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.

Summary

In a double-blind split-lesion RCT (12 patients, 36 lesions), Er:YAG laser combined with SVF significantly outperformed PRP and saline in improving epidermal/dermal density and thickness measures, with the highest patient and physician satisfaction at 3 months and no significant complications. PRP also improved dermal and total density versus saline.

Key Findings

• SVF + Er:YAG significantly increased epidermal density (45.95 to 51.19; p=0.001) and outperformed PRP and saline in multiple thickness and density metrics.
• All groups improved in thickness indices (complete, epidermal, dermal) and R5 cutometer, indicating laser benefit; PRP exceeded saline in dermal/total density.
• Patient and physician satisfaction were highest in the SVF group (p=0.001), with no significant post-treatment complications reported.

Clinical Implications

Consider combining SVF with Er:YAG laser for striae distensae to enhance structural and biomechanical outcomes; larger, multi-session trials are warranted to confirm durability and generalizability.

Limitations

• Small sample size (12 patients) and single-session treatment limit generalizability.
• Short follow-up (3 months) without histologic correlation or long-term durability data.

Future Directions

Larger, multi-center trials with multiple sessions, longer follow-up, standardized PROMs, and histologic endpoints to validate efficacy and durability.