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Background: The impact of striae gravidarum (SG), or stretch marks of pregnancy, on quality-of-life is unclear. The purpose of this study was to investigate how SG impact life-quality in pregnant women. Methods: In this cross-sectional survey study of healthy pregnant women who developed SG during their current pregnancy, we asked about the impact of lesions on emotional, psychological, and life-quality facets. Spearman product-moment correlation coefficients (r) were generated to determine the strength of relationships between variables. Results: We analyzed 116 valid surveys. Participants reported permanency of SG as the top physical concern (n=87, 75%). Regarding severity, nearly three-quarters of participants rated their lesions as “very prominent” (n=24, 21%) or “moderate” (n=57, 49%). Among life-quality facets queried, embarrassment/self-consciousness was the one most frequently associated with SG, with over one-third of participants reporting “a lot” (n=19, 16%) or a “moderate” (n=26, 22%) amount of embarrassment/self-consciousness related to having SG. Lesion severity significantly correlated with the degree of embarrassment/self-consciousness (r=0.543), as well as the impact of SG on other life-quality facets, including overall quality-of-life (r=0.428), clothing choice (r=0.423), self-image/self-esteem (r=0.417), feelings of anxiety/depression (r=0.415), and social activities (r=0.313) (all p≤0.001). Nearly one-quarter of participants felt that emotional distress related to SG was similar or more than that caused by other skin problems, such as acne, psoriasis, or eczema. Conclusion: SG can be associated with a host of negative reactions reflecting increased psychological and emotional distress, including embarrassment and decreased quality-of-life. These consequences may compound the emotional stress of pregnancy, potentially warranting psychological support and adjustment strategies.

Striae distensae (SD), also known as stretch marks, are common skin lesions causing significant psychological stress and cosmetic disfigurement. They are common to be seen during pregnancy, rapid weight change, puberty and many other pathological conditions including Cushing disease, anorexia nervosa or even excessive use of certain drugs. Clinically, they appear as either red raised linear bands known as striae rubrae (SR) or white depressed atrophic bands known as striae albae (SA). They were first described histopathologically in 1889. Many theories have been established to explain the etiopathogenesis of SD, yet the exact mechanism is still unclear. Also, many treatment modalities have been applied to reach the maximum efficacy with the least side effects. The aim of this review article is to optimize the most recent and accepted concepts on etiopathogenesis and pathophysiology of SD which may help in finding the best lines of management with the most satisfactory outcomes.

Stretch marks (SM) feature visible linear scars developing on the body in the areas of excessive stretching of the skin. This is a benign skin condition, but because of their aesthetic implications, they can cause distress among their sufferers. SM show high prevalence, probably more than 50 % among pregnant women, and 50 to 90 % in the general population. SM affect more likely certain ethnic groups, especially dark-skinned patients. During pregnancy, risk factors include family history, but also important weight gain whilst more generally elevated body mass index also constitutes a risk factor. Clinically, the initial erythematous and violaceous lesions referred to as striae rubrae fade into wrinkled, hypo-pigmented, atrophic scar-like marks named striae albae. Four main theories support SM formation: 1) mechanical stretching of the skin; 2) hormonal changes; 3) an innate structural disturbance of the integument; 4) genetic predispo­sitions. Histologically various abnormalities of collagen and elastic fibres are described at dermal level. The treatment of SM is always deceptive. Topical treatments are the commonest, among them Centella asiatica or hyaluronic acid creams, almond oil, topical retinoids, cocoa butter or olive oil are the most popular. Chemical peels may also be used with limited success. Various office procedures may also be performed, such as microdermabrasion, radiofrequency, laser/light therapy, platelet-rich plasma and others, but the results are often limited and deceptive for both the patient and the dermatologist. More remains to be done about the study of this frequent dermatological disorder.

Background Stretch marks are linear scars that result from elastic fiber destruction. They usually occur as the consequence of rapid change in the body mass (weight gain and loss, pregnancy, weightlifting), long‐term steroid use, or endocrinopathies. Treatment is challenging and mainly based on topical and procedural therapies, although the standard of care is still under debate. Purpose To evaluate the efficacy and tolerance of a topical oil formulation of plant extracts and vitamins on the aesthetic improvement of stretch marks and xerosis. Materials and methods Fifty male and female patients, aged between 14 and 45 years, with stretch marks referring at the University Hospital Federico II, Naples, were enrolled between March and November 2019. Topical application of plant extracts and vitamin‐rich oil was performed twice daily on affected skin for 4 months. Patients were monitored at baseline (T0), and at two‐month (T1) and 4‐month (T2) follow‐ups, through clinical and dermoscopic assessment, confocal microscopy, cutaneous ultrasound, MoistureMeterEpiD, and X‐Rite spectrocolorimeter. Primary endpoints were as follows: 70% clinical improvement of stretch marks and 3‐point decrease in clinical score from baseline to T2. Secondary endpoints were as follows: change in the T0 parallel pattern of collagen fibers at confocal microscopy, cutaneous thickness increase at ultrasounds, cutaneous hydration increase at MoistureMeterEpiD, erythema reduction at X‐Rite spectrocolorimeter, and safety and adverse events (AEs). Results At 4‐month follow‐up, stretch marks improved objectively and subjectively in all patients (p

Striae distensae, also known as stretch marks, particularly associated with female sex, pregnancy, obesity, and/or hormonal change, are linear bands of benign dermal lesions. Although not posing any health risk, aesthetically unpleasing stretch marks can cause significant psychological distress among those affected. In abundance of therapeutic approaches, some literature sources proclaim platelet‐rich plasma to be a promising treatment modality for striae distensae. We aimed to shed some light on the current literature evidence of platelet‐rich plasma for treating stretch marks and performed an English literature analysis with two independent reviewers in accordance with PRISMA guidelines searching the PubMed and Web of Science databases in June 2019. Of the 12 found studies, 6 matched inclusion criteria. With no control groups in two, just two other reports used intraindividual comparisons, and all but one publication performed histopathological assessments. All studies observed clinical and subjective improvements without using validated scores or patient‐reported outcome measures (PROMs). The main findings were that multiple treatments with platelet‐rich plasma demonstrated increased epidermal thickness, rete ridges formation, and collagen/elastin formation, while decreasing the inflammatory cell infiltrate. The current literature evidence supporting the use of platelet‐rich plasma for striae distensae is poor. We propose in this review an outline for a study protocol with intraindividual control groups, standardised scores, validated PROMs, and participant incentives to enhance the scientific power in future clinical trials.

