BIWEEKLY IN-OFFICE INJECTABLE TREATMENT OF STRIAE DISTENSAE VS A LONG-TERM DAILY USE OF TOPICAL VITAMIN C
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J. Appl. Cosmetol. 19, 107-112 (October/December 2001)
BIWEEKLY IN-OFFICE INJECTABLE TREATMENT OF
STRIAE DISTENSAE VS A LONG-TERM DAILY USE
OF TOPICAL VITAMIN C
P. Morganti', P. Palombo>, G. Fabrizi', M. Palombo' , and S. Persechino•
' R. & D. Mavi Sud S.r.l, Aprilia - ltaly,
2
Head of Plastic Surgery Dept. S. Eugenio HospitaL Rome - ltaly,
3 Dept. Of Derm., Univ. Sacred Heart, Rome - ltaly,
' Plastic Surg. Dept. S. Eugenio Hosp., Rome - ltaly,
5
R&D JSCD, Rome-ltaly
Received: October 200 I. Presented at The IOth EADV Congress, Munich, I 0-14 October, 200 I.
Key words: Striae distensae, Betaglucan, Vitamin C, Hyaluronan.
Summary
The treatment of striae distensae (SO) is difficult, generally unsatisfactory, and no placebo-controlled
study has been carried out to ascertain the effect of different topica! treatments.
The aim of thi s study was to contro! the acti vity of both an office injectable treatment and a topica)
treatment of water solutions of vitamin C, betaglucan and hyaluronic acid (active A).
A single blind placebo-controlled randomi zed comparative clinica! study was performed on 66 wo-
men aged between 18-24, with SO localized over the abdomen and buttocks. The subjects were d i-
vided into 3 study groups. Active B was applied at home twice a day for 16 weeks to 24 patients
(group A). Twice a week they received also derma) injection of active A fo r the entire period. 22 pa-
tients in group B appl ied, twice a day, active B for 16 weeks. The remaini ng 20 patients in group C
applied a placebo solution (distilled water) twice daily during the same period.
The differences between the results in the different groups were statistically significant at week l 2
and 16 (p
Biweekly in-office injectable treatment of striae d1stensae vs a long-term daily use of topica/ vitamin e tamento iniettivo e/o topico di una soluzione acq uosa di vitamina C, betaglucano e acido ialuronico E' stato eseguito uno studio clinico a doppio ceco randomizzato su 66 donne di età compresa tra 18- 24 anni con presenza di SD localizzate su addome e glu tei. I soggetti sono stati suddivisi in 3 gruppi. ACTIVE B è stato applicato localmente a casa due volte al giorno per sedici settimane su 24 sogget- ti del gruppo A che, due volte alla settimana, veni vano anche trattati con applicazioni sottocutanee di un prodotto analogo sterile ed apirogeno ( ACTIVE A). 22 pazie nti del gruppo B veni vano trattati due volte al dì con la sola soluzione topica ( ACTIVE B). Ai restanti 20 soggetti (gruppo C) veniva applicata localmente la soluzione place bo (acqua di stillata). I dati ottenu ti alla 12° ed alla 16° settimana, controllati clinicamente ed istologicamente, sono risul- tati statistica mente significati vi (p< 0.05) nei diversi gruppi. Comunque l' uso cong iunto delle applicazioni topiche e di q uelle inietti ve (gruppo A) è risultato su- periore del 57% (p< 0.05) se paragonato con il solo uso topico (+32% p
Morganti P., Palombo P., Fabrizi G., Palombo M., and Persech1no S.
INTRODUCTION Clinica/ Methodology
The treatment of striae distensae (SD) is diffi- A sing le 4 months blind placebo-controlled ran-
c ult, generally un satisfactory, and no placebo- domi zed comparative study was performed on
controlled study has been carried out to ascertai n 66 women aged between 18-24, with SD local i-
the effect of different topica! treatments (1-7). zed over the abdomen and buttocks.
