide laser. Dermatol Surg 39(10):1452–1458. https://doi.org/10.1111/dsu.12268

    Article  CAS  PubMed  Google Scholar 

  12. Huang Q, Xu LL, Wu T, Mu YZ (2022) New progress in therapeutic modalities of striae distensae. Clin Cosmet Investig Dermatol 15:2101–2115. https://doi.org/10.2147/ccid.S379904

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Alster TS, Li MK (2020) Microneedling treatment of striae distensae in light and dark skin with long-term follow-up. Dermatol Surg 46(4):459–464. https://doi.org/10.1097/DSS.0000000000002081

    Article  CAS  PubMed  Google Scholar 

  14. Hague A, Bayat A (2017) Therapeutic targets in the management of striae distensae: a systematic review. J Am Acad Dermatol 77(3):559-568.e518. https://doi.org/10.1016/j.jaad.2017.02.048

    Article  CAS  PubMed  Google Scholar 

  15. Liu L, Ma H, Li Y (2014) Interventions for the treatment of stretch marks: a systematic review. Cutis 94(2):66–72

    PubMed  Google Scholar 

  16. Sawetz I, Lebo PB, Nischwitz SP, Winter R, Schaunig C, Brinskelle P, Kamolz LP, Gualdi A, Lumenta DB (2021) Platelet-rich plasma for striae distensae: What do we know about processed autologous blood contents for treating skin stretchmarks?-A systematic review. Int Wound J 18(3):387–395. https://doi.org/10.1111/iwj.13541

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sterne JA, Hernan MA, Reeves BC, Savovic J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hrobjartsson A, Kirkham J, Juni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schunemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 355:i4919. https://doi.org/10.1136/bmj.i4919

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tang Z, Wen S, Liu T, Yu A, Li Y (2021) Comparative study of treatment for striae alba stage striae gravidarum: 1565-nm non-ablative fractional laser versus fractional microneedle radiofrequency. Lasers Med Sci 36(9):1823–1830. https://doi.org/10.1007/s10103-020-03203-y

    Article  PubMed  Google Scholar 

  19. Nada HA, Sallam MA, Mohamed MN, Elsaie ML (2021) Optical coherence tomography-assisted evaluation of fractional Er: YAG laser versus fractional microneedling radiofrequency in treating striae alba. Lasers Surg Med 53(6):798–805. https://doi.org/10.1002/lsm.23349

    Article  PubMed  Google Scholar 

  20. Sobhi RM, Mohamed IS, El Sharkawy DA, El Wahab M (2019) Comparative study between the efficacy of fractional micro-needle radiofrequency and fractional CO2 laser in the treatment of striae distensae. Lasers Med Sci 34(7):1295–1304. https://doi.org/10.1007/s10103-019-02792-7

    Article  PubMed  Google Scholar 

  21. Al-Muriesh M, Huang CZ, Ye Z, Yang J (2020) Dermoscopy and VISIA imager evaluations of non-insulated microneedle radiofrequency versus fractional CO2 laser treatments of striae distensae. J Eur Acad Dermatol Venereol 34(8):1859–1866. https://doi.org/10.1111/jdv.16266

    Article  CAS  PubMed  Google Scholar 

  22. Saki N, Rahimi F, Pezeshkian FS, Parvar SY (2022) Comparison of the efficacy of microneedling versus CO2 fractional laser to treat striae alba: a randomized clinical trial. Dermatol Therapy 35(1).https://doi.org/10.1111/dth.15212

  23. Naspolini AP, Boza JC, da Silva VD, Cestari TF (2019) Efficacy of microneedling versus fractional non-ablative laser to treat striae alba: a randomized study. Am J Clin Dermatol 20(2):277–287. https://doi.org/10.1007/s40257-018-0415-0

    Article  PubMed  Google Scholar 

  24. Soliman M, Mohsen Soliman M, El-Tawdy A, Shorbagy HS (2019) Efficacy of fractional carbon dioxide laser versus microneedling in the treatment of striae distensae. J Cosmetic Laser Therapy 21(5):270–277.https://doi.org/10.1080/14764172.2018.1525749

  25. Khater MH, Khattab FM, Abdelhaleem MR (2016) Treatment of striae distensae with needling therapy versus CO2 fractional laser. J Cosmetic Laser Therapy 18(2):75–79.https://doi.org/10.3109/14764172.2015.1063665

  26. Nassar A, Ghomey S, El Gohary Y, El-Desoky F (2016) Treatment of striae distensae with needling therapy versus microdermabrasion with sonophoresis. J Cosmetic Laser Therapy 18(6):330–334.https://doi.org/10.1080/14764172.2016.1175633

