Striae Distensae (SD), or stretch marks, are medically benign and asymptomatic, but this linear scarring of the skin is very distressing for those who suffer from it. Most women will experience striae, especially for whitened striae known as Striae Alba (SA).
Researchers at Srinakharinwirot University in Bangkok, Thailand have reported significant results using Venus Viva™, a device based on a patented form of fractional radio frequency called NanoFractional RF ™ (1).
The researchers conducted a clinical evaluation of the efficacy and safety of NanoFractional RF ™ in a blinded before-after study on 33 subjects in Thailand with Striae Alba, the chronic form of SD that presents as white wrinkled dermal scars.
Summary: Key Findings and Implications
The results of the study by Dr. Napatthaorn Pongsrihadulchai and colleagues at Srinakharinwirot University published in the Journal of Cosmetic Dermatology in September 2016 were significant: Stretch marks decreased in length, width and surface area after each treatment starting at four weeks.
After 12 weeks and three treatments with Venus Viva™, a statistically significant reduction in total surface area was recorded.
In addition, collagen and elastin increased, with the study demonstrating significant treatment-induced dermal collagen and elastin production at four weeks after treatment.
Patients were highly satisfied with the results. The satisfaction scores were “Satisfied” and “Very Satisfied” for changes on texture, size, and overall improvement being 96.67%, 93.94% and 96.97% respectively.
The study results confirmed:
- The availability of a safe, effective treatment for Striae Alba. Venus Viva™ has evidenced its efficacy with strong satisfaction among recipients and providers.
- This is an important new application for Venus Viva™ For aesthetic practitioners who already offer Venus Viva™, this represents the potential to serve a new patient base. For practices seeking a multi-indication treatment, the findings underscore the value that Venus Viva™ brings as an effective and versatile therapeutic device.
Epidemiology, Clinical Presentation and Patient Concerns
About 90 percent of pregnant women, 70 percent of adolescent girls and 40 percent of adolescent boys have stretch marks. (2) All races are affected, and stretch marks commonly appear on the breasts, abdomen, buttocks and thighs.
Demand for treatments is strong. U.S. consumers spent about $161.4 million in 2014 on creams intended to minimize pregnancy-related stretch marks, and compound annual growth of 5.7 percent is expected in this market through 2023. (3)
SD is caused by progressive stretching of the skin connective tissue due to changes in the contours of the body, (4) but the precise pathogenesis is not well understood. Females are 2.5 times more susceptible than males. (5) Initially, SD are red lesions, Striae Rubra, which become Striae Alba as they age.
Embarrassment over striae is acute, and this condition has negative consequences for quality of life. One survey among women (6) found that 81 percent of respondents felt self-conscious about stretch marks, 69 percent were eager to get rid of them and 20 percent have avoided having sex with the lights on because of striae.
Among sufferers of stretch marks that appeared as a result of pregnancy, respondents reported embarrassment (44 percent), helplessness (34 percent) and dread (22 percent).
Historical Overview of Treatment Modalities
The search for treatments of SD has to date met with disappointing results, and no standard treatment has been identified. Therapeutic approaches have sought to reduce the color and texture differences of striae from the surrounding skin.
For Striae Alba, the main interventions have been topicals such as chemical peels and retinoids, and therapies including pulsed dye lasers, ablative and non-ablative fractional lasers, microneedle radiofrequency, dermabrasion and phototherapy. More recently, combination treatments such as fractionated microneedle radiofrequency with fractional carbon dioxide laser have been studied. (4)
Some studies have found fractional laser to be effective (7, 8) but it causes hyperpigmentation in some patients, especially those with darker skin. (9,10) Studies on non-ablative microneedle RF showed improvement of 30 to 50 percent in SA. (11)
This study enrolled 33 subjects ages 18 to 60 with Striae Alba on their thighs, abdomen or buttocks (11 each). They had Fitzpatrick skin types III-IV.
Each participant received three sessions of treatment with Venus Viva™ at fourweek intervals.
Clinical outcomes were assessed through pre- and post-treatment measurement of scar surface area, length and width. Histopathological results were measured in terms of the changes in the number of collagen and elastin bundles.
The study results show efficacy for Venus Viva™ as a treatment for SA.
- Total surface area as documented by Pictzar™ software measurement decreased from an average mean of 6.21 cm 2 at baseline to 4.70, 3.55 and 2.55 cm2 at consecutive intervals. P values < 0.001 indicate a high statistical significance. (See figure 1 – data adapted from Table 2, page 4)
- Average mean width and length also declined at each interval with a statistical significance of P < 0.001.
- Patient satisfaction increased over the course of the study. Patients’ selfreported satisfaction scores of 4 and 5 (satisfied and very satisfied) for changes in texture, size and overall improvement were 96.97 percent, 93.94 percent and 96.97 percent respectively.
- Physician satisfaction showed concordant results with about 69.7 percent of study participants rated as having greater than 50 percent improvement.
- The treatments were well tolerated with a mean pain score of 2.33 on a 0 to 10 scale.
