Carboxytherapy versus its Combination with Fractional CO2 Laser for the Treatment of Striae Distensae: An Objective, Right-to-left, Comparative Study.

Abstract

Background: Striae distensae (SD) is a common cutaneous disorder which appears as linear lesions seen mainly in women. Since previously described in 1889, SD has presented a significant challenge regarding its evaluation and treatment. Carboxytherapy was recently reported as an effective treatment for SD.

Objectives: We sought to objectively compare the clinical effectiveness of carbon dioxide therapy (CDT) as monotherapy versus a combination of CDT and fractional CO₂ laser in the treatment of SD.

Methods: This randomized prospective study included twenty cases with bilateral and symmetrical SD. Each patient was treated with CDT only on the right (Rt) side of the body, while the left (Lt) side received a combination of CDT and fractional C0₂ laser.

Results: Clinical evaluation revealed a clearly significant clinical improvement in SD lesions after both techniques regarding length, width, texture, and pigment changes. Although the Lt side showed slightly better improvement, however no statistically significant difference could be observed between both sides. In the meantime, the objective improvement observed by the 3D camera and histometric analysis correlated with the clinical improvement. Special stains showed collagen deposition which became more compact, dense and better organized, accompanied by evident increase in elastic fibers in a normal linear microfibrillar pattern after treatment on both sides.

Conclusion: CDT demonstrated efficacy and safety as a minimally invasive modality for management of SD, as it induces collagen remodeling and better organization of elastic fibers with minimal side effects and downtime.