T he s ubj ects were ra ndom ly di vided into 3
groups:
AIM
I. Group A: composed of 24 patients, appl ied
The a im of thi s study was to contro! the activity Acti ve B at ho me twice a day fo r 16 weeks.
on striae di stensae of both an office injectabl e Twice a week and for the e ntire period, they
treatment (active A) a nd a topica! one (active B) received also dermal injection of Acti ve A.
by the use of water solutions of vitamin C , beta- The product was applied directly on the SD
glucan and hyaluronic acid. As matter of fact it a rea c leaned both by a s upplied cleansing
seems that this treatment increasing the secre- foam m a nd a scrub ; Skin Biopsies
5. Scrub: Aqua (Water), Decyl Glucoside, Gly-
cerin, Hydrogenated Jojoba Oil, Trideceth-9, Biopsies speci men were taken from a SD area,
Potassium Azelaoy l Diglicinate, Peg-5 Octa- sectioned in to 1-mi m wide strips, fixed in for-
noate, G lyci ne, Carbomer, Sodium Hydroxy- ma lin at 4 °C fo r 18 hours a nd tran sferred to
methylglyci nate, Polyethylene, Phosphatidyl- ethanol for further fi xation, and paraffin embed-
c holine, Propyle ne Glycol, Phenoxyethanol, ded. Three-micrometer sections were studied by
Arginine, Aloe Barbadensis (Aloe Barbaden- means of SEM or norma i histology.
sis Extract), AlcohoJ
Biweekly in-office injectable treatment of striae distensae vs a /ong-term daily use of topica/ vitamin e
lnjection Methodology DISTENSAE as well as the skin tolerance after
the applicatio n phase.
ACTIVE A was injected by using a Jinear threa- O= normai color and dermatoglyphic pattern;
ding puncture technique with a 30-gauge need- 0.5 = white/pinky color and dermatoglific pat-
le. For each SD skin area was used from I to 4 tern less evident
ml of the product diluted with 3 percent carbo- 1 =pink color, moderately flat skin
caine. 2 = intense pink color, flat skin
3 = violaceous color, flat skin
Prophilometry The obtained clinica! res ults are reported on
Figure 2.
Prophi lometry of the SD areas was carried out
SKIN APPEARANCE OF STRETCH MARKS "AFTER A 16 WEEKS
by scanning the surface of its skin replica and OF TOPICAL ANO/OR INJECTABLE TREATMENT VITA MIN C BASED"
quantitati vely determining its mi crotopography n = 66 - t = 22 •e - RH =50"4
accordi ng to Makky et al (9,10). The impression
of the SD area was taken by using the SIFLO®
rubber (Flexico D evelop ment Ltd., London,
UK) and the quantitative topographic measure- "'
ment of the surface microrelieves was determi-
ned by the Confocal Laser Scanning Microsco-
pe (CLSM) (11 ,12). ••
The obtained results are reported on Fig. 1.
[ 0 G1 ov11 e !Placebo) cG10~ e (Jopi131 f reamenl) ciGroup A ( ToplUt 11'111 ln,llcl111111 1nil .) I
Furrow depth measurements of strlae di stansae aner a 16 'W8eks of
llUp- UUAlll--V l !Cftf(.oNT.U•l.Otl 90.....l'IJ....0iic)tlll'ICANf»4 ttl Q TOOlllOWS
toplc al andlor injectable treatments Vitamln C based Fig. 2 . ...., _ 'l'Ja:ifl'f Ol
Morgant1 P, Palombo P, Fabrizi G., Palombo M., and Persechino S.
and stimulate both fibrobl asts and celi prolifera-
tion (Fig. 3 and 4).
No side effects were observed during the treat-
ment period, except a light burni ng at the mo-
me nt of the injection.
CONCLUSIONS
From the obtained results from this first place-
bo-controlled study it seems realis tic to state
that this bala nced solution of di fferent active
compounds, such as vitamin e, hya luron ic acid
and betaglucan able to normalize the histologic
a rchitec ture of the dermis a nd e pide rmi s to-
gether with the de rmatoglyph ic skin pattern,
may be successfu ll y in the treatm ent of striae
di stensae and derma