Carboxytherapy is a medical technique during which a sterile gas—carbon dioxide—is injected into the subdermal tissue. The utility of carbon dioxide injections has enhanced the practical relevance of carboxytherapy as a method for the management of multiple disorders. We have evaluated its use in the treatment of dermatologic conditions by searching electronic databases (ie, MEDLINE and PubMed) for contributions in the English language through January 2021. Carboxytherapy provides an attractive aesthetic option in skin rejuvenation, atrophic scars, striae distensae (stretch marks), cellulite-fibrolipodystrophy adhesions after liposuction, and certain types of alopecia. We discuss the drawbacks of the procedure including inadvertent lipolysis, long-lasting emphysema, and suboptimal outcomes.

Authors present a study about the contraction forces observed in striae distensae fibroblasts (SMF) in a collagen scaffold. Collagen lattices were used to study the mechanical behavior of SDF within the collagen matrix compared to the lattices produced using the healthy skin derived fibroblasts (NSF). A Forcebox device was used to measure the contractile forces. Striae Rubrae fibroblast’s contractile force was by 28% greater than that generated by the NSF and striae albae fibroblasts (P

BACKGROUND AND OBJECTIVES Striae distensae (SD) is a challenging skin condition. Striae alba (SA) represents the chronic late atrophic stage of SD. Fractional laser technology is among the modalities used for treating SD. Lately, fractional microneedling radiofrequency (FMR) is gaining increased popularity in treating SD. The aim of our study was to assess and compare the efficacy of FMR and fractional Er:YAG laser in the treatment of SA. STUDY DESIGN/MATERIALS AND METHODS Twenty female patients were enrolled in the study fulfilling all inclusion and exclusion criteria. On a randomly selected half side of the body, the patients were treated with 2940 nm fractional Er:YAG laser while the other half side was treated with the FMR. RESULTS Both modalities showed a significant reduction in the width of the widest striae (P

BACKGROUND Striae gravidarum (SG) are a form of scarring on the skin observed during pregnancy and an important cosmetic problem. Vitamin D plays an important role in the skin. AIMS To assess the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the presence and severity of SG in primigravid women. METHODS The study included 91 primigravid women at the gestational age of 36-41 weeks. Patients were examined and divided into two groups with respect to whether they had SG or not. Striae were scored using the numerical scoring system of Atwal et al. The serum 25(OH)D levels were evaluated. RESULTS While 55 patients (60.5%) had SG, 36 (39.5%) did not. The mean serum 25(OH)D level of women with SG was 17.69 ± 9.81 ng/mL and of women without SG was 21.18 ± 11.71 ng/mL. There was no statistically significant difference between two groups (P = .144). Multivariate logistic regression analysis has shown that women who have normal values of serum 25(OH)D (≥30 ng/mL) have a lower risk of having SG than women who have scarce levels of serum 25(OH)D (

The skin during pregnancy undergoes profound changes that are associated with multiple endocrine, metabolic, and immunologic adjustments to this state. Pregnant patients develop physiologic or endocrine-induced skin changes, dermatoses specifically related to pregnancy, and skin diseases seen in the nonpregnant state. The physiologic changes occur with such regularity during pregnancy that they are considered virtually normal, but these changes sometimes become pathologic when severe. Pigmentary changes during pregnancy include darkening of the areolae, producing what is known as secondary areolae. Nail changes seen during pregnancy include Beau's lines, brittleness or softening, distal onycholysis, subungual keratosis, and accelerated nail growth. Vascular changes occur during pregnancy and are related to distention, fragility, and proliferation of vessels. Breast changes during pregnancy include enlargement, tenderness, erect nipples, hyperpigmentation of nipples and areolae, prominence of veins, striae, and Montgomery's tubercles. ues of pregnancy. Striae distensae, or stretch marks, are linear violaceous bands, which progress over time to pink or white atrophic lines.

Hookworm-related cutaneous larva migrans is caused by the subcutaneous migration of hookworm larvae. The characteristic sign is a serpiginous cutaneous track. Folliculitis is an uncommon clinical manifestation. We report a case of hookworm-related folliculitis in a woman performing skin bleaching. A 33-year-old woman presented with a widespread cutaneous eruption made of erythematous and itchy follicular papulo-nodules, with erythematous serpiginous tracks, about 5-10cm long and numerous streaks of scratching, located on the limbs, buttocks and trunk. The cutaneous lesions occurred two days after contact with the floor of a warehouse contamined by faeces of cats. The lesions have been evolving for a week and have been treated with antibiotics without success. Clinical examination found cutaneous atrophy, purple stretch marks and hyperpigmentation of dorsal parts of fingers joints. The patient reported having been using bleaching cosmetics containing topical steroids and hydroquinone for twelve years. She was cured within 4 weeks with oral albendazole 400mg per day during 7 consecutive days.

BACKGROUND Striae distensae (SD) are skin lesions of parallel streaks, which mostly occur during rapid tissue expansion. Considering the etiological mechanism of SD, including dermal network ruptures and alignment to mechanical stretch, structural directionality or anisotropy could be expected. Non-invasive objective methods for measuring the anisotropy of SD have not been suggested yet. Therefore, we evaluated the anisotropic properties of SD with regard to skin surface texture and viscoelasticity, to verify them as new objective evaluation parameters of SD. METHODS Thirty-two healthy subjects with SD on their body participated. Anisotropy of skin surface texture and biomechanical properties of SD-involved skin and adjacent normal skin was assessed and compared. RESULTS Analysis of skin surface texture, based on the ×60 magnified images, revealed that SD have more disordered patterns compared to the regular honeycomb patterns seen in the normal surrounding skin. SD have bigger sizes of each blob than normal skin. The overall anisotropy of skin texture was significantly higher in SD. Skin biomechanical parameters, measured using Cutiscan® , indicated the less deformable, less recovered, and less viscoelastic properties of SD. When comparing viscoelastic properties over 360°, SD were more anisotropic than the adjacent normal skin as well. CONCLUSION We observed that SD were significantly more anisotropic than adjacent normal skin with regard to skin surface texture and viscoelasticity. Therefore, anisotropy could be an objective evaluation parameter to represent the distinctive features of SD. It can be applied for evaluation of the SD severity and clinical efficacy of various treatments.

