Evaluation and Comparison of the Efficacy and Safety of Erbium YAG Laser Along With Normal Saline vs. Its Combination With Stromal Vascular Fraction (SVF) and Platelet-Rich Plasma (PRP) in the Treatment of Striae Distensae: A Double-Blind Randomized Clinical Trial.

Background: There is no definitive solution for the treatment of striae distensae (SD), and effectiveness of each treatment method remains controversial. We aimed to investigate and compare the efficacy of the combination of Erbium YAG (Er:YAG) laser and stromal vascular fraction (SVF), the combination of Er:YAG laser and platelet-rich plasma (PRP) and Er:YAG laser plus saline in the treatment of SD.

Materials And Methods: In 12 participating patients with at least three lesions (36 lesions in total), each lesion was treated with an Er:YAG laser. SVF was randomly injected intradermally for the first lesion, PRP for the second lesion, and normal saline as placebo for the third lesion. Treatment duration was one session, and the safety and efficacy of the treatment was assessed 3 months later using the following items: evaluation of biometric parameters including corneometery, erythema, melanin, tewametery, color, cutometery, complete thickness, epidermal thickness, dermal thickness, complete density, epidermal density, and dermal density; assessment of patient and physician satisfaction using Likert score; and recording of adverse effects of treatment.

Results: The study involved 12 patients (evaluating 36 lesions in total), predominantly women (83%), with an average age of 39.16 years. The analysis revealed significant improvements in biometric indices, including complete thickness, epidermal thickness, dermal thickness, and R5 cutometer readings across all groups after the intervention. Notably, the SVF and PRP groups showed statistically significant enhancements in dermal and complete density compared to the placebo group. The SVF group demonstrated a significant increase in epidermal density (from 45.95 to 51.19, p = 0.001), unlike the PRP and placebo groups which showed nonsignificant changes. Comparing the average changes in biometric factors, the SVF group exhibited significantly greater increases in complete thickness, dermal thickness, complete density, epidermal density, and dermal density than the other groups. Both patient and physician satisfaction scores were highest in the SVF group (p = 0.001), with no significant posttreatment complications reported.

Conclusion: Our results showed that the combination of Er:YAG laser and SVF injection could be considered an effective and safe treatment method in the treatment of SD.

Trial Registration: IRCT20200127046282N14.