- Postinflammatory hyperpigmentation (PIH) was observed in six patients or 18.1 percent, and this improved with topical treatment with 4 percent hydroquinone. This compares to incidence of PIH of 81.8 percent for fractional CO2 laser and 36.4 percent for fractional Erbium glass laser. (12) The side effect of PIH with Venus Viva™ was similar to that of non-ablative fractional microneedle RF (18.1 percent vs 20 percent), demonstrating the safety of the treatment for SA.
- Collagen and elastin increases were noted at four weeks after treatment. At 12 weeks, a significant increase the number of collagen and elastin bundles was observed compared to the baseline (P = 0.005 and 0.012, respectively). Moreover, the collagen bundles became thicker and more densely accumulated at upper dermis than the baseline.
“In conclusion, nanofractional RF is highly effective and safe for the treatment of Striae Alba,” the study reported.
Study Strengths and Advantages of Venus Viva™
The study was notable for its strong design, which included use of blinded assessors, an ample sample size, participation of subjects with darker skin tone, employment of objective measuring techniques and results that were statistically significant.
In addition to being safe and effective, the authors noted that Venus Viva™’s small pin size can reduce side effects and recovery time. Also in contrast to lasers, RF does not target the chromophores on the skin, so it is considered to be safe for use in all skin types.
Is Venus Viva™ Right for Your Practice?
The potential to achieve improvement in stretch marks offers aesthetic practitioners a new opportunity to delight patients and improve their quality of life. Venus Viva™ can open new markets for your practice and serve as a multiindication workhorse.
Venus Concept, which works with leading practitioners in more than 60 countries, is at the forefront of aesthetic innovation. But our commitment to your progress doesn’t stop in the laboratory. Offered under a unique business model that maximizes your ROI, every product is backed by the most comprehensive warranty program in the industry, unmatched marketing support, continuous clinical education, valuable practice enhancement programs, and more—all at no additional cost.
If you’d like to learn more, reach us at 888.907.0115 option 5.
- Pongsrihadulchai N, Chalermchai T, Ophaswongse S, Pongsawat S, Udompataikul M. An efficacy and safety of nanofractional radiofrequency for the treatment of striae alba. Journal of Cosmetic Dermatology. 2016.
- Alaiti S. Striae Distensae [Internet]. Emedicine.medscape.com. 2016 [cited 17 January 2017]. Available from: http://emedicine.medscape.com/article/1074868-overview#a6
- Sudip S. Improving General Fertility Rate Steers Sales of Pregnancy Products Worldwide, says TMR [Internet]. Transparency Market Research. 2016 [cited 17 January 2017]. Available from: http://www.transparencymarketresearch.com/pressrelease/us-pregnancyproducts- market.htm
- Fatemi Naeini F, Behfar S, Abtahi-Naeini B, Keyvan S, Pourazizi M. Promising Option for Treatment of Striae Alba: Fractionated Microneedle Radiofrequency in Combination with Fractional Carbon Dioxide Laser. 2016.
- Elsaie M, Baumann L, Elsaaiee L. Striae Distensae (Stretch Marks) and Different Modalities of Therapy. Dermatologic Surgery. 2009;35(4):563-573.
- Stretch Marks, Scars and Skin Concerns [Internet]. Dermascope.com. [cited 17 January 2017]. Available from: http://www.dermascope.com/scopethis/ stretch-marks-scars-and-skin-concerns#.WHxPy1zj2VA
- de Angelis F, Kolesnikova L, Renato F, Liguori G. Fractional Nonablative 1540-nm Laser Treatment of Striae Distensae in Fitzpatrick Skin Types II to IV: Clinical and Histological Results. Aesthetic Surgery Journal. 2011;31(4):411-419.
- Kim B, Lee D, Kim M, Song K, Cho W, Lee C et al. Fractional Photothermolysis for the Treatment of Striae Distensae in Asian Skin. American Journal of Clinical Dermatology. 2008;9(1):33-37.
- Yang Y, Lee G. Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO2Fractional Laser: A Randomized Controlled Trial. Annals of Dermatology. 2011;23(4):481.
- Lee S, Kim J, Lee S, Lee J, Kang J, Kim Y et al. Treatment of Striae Distensae Using an Ablative 10,600-nm Carbon Dioxide Fractional Laser. Dermatologic Surgery. 2010;36(11):1683-1690.
- Kim J, Lee H, Kim J, Moon S, Ko J, Lee M et al. Objective Evaluation of the Clinical Efficacy of Fractional Radiofrequency Treatment for Acne Scars and Enlarged Pores in Asian Skin. Dermatologic Surgery. 2014;40(9):988-995.
- Ryu H, Kim S, Jung H, Ryoo Y, Lee K, Cho J. Clinical Improvement of Striae Distensae in Korean Patients Using a Combination of Fractionated Microneedle Radiofrequency and Fractional Carbon Dioxide Laser. Dermatologic Surgery. 2013;:n/a-n/a.