Objective: We study the risk factors that affect the formation of striae gravidarum in women in Jiangsu Province of China under current living habits. Materials and methods: This sample is based on 400 primiparas from obstetric of the Affiliated Hospital of Jiangnan University in Wuxi from February 2017 to October 2017. Among them, there are 200 pregnant women with striae gravidarum and 200 without striae gravidarum. Striae gravidarum predictors were selected such as age, height, pre-pregnancy BMI, postpartum BMI, daily sitting time, weight gain during pregnancy, fetal weight, and diet on maternal. Results: (1) The pregnant women who had striae gravidarum were generally lower in height than those who did not have striae gravidarum and had a higher BMI index than those who did not have striae gravidarum before and after childbirth. (2) In the pregnant women who have had striae gravidarum, the incidence of abdominal striae gravidarum in sedentary women is significantly lower than those in non-sedentary women, the incidence of striae gravidarum in legs is higher than those in non-sedentary women, and no significant difference in hip striae gravidarum. (3) In all pregnant women who have striae gravidarum, abdomen striae gravidarum tend to be lighter and leg striae gravidarum tends to be heavier in sedentary women, but no significant effect on the hip. (4) Regular consumption of honey, milk, trotters, freshwater fish, eggs, and tremella can reduce the incidence of striae gravidarum. Conclusion: The lifestyle and eating habits have a certain influence on the formation and severity of stretch marks. Keywords: Striae gravidarum, Sedentary, Legs, Estrogen, Collagen

SUMMARY Striae distensae, or stretch marks, are common linear lesions of atrophic skin characterized histologically by epidermal atrophy, absent rete ridges, and alterations in connective tissue architecture. Hormonal excess, mechanical stress, and genetic predisposition are all associated with striae distensae, but their exact pathogenesis remains unknown. Despite a multitude of options, no single treatment has yet proven effective. In this article, the authors describe an up-to-date overview of striae distensae in terms of their etiology, pathophysiology, and therapeutic options. Further research is required to better elucidate their pathophysiology and to develop targeted effective treatments.

Striae distensae (SD), commonly known as stretch marks, represent linear dermal scars associated with epidermal atrophy. It is prevalent in all races. Objective: The aim of this study was to compare the efficacy and the safety of use of ablative fractional CO2 laser therapy and carbon dioxide gas intradermal injection in treatment of striae distensae. Methods: The present study included 20 patients diagnosed with striae distensae who had never received any previous treatment for SD. There were three groups; each group composed of 10 patients: The first group was treated with ablative fractional CO2 laser resurfacing 10,600 nm The treatment parameters in this study were: energy (30-40 mJ), pulse duration (1.4-1.8 ms), scanning area (20 mm x 5 mm), depth level (1-2) and density level (8-16) according to each patient condition and skin type. Stria of the second group was treated with intradermal injection of carbon dioxide gas. 4-mm bunch biopsies were taken from patients before and after treatment by and results showed high percentage of excellent improvement with fractional CO2 laser.Results: Carbon dioxide laser showed significant higher percentage of excellent improvement after last session of treatment of SD, when compared with carbon dioxide injection.Conclusion: Treatment with CO2 laser showed significant higher frequency of striae with excellent improvement, with good improvement, when compared to treatment with CO2 injection (carboxytherapy). Fractional CO2 laser is promising tool in dermatology and in treatment of SD (safe and effective).

BACKGROUND Striae gravidarum (SG), popularly called as stretch marks, is a common pregnancy-related asymptomatic skin condition, but is a cosmetic concern for females. A few epidemiological studies have been reported from Asian countries. However, no such study has been done in Nepal. AIMS This study was aimed to know the prevalence and risk factors associated with SG in a cohort of multi-ethnic postpartum Nepalese women who had delivered after completion of 36 weeks. PATIENTS/METHOD A cross-sectional comparative study was conducted among 420 postpartum females who had delivered after completion of 36 weeks of gestation. Data were collected in the form of a questionnaire and relevant physical examination was done. The severity of SG was assessed by using Davey's scoring. RESULT Out of 420 females, 260 (62%) had SG while 160 (38%) did not. According to the results of logistic regression analysis, young age ( 100 cm), increased weight gain during pregnancy (>15 kg), presence of family history of SG, gestational diabetes mellitus, altered bowel movement, and presence of striae on the breasts, thighs, and buttocks were found to be independent risk factors for SG. CONCLUSIONS Future expectant mothers must be informed about the risk factors of SG development. They need to be made aware that SG can be prevented by considering the modifiable risk factors, such as excessive weight gain. They should also be informed that SG is permanent and currently there is no definite treatment.

Background: Striae Distansae (SD) are a disfiguring dermal lesion, characterized by lines of dermal atrophy, occurring at sites of dermal damage caused by stretching. They affect adolescents and more than 70% of pregnant females due to stretching of the skin.Objectives: To assess and to compare the effect of 1, 064 nm Long Pulsed (LP) Nd: YAG laser and Fractional CO2 laser clinically and histologically in treating SD.Materials/Methods: Thirty female patients with bilateral symmetrical SD were treated with Fractional CO2 laser on one side and long-pulsed Nd: YAG laser on the other side. All patients treated with 3 laser sessions at 3 weeks interval. Global Aesthetic improvement scale (GAIS) and the score of patient satisfaction were used to evaluate improvement 3 months post treatment. Four mm punch biopsies were taken from each side before treatment and 3 months after the last session to measure epidermal and collagen thickness.Results: More significant clinical improvement was noted with the Nd:YAG laser than Fractional CO2 laser. Both GAIS and satisfaction score were significantly higher in the Nd:YAG laser treated side epidermal and collagen thickness were evidently increased in the lesions treatd by Nd: YAG laser than those treated by Fractional CO2 laser with no significant difference.Conclusions: Long pulsed Nd-YAG laser is clinically more effective than the Fractional CO2 laser in treating SD without serious adverse effects, although there was no significant difference between them histopathologically.