  27. Mohamed Ali BM, EI-Tatawy RA, EIfar NN, Mohamed Ali DA (2017) A comparative clinical and histopathological study of microneedling versus microdermabrasion (aluminum oxide crystals) in the treatment of striae distensae. J Egyptian Women’s Dermatol Soc 14(2):92–99. https://doi.org/10.1097/01.EWX.0000511156.50929.3b

    Article  Google Scholar 

  28. Salve V, Pathave H, Nayak C (2021) A clinical and histopathological study comparing efficacy of microneedling versus cryoroller liquid nitrogen therapy in the treatment of striae distensae. Turkish J Dermatol 15(1):11–15. https://doi.org/10.4103/tjd.tjd_12_21

    Article  Google Scholar 

  29. Seong GH, Jin EM, Ryu TU, Kim MH, Park BC, Hong SP (2021) Fractional radiofrequency microneedling combined with fractional carbon dioxide laser treatment for striae distensae. Lasers Surg Med 53(2):219–226. https://doi.org/10.1002/lsm.23264

    Article  PubMed  Google Scholar 

  30. Litchman G, Nair PA, Badri T, Kelly SE (2023) Microneedling. StatPearls Publishing LLC., Treasure Island (FL)

    Google Scholar 

  31. Abdel-Motaleb AA, Zedan H, Mostafa MM, Abu-Dief EE, Gebril SM, Hussein MRA (2022) Combined microneedling with topical application of platelet-rich plasma versus microneedling alone in the treatment of stria distensae: clinicopathological analysis. J Dermatol Treat 33(2):836–847. https://doi.org/10.1080/09546634.2020.1782323

    Article  CAS  Google Scholar 

  32. Juhasz MLW, Cohen JL (2020) microneedling for the treatment of scars: an update for clinicians. Clin Cosmet Investig Dermatol 13:997–1003. https://doi.org/10.2147/CCID.S267192

    Article  PubMed  PubMed Central  Google Scholar 

  33. Alster TS, Graham PM (2018) Microneedling: a review and practical guide. Dermatol Surg 44(3):397–404. https://doi.org/10.1097/dss.0000000000001248

    Article  CAS  PubMed  Google Scholar 

  34. Nair P, Tandel J (2021) Microneedling: a means of collagen induction therapy. J Dermatol Dermatol Surg 25(2):49–53. https://doi.org/10.4103/jdds.jdds_126_20

    Article  Google Scholar 

  35. Fatemi Naeini F, Behfar S, Abtahi-Naeini B, Keyvan S, Pourazizi M (2016) Promising option for treatment of striae alba: fractionated microneedle radiofrequency in combination with fractional carbon dioxide laser. Dermatol Res Practice. https://doi.org/10.1155/2016/2896345

  36. Afify AA, Fawzy HM, Ali Al-Rubaiay NH, Abdallah M (2020) Fractional microneedling radiofrequency in striae alba: do growth factors add value? J Cosmet Dermatol 19(10):2583–2590. https://doi.org/10.1111/jocd.13447

    Article  PubMed  Google Scholar 

  37. Abdallah MMA, Abd Elfattah Afify A, Al-Rubaiay NHA (2021) Treatment of striae alba using fractional radiofrequency with and without lyophilized growth factors. QJM 114(SUPPL 1). https://doi.org/10.1093/qjmed/hcab093.036

  38. Ibrahim ZA, El-Tatawy RA, El-Samongy MA, Ali DA (2015) Comparison between the efficacy and safety of platelet-rich plasma vs. microdermabrasion in the treatment of striae distensae: clinical and histopathological study. J Cosmet Dermatol 14(4): 336–346.https://doi.org/10.1111/jocd.12160

  39. Hersant B, Niddam J, Meningaud JP (2016) Comparison between the efficacy and safety of platelet-rich plasma vs microdermabrasion in the treatment of striae distensae: clinical and histopathological study. J Cosmet Dermatol 15(4):565. https://doi.org/10.1111/jocd.12246

    Article  PubMed  Google Scholar 

  40. Jha AK, Sonthalia S, Jakhar D (2018) Platelet-rich plasma with microneedling and trichloroacetic acid peel for treatment of striae distensae. J Am Acad Dermatol 79(6):e107–e108. https://doi.org/10.1016/j.jaad.2018.06.001

    Article  PubMed  Google Scholar 

  41. Ebrahimi Z, Alimohamadi Y, Janani M, Hejazi P, Kamali M, Goodarzi A (2022) Platelet-rich plasma in the treatment of scars, to suggest or not to suggest? A systematic review and meta-analysis. J Tissue Eng Regen Med 16(10):875–899. https://doi.org/10.1002/term.3338

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Lvping Huang.

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Sun, X., Jia, X. & Huang, L. Microneedling Therapy for Striae Distensae: Systematic Review and Meta-Analysis. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03954-x

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