“Drug delivery” or permeation of drugs through the skin has aroused great interest of dermatologists in the last years. Lasers, ablative radiofrequency, and micro-needling are used to promote drug penetration through this technique. Several drugs and cosmeceuticals have been described for use in drug delivery. Among them, the most studied are MAL, ALA, 5-FU to treat the cancer field, and pre-neoplastic lesions with excellent results. Other indications include photodamaged skin, stretch marks, scars, melasma, and alopecia. In this chapter, we will discuss the procedure for many different indications, their results, and limits.

Stretch marks, or striae distensae, are one of the most common benign cutaneous lesions, and, for some, the aesthetic appearance can be distressful. Various treatments are available and include the use of preventative measures such as topical ointments and oils. Other methods such as the use of light and lasers in acute lesions (striae rubrae) have resulted in improvement of the appearance. In chronic lesions (striae albae) the outcome is poor.

When an intervention is made in Afrodescendant patients, the most significant difference in relation to Caucasians, for example, corresponds to the amount of melanin. This peculiarity of ethnic skin requires special attention from the dermatologist when choosing a treatment for scars, stretch marks, cellulite, wrinkles, flaccidity, and bleaching of spots, as well as extra care in the preparation, during treatment and post-procedure, in order to avoid complications. It is worth noting that in a mixed country like Brazil, where the majority of the population is ethnically diverse, interventions will always be subject to unexpected effects, even on skins considered less susceptible to complications. The percutaneous induction of collagen with needles presents a proposal to stimulate the production of collagen, without causing the deepithelialization observed in ablative techniques and without the heating of lights. The epidermis and dermis are perforated but not removed. The procedure is safe even when there is so much melanin.

An electrosurgery device is composed of a current generating unit and two electrodes: one active and one dispersive. By using an electrode consisting of a series of eight needles 0.1 mm thick and 2.0 mm long, we will equally divide by eight the energy selected for contact. With the proper configuration of the device, we can realize eight columns of 0.1 mm per shot, with a depth of 2.0 mm. Thus it is plausible the epidermal restitution is in an integral form and mechanical and thermal dermal stimulus, producing tissue retraction and synthesis of collagen. The multi-needle radiofrequency (MNR) technique has its applicability on periorbital skin excess and flaccidity, periorbital hyperpigmentation, static facial wrinkles, acne scars, superficial skin flaccidity, xanthelasma, syringoma, surgical scars, and stretch marks, among others. The use of high-frequency randomized fractional energy triggered on the skin results in dermal regeneration at the papillary-reticular interface through the stimulation of fibroblasts with consequent synthesis of collagen and elastic fibers, as well as epidermal regeneration produced by the migration of keratinocytes.

Introdução: A gravidez corresponde a um período em que não deve receber destaque apenas pelo desenvolvimento de um novo ser, mas sim, por um conjunto de modificações que podem suceder na vida de uma gestante, como é o caso das alterações estéticas em seu corpo e modificações exteriores para o recebimento de uma criança. Objetivo: Identificar as principais alterações estéticas durante o período gestacional. Metodologia: Caracterizada como revisão integrativa da literatura por meio de uma abordagem exploratória, quantitativa e qualitativa, no qual foi utilizada para o levantamento dos dados bibliográficos a base de dados Lilacs, Scielo Pubmed por meio da Biblioteca Virtual em Saúde (BVS). Foram utilizados como critérios de inclusão para a pesquisa artigos originais em língua portuguesa e inglesa publicados entre 2009 e 2017, disponíveis online, na integra e como critérios de exclusão, dissertações, revisões sistemáticas, revisões integrativas, bibliográficas ou de meta-análise. Assim como os materiais que não obtinham nenhuma associação com a temática central da pesquisa. Resultados e Discussão: Dentre as principais alterações constatadas durante a gestação, podemos mencionar: o aumento das mamas, aumento de peso, desenvolvimento de estrias, varizes e melasma. Considerações Finais: Diversas alterações estéticas podem ser averiguadas durante a gestação, mas esses impactos negativos podem ser diminuídos com o aparato de um profissional da área da saúde, para que as gestantes possam obter as recomendações necessárias para que possam obter uma gravidez saudável e o desenvolvimento adequado da criança.

BACKGROUND Striae distensae (SD) is a very common skin problem. Although a lot of treatment modalities have been proposed, few of them are effective. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many indications of cosmetic dermatology such as SD. OBJECTIVES To objectively evaluate the use and effectiveness of CDT for treatment of SD. PATIENTS AND METHODS Twenty patients were subjected to 8 sessions of CDT injection at 2-week intervals using carboxy-gun. Patients were photographed, and skin specimens were obtained from the treated area before and after 4 months of treatment. Using a computerized 3D camera, skin topography was objectively analyzed before and after treatment. Evaluation of collagen and elastic fibers by special histopathological staining, in addition to histometric analysis, was also done to evaluate treatment efficacy. RESULTS Clinically, SD was statistically significantly improved after CDT injection compared with baseline (mean percentage of improvement of length and width, 59.8 ± 15.9; P

Parabens are widely used as antimicrobial preservatives in personal care products (PCPs). Stretch mark cream is widely used by pregnant and lactating women for the treatment of striae gravidarum. This can be a potential source of paraben exposure, not only to pregnant/lactating women but also to fetuses/newborns. Little is known, however, with regard to the occurrence of parabens in stretch mark creams. In this study, we analyzed eight parabens and their metabolites in 31 popular stretch mark creams originated from various countries including China. The concentrations of Σparaben (sum of eight parabens/metabolites) ranged from 0.007 to 1630 μg/g, with mean and median values of 453 and 273 μg/g, respectively. Methyl- and propyl-parabens accounted for >95% of Σparaben concentrations. We examined the measured paraben concentrations against ingredients listed on the product labels. Parabens were listed as ingredients in those creams that contained concentrations >100 μg/g except for four samples with such high concentrations. Six cream samples that were labeled ‘paraben-free’ contained trace levels (0.007–9.92 μg/g) of these preservatives. Mean dermal ∑paraben exposure dose from the use of stretch mark creams (30.6 μg/kg bw/day) was well below the current acceptable daily intake value (5 mg/kg bw/day). In comparison to diet and indoor dust ingestion pathways, paraben-laden stretch mark cream may be a major source of paraben exposure in pregnant and lactating women. This study provides information on parabens and other preservatives in stretch mark creams and measures to reduce exposures during pregnancy and lactation.

Objectives: The study was conducted to identify the striae gravidarum (SG) prevalence in primigravid women, the influencing risk factors and the preventive interventions, and also to investigate its effect on body perception. Methods: This cross-sectional and descriptive study was conducted on 421 primigravid women who presented to a training and research hospital to have a nonstress test during routine follow-up. The data of the study were collected with the “Data Collection Form”, “Fitzpatrick Skin Type Scale”, “Davey’s Severity Score of Striae Gravidarum” and “Body Image Scale (BIS)”. Results: SG was found to be present in 67% of primigravid women. According to the results of the logistic regression analysis conducted, the presence of social security, sleep duration, BMI in pregnancy, and a history of striae in the mother and/or sister were found to be associated with SG presence (p < 0.05). A very weak positive relationship was found between SG severity in primigravidas and the score obtained from BIS (p < 0.05). The body perception of the pregnant women worsened in the presence of SG and a very weak negative relationship was found between the number of interventions used for prevention and the BIS score (p < 0.05). Conclusion: SG is seen in 7 of 10 women and affects body perception negatively. We recommend providing training and consultancy services both before and during pregnancy on the interventions and lifestyle changes required and topical preparations that can be used to prevent or decrease the severity of SG while taking the risk factors causing the problem into account. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Background Striae gravidarum are a common occurrence in pregnancy and many women use a topical product to prevent their development or lessen their appearance if they do develop. There is a lack of evidence on the effectiveness of many of the products used by women. This study arose from challenges in recruitment to a pilot randomised trial (ISRCTN trial registration number:76992326) designed to evaluate the feasibility of a definitive trial to compare a moisturising oil to no treatment in the prevention and reduction in severity of striae gravidarum. The study reported here explored the factors influencing recruitment to that pilot trial. Methods A qualitative descriptive study was undertaken involving primigravid women attending an Irish maternity hospital. Data were collected by semi-structured telephone interviews over a four-week period and analysed using the framework method of analysis. Fifteen interview transcripts were included in the analysis. Results Four main themes consisting of twelve categories were identified from the interview data. The themes focused on women’s prevention of stretch marks and their choice of anti-stretch mark product, who and what influenced that choice and influences on trial participation. In relation to influences on trial participation, the possibility of being randomised to the non- intervention or control group was a deterrent for many women. Conclusions The prevention of stretch marks is important to pregnant women, as is their choice of product to prevent them. Offering women the opportunity to be part of a trial that would be of low burden and would test a well-known product may optimise recruitment. However, reluctance to be randomised because of the possibility of being allocated to the non-intervention control group suggests that further work is needed in this field on how best to communicate uncertainty to potential participants.

Striae distensae are caused by rapid stretching of the skin. They are often secondary to obesity or pregnancy and can lead to significant cosmetic disfigurement.To determine the efficacy, indications, and side effects of commonly used energy devices in the treatment of striae.A comprehensive literature search was performed using the PubMed and Medline databases.A total of 41 relevant articles were identified. Radiofrequency (RF) was the commonest employed modality (11 studies), followed by the COThe therapeutic measures for striae are multiple and no current treatment offers consistent and complete resolution. However, energy devices are a safe and potentially effective modality in the treatment of striae.

Objectives: The aim of the study was to investigate the prevalence of self-reported skin complaints during pregnancy, applied treatment and the impact on well-being of pregnant women. Material and methods: We asked 1935 women that were maximum 4 years after labor to fill in our questionnaire. The questionnaire included questions concerning the course of pregnancy, observed skin lesions, applied treatment and influence on the quality of life. Results: Skin changes during pregnancy were reported by 1447 patients (74.78%). The prevalence of self-reported skin complaints were as follows: stretch marks (77.4%), acne (21.6%) and recurrent herpes labialis (11.6%). In 43.67% (n = 632) of women who reported dermatological problems during pregnancy the disease caused significant deterioration in their well-being. Only 168 patients (11.61%) received dermatological treatment from their obstetricians. Dermatological con­sultation required 217 patients (14.99%). For 133 of treated women (25.68%) the recommended treatment was expensive. However, in the majority of patients (379; 73.15%) who received treatment the skin changes resolved after therapy. Skin symptoms resolved significantly faster in the treated group (3.5 ± 4.3 week vs 5.8 ± 6.2 week; p < 0.001). Conclusions: Self-reported skin complaints seem to be a relevant problem during pregnancy. Proper skin care as well as appropriate treatment applied by obstetricians and/or dermatologists may help women to recover.

Striae distensae or stretch marks are dermal scars characterized by flattening and atrophy of the epidermis. They develop particularly during adolescence but they can also appear in other situations such as pregnancy, the use of prolonged therapies with topical or systemic corticosteroids, Cushing's syndrome, Marfan's syndrome, prolonged use of lightening creams, cachexia, rapid weight loss or the use of androgenic and anabolic substances. Treatment options often take a long time, and the results are often disappointing, causing significant psychological distress in patients. We propose a completely innovative approach, combining the skinbooster technique with the microneedling technique. These minivasive methods work by inducing tissue remodeling and stimulating the synthesis of new collagen. Confocal microscopy can show and follow the skin changes made by these therapies, thus becoming an important and valid therapeutic monitoring tool for aesthetic dermatology.

Rare and dreaded, necrosis of the nipple-areola complex (NAC) is one of the major complications of breast reduction surgery. Our objective was to establish a management algorithm summarizing the different possible treatments reported in the literature. The data extracted from the articles selected for this literature review covered surgical techniques, frequency of NAC necrosis, type of necrosis, and management proposed for women who have had this surgery for macromastia. In the 54 articles finally selected, the mean frequency of NAC necrosis was 5.1%. The risk factors for necrosis were the weight of the tissue resected, smoking, obesity, the surgical technique used, and stretch marks. The treatments proposed were listed according to four categories of issues: patient-specific susceptibility, type of breast, surgical technique, and its technical performance. No consensus exists about the management of NAC necrosis, which remains a complication feared by surgeons. We propose a management algorithm that simplifies the therapeutic indications. Level of Evidence: Not ratable

In aesthetic medicine, plasma can successfully treat scarring, stretch marks, acne, dyskeratosis, xanthelasma, warts, verrucae, naevi, fibromas, seborrhoeic keratosis and a host of other skin lesions. For most patients, the most exciting revolution in plasma technology is non-surgical blepharoplasty. There are so many plasma or fibroblast devices on the market that vary in price and are marketed at both medics and non-medics, but what exactly is plasma? This article will discuss what plasma is, as well as exploring the indications for use, complications that come with this device and how to treat the upper eyelid.

Striae distensae are a frequent skin condition associated with pregnancy, weight change or lack of skin elasticity. The aim of this research was to obtain a topical product containing herbal active ingredients with documented antioxidant and anti-inflammatory activity (Punica granatum seed oil and Croton lechleri resin extract) and demonstrate its positive effect on prevention and treatment of striae distensae. First, the cream base formulation was optimized through experimental design. Secondly, the cream containing the two active ingredients was investigated in an interventional nonrandomized clinical trial. The clinical outcome was assessed through biophysical parameters and ultrasonographic evaluation. The state of the skin was evaluated by biophysical measurements and ultrasonography at the beginning of the study and after 3 and 6 weeks. The experimental design was successfully used to set the best ranges for the technological and formulation factors to obtain a cosmetic formulation with optimal characteristics. The study of clinical efficacy on the optimal formulation revealed an increase in the dermis thickness, hydration and elasticity values in both groups after 6 weeks of cream application. The new oil-in-water cream containing P. granatum seed oil and C. lechleri resin extract can be helpful in the prevention or improving of skin changes associated with striae.

Objective. To determine the prevalence of skin changes during pregnancy and to relate their occurrence to specific factors in a population of south Brazil. Methods. A cross-sectional analytical study was carried out with 1284 puerperal patients. A questionnaire about skin changes during pregnancy was developed and applied by the authors to all puerperal women admitted in a tertiary hospital in south Brazil. Results. The appearance of striae during pregnancy was reported by 633 women (49.5%) and had a statistically significant association with primiparity, presence of stretch marks before pregnancy, and gestational weight gain above 21 kg. Facial blemishes were reported by 33.9% (n=434) and were associated with a positive family history, multiparity, and the use of facial sunscreen (p<0.0001). The onset or worsening of acne was identified in 35.7% (n=456) and was statistically associated with primiparity and Fitzpatrick phototypes IV and V. Hair alterations were reported by 44.5% (n=569) and were associated with primiparity (p=0.029). Conclusion. Although most of the skin changes during pregnancy are considered “physiologic,” they can cause significant discomfort. Thus, it is important to know them and to understand which risk factors may be associated with such changes.

Since it has been developed and improved over the last two decades, microneedling is one of the few examples that combine technology and simplicity. It is an effective, safe, and minimally invasive technique involving puncturing of the skin by rolling a handheld device with fine needles. The success of the technique is precisely to provide regeneration rather than cicatrization. As opposed to ablative procedures, microneedling preserves the epidermis and promotes normal collagen formation in place of scar collagen [1]. In addition to acne scars, it is also used for skin rejuvenation, other etiologies scars, stretch marks, alopecia, acne, hyperhidrosis and as a transdermal delivery system for therapeutic drugs and vaccines (drug delivery) [2].

Striae distensae or stretch marks are dermal scars, most of the time characterized by flattening and atrophy of the epidermis, although some present a hypertrophic aspect, similar to thick lines. A common, permanent, aesthetically undesirable skin condition, SD are often a significant source of distress to patients.

Aim To evaluate the diagnostic value of striae gravidarum (SG) presence and localization in predicting the intraperitoneal adhesion (IPA) risk in pregnant women with a history of at least one previous cesarean delivery (CD). Methods A total of 100 pregnant women with repeated CD were included in this prospective observational study. Patients were divided into three groups according to severity of SG with Davey scoring system. Intraoperative adhesion severity and extension were evaluated by using Nair classification system. Moreover, operation duration and neonatal outcomes were analyzed. Results Demographic features were comparable between the groups. Adhesion scores were significantly higher in mild and severe SG groups (for mild SG: 1.93 +/- 0.99, for severe SG: 2.81 +/- 0.88 and for no SG: 1.4 +/- 0.57; P < 0.001). Analysis revealed a positive correlation between IPA and severity of SG (P < 0.001). There was a correlation between increased striae density and adhesion severity especially in the right and left upper quadrants of the abdomen (for right quadrant: r = 0.515, P < 0.001; for left quadrant: r = 0.359, P = 0.005). Conclusion Our results suggest that preoperative evaluation of SG severity and extend particularly in upper quadrants is a feasible option to predict IPA risk in patients with repeated CD. WOS:000486797900001 2-s2.0-85073813672 PubMed: 31531933

Background: With the advent of more sensitive culture and molecular diagnostic testing modalities, Bartonella spp. infections have been documented in blood and/or cerebrospinal fluid specimens from patients with diverse neurological symptoms. Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by an unusually abrupt onset of cognitive, behavioral, or neurological symptoms. Between October 2015 and January 2017, a 14-year-old boy underwent evaluation by multiple specialists for sudden-onset psychotic behavior (hallucinations, delusions, suicidal and homicidal ideation). Methods: In March 2017, Bartonella spp. serology (indirect fluorescent antibody assays) and polymerase chain reaction (PCR) amplification, DNA sequencing, and Bartonella enrichment blood culture were used on a research basis to assess Bartonella spp. exposure and bloodstream infection, respectively. PCR assays targeting other vector-borne infections were performed to assess potential co-infections. Results: For 18 months, the boy remained psychotic despite 4 hospitalizations, therapeutic trials involving multiple psychiatric medication combinations, and immunosuppressive treatment for autoimmune encephalitis. Neurobartonellosis was diagnosed after cutaneous lesions developed. Subsequently, despite nearly 2 consecutive months of doxycycline administration, Bartonella henselae DNA was PCR amplified and sequenced from the patient’s blood, and from Bartonella alphaproteobacteria growth medium enrichment blood cultures. B henselae serology was negative. During treatment with combination antimicrobial chemotherapy, he experienced a gradual progressive decrease in neuropsychiatric symptoms, cessation of psychiatric drugs, resolution of Bartonella-associated cutaneous lesions, and a return to all pre-illness activities. Conclusions: This case report suggests that B henselae bloodstream infection may contribute to progressive, recalcitrant neuropsychiatric symptoms consistent with PANS in a subset of patients.

Stretch marks or striae distensae (SD) cause emotional distress and negatively affect the psychological well-being of patients. We investigate and compare two methods for quantifying the severity of SD: visual scoring of images captured using a clinical visible-light dermatological camera (C-Cube, Pixience Inc) and measuring the local birefringence of skin using polarization-sensitive optical coherence tomography (PS-OCT). Data on skin visually affected by SD and visually normal skin were collected from 19 human volunteers. Our results show a weak correlation between visual scores of the C-Cube images and the birefringence values obtained from the PS-OCT system. SD datasets have a significantly larger birefringence values compared to visually normal datasets.

Carboxytherapy is a new method of anti-aging treatments for the skin, which has clinically confirmed its efficacy and safety, and has good prospects of application in cosmetology. However, there is no systematization of the information about the mechanisms of action that can substantiate its use in cosmetics and pharmacy. Therefore, the aim of this review is to study the mechanisms of action of local effects of CO2 in cosmetology. In cosmetology the effect of carboxytherapy is provided by multifactorial mechanisms of reflex hemosensor (the impact on chemoreceptors), mechanical reflex (Zecharia zone-Ged, baroreceptors), biochemical (the change in the CO2 concentration in the blood), which create the conditions for the system of self-regulation and support in the skin. It is due to the polyvalent mechanism of action the CO2 therapy pharmacodynamics in cosmetology includes a variety of local and resorptive effects on the skin: increased vasodilation, oxygenation, neovasculization of the blood- and lymph flow; restoration of elasticity and the skin turgor; smoothing of photo-aging signs (the anti-aging effect); lifting and smoothing of wrinkles; relief of stress and skin fatigue; the qualitative improvement of the skin texture; lighting and colour alignment; reduction of swelling and pastosity; strengthening the skin around the eyes; the immunity restoration and removal of the skin inflammation (acne, rosacea); the antibacterial effect (elimination of bacteria that cause acne scars); stimulation of angiogenesis and inhibition of melanogenesis; reduction in the local adipose tissue (lipolysis); eliminatation of toxins; intensification of the sweat and sebaceous glands function. Carboxytherapy helps when the signs of the skin aging (wrinkles and double chin) appear, contributes to the figure correction (cellulitis), eliminates many cosmetic defects (stretch marks, dark circles), and promotes to the skin restoration after aggressive methods of rejuvenation and rehabilitation after burns.

This article utilizes notions of ‘agency’ to explore the relationship between experiences of pregnancy loss and narratives about related skin-based body modifications. The term ‘pregnancy loss’ is used to denote a range of medical events with potentially far-reaching emotional and social consequences. The research from which the empirical content of this article is drawn seeks to bring together feminist interests and the discipline of human geography to examine experiences of pregnancy loss. Different aspects regarding ‘agency’ are attended to through several practices—namely, the acquisition, display/concealment and narration of skin-based bodily marks like stretch marks and memorial tattoos. This includes a discussion on notions of ‘choice’ in terms of receiving/acquiring changes to the skin through pregnancy and pregnancy loss, regarding which stretch marks and tattoos are often pitted as oppositional. A more complex picture of agency is explored and illustrated with the narratives of several w...

Introdução: A estria consiste em uma atrofia tegumentar adquirida, de caráter linear, a qual pode se apresentar em maior número ou não, trata-se de uma afecção que acomete bastante as gestantes e que produz significativo impacto emocional. Objetivo: Caracterizar a etiopatologia das estrias e comparar a teoria mecânica e hormonal com a influência genética. Metodologia: Trata-se de um estudo de caráter descritivo e de abordagem quantitativa. A coleta de dados foi realizada em Unidades Básicas de Saúde da Família localizada na cidade de Lagoa Seca. A amostra foi composta por pacientes puérperas que estavam em acompanhamento da enfermagem na unidade. Resultados e Discussão: A respeito dos heredogramas gerados é possível observar a prevalência de indivíduos acometidos por estrias em maioria dos casos na primeira e segunda geração. Outro achado interessante é que a característica apareceu em dado momento com frequência em determinado grupo, em outro apareceu com escassez. 80% das pacientes entrevistadas ressaltaram que as suas estrias tem assimilação com o de algum familiar e apenas 20% relataram localização diferente. Considerações finais: É possível inferir que o desenvolvimento da estria pode ser associado decorrente de características única do genótipo ou não, foi possível reconhecer o papel da hereditariedade como fator etiológico na presente amostragem.

Background Striae distensae, or stretch marks, are a common and distressing condition affecting females two-and-a-half times more frequently than males. Despite the numerous products available for stretch mark prevention and treatment, there have been few studies that consider consumer product preference. Objective The aim of this study was to determine which products were preferred by consumers for the prevention and treatment of stretch marks based on product vehicle and product ingredients. Methods In January 2020, a search was conducted on internet retailer Amazon for products related to stretch marks. The top products were identified as those with 100 reviews or greater and a rating of 4 or higher. The products were classified as either stretch mark–specific or non stretch mark–specific. Price, rating, type of vehicle, and specific ingredients of both product groups were compared. Vehicle-type and ingredients in both product groups were compared with two-tailed two-sample proportion tests to determine if certain vehicles or ingredients were more likely to be found in stretch mark–specific products. P Results Out of over 10,000 products, 184 were selected as the top products according to the review and rating criteria of which 117 (63.6%) were stretch mark–specific and 67 (36.4%) were non stretch mark–specific. Oil was the most common vehicle (131/184, 71.2%) while vitamin E was the most common ingredient (58/184, 31.5%). Oil, as a vehicle, was more likely to be found in stretch mark–specific products than in non stretch mark–specific products (P=.001). Olive oil (P=.02) and cocoa butter (P=.08), Centella asiatica (P=.01), and shea butter (P=.003) were the ingredients more likely to be found in stretch mark–specific products than in non stretch mark–specific products. Conclusions This study demonstrated that there are many products available for the prevention and treatment of stretch marks and identified specific ingredients in the products preferred by customers. There are few studies investigating the effectiveness of the major ingredients in the stretch mark products that are preferred by consumers. Future studies can focus on the effectiveness of the ingredients found in the products that are preferred by consumers.

BACKGROUND This registry study evaluates the effects of oral Centellicum®, a new preparation of Centella asiatica (CA) on cutaneous stretchmarks (SMs) on the lower abdominal wall in comparison with the topical treatment with a specific antistretch cream. This cream is used for pregnancy SMs. The aim of the management was to give back to the structurally damaged skin areas (apparent as SMs) a normal elasticity and resistance and improving the local microcirculation. METHODS We selected 78 healthy women with SMs at least 6 months postpartum available to follow the registry plan. The subjects were evaluated in three treatment groups: Clarins, stretch mark minimizer, the hydrating control cream and Centellicum® 3X225 mg/day for 6 weeks. RESULTS The three registry groups of otherwise healthy subjects were comparable at inclusion and 6 weeks: 25 women used the SMs cream 1 (mean age 34.4;3.2); 28 control women (age 35.2;2) used the hydrating control cream. The third group (25 women; mean age 35.3;1.5) used the hydrating control cream and oral Centellicum® as a supplementary management. Standard management was used in all groups. As for the safety issue, no allergy, no side effects and no tolerability problems were observed. The compliance was very good and there were no drop outs. No other drug or treatment was used during the registry period. Skin thickness (ultrasound, measuring at the edge of at the largest visible stretchmark) increased significantly more at 6 weeks with Centellicum® in comparison with both controls (P

Background Currently, the exact incidence of Polymorphic Eruption of Pregnancy (PEP) in the Mexican population is unknown. PEP tends to manifest in the abdomen, primarily in the stretch marks caused by distension. It is characterized by severely pruritic urticarial-like papules that converge in plaques, extending to the buttocks and proximal thighs. Our study determined its incidence, along with other common dermatoses in pregnancy. Methods Patients between 14 and 45 years of age were evaluated. In each patient, a complete medical history and physical examination was performed with emphasis on skin and adnexa. Patients were followed until the end of their pregnancy. Results A total of 217 women were included. PEP was identified in three patients (1.38%), all primigravida, with single fetus pregnancy, and all concluded their pregnancy by vaginal delivery. The neonates were 2 females and 1 male. No other gestational pathologies were identified. Conclusions We identified a higher incidence of PEP than reported, without association to complications or need for medical management. There may be an association between high maternal weight and the presence of PEP, however a larger sample is needed.

PURPOSE: To evaluate the therapeutic efficacy and complications of microneedling (dermaroller) therapy as a treatment modality in the treatment of facial scars resulting from acne, trauma and surgery. MATERIALS AND METHODS: Fifty patients with facial acne scar, traumatic scar, hypertrophic scars and scars with skin discoloration reporting to our institute were included in the study. Microneedling procedure was performed with the help of dermaroller. Postoperative wound was evaluated by three evaluators by comparing preoperative and postoperative clinical photographs. RESULTS: Seven out of the total 50 patients (14%) showed an excellent response to dermaroller treatment, while 26 patients (52%) had a good response. Fourteen patients (28%) had fair response, and 3 patients (6%) had poor response. CONCLUSION: Microneedling therapy with dermaroller is one of the simplest, yet most effective skin treatments for scars, stretch marks, deep wrinkles, etc. The dermaroller is a definitive credit crunch skin rescue option. It is simple yet effective and suitable for all skin types and skin tones.

Background Striae gravidarum (stretch marks) are considered the most common connective tissue/skin change in pregnancy. Though not a health issue they can affect women in different ways, for example, cause stress or be an aesthetic or cosmetic concern. Many women use one or more of the commercially available products to try and prevent their development during pregnancy despite the fact that that there is a lack of high-quality evidence to support their use. There is a dearth of studies on the prevention of striae gravidarum and large, robust trials are lacking. Until such time as more products are investigated, much of the knowledge remains anecdotal. This pilot study will evaluate the feasibility of conducting a study to evaluate the effectiveness of a commercially available moisturising oil compared to no treatment for the prevention and reduction in severity of striae gravidarum. Methods The definitive study will be a randomised controlled trial to evaluate the effectiveness of a moisturising oil (commercially available moisturising oil) compared to no treatment for the prevention and reduction in severity of striae gravidarum. This protocol is for a pilot randomised trial to evaluate the feasibility of conducting such a study. The pilot study will be a two-arm, unblinded, pragmatic parallel randomised trial with a 1:1 randomisation ratio between control and intervention groups. Women in the intervention group will be asked to apply a moisturising oil to their abdomen during pregnancy, while women in the control group will not use any treatment. It is proposed to recruit 20 primigravida, who are 12–16 weeks pregnant from an Irish Maternity Hospital, in each arm to assess the feasibility of running such a trial. Discussion This pilot trial will evaluate the feasibility of conducting the main study to evaluate the effectiveness of a moisturising oil (commercially available moisturising oil) compared to no treatment for the prevention and reduction in severity of striae gravidarum. It will potentially initiate the generation of high-quality evidence to guide women in their choice of anti-stretch mark product. Trial registration ISRCTN Registry, ISRCTN76992326. Registered on 14 July 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2898-7) contains supplementary material, which is available to authorized users.

Microneedling is a very simple, safe, effective, and minimally invasive therapeutic technique. It was initially introduced for skin rejuvenation, however, now it is being used for a very wide range of indications including acne scar, acne, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, stretch marks, and many more. Moreover, during the last 10 years, many new innovations have been made to the initial instrument, which was used for microneedling. This technique can be combined with other surgical techniques to provide better results. In particular, it is a very safe technique for dark skin types, where risk of postinflammatory pigmentation is very high with other techniques that damage the epidermis. In this review article, we are updating on the different instruments now available for this procedure, and its efficacy when performed alone or in combination with other techniques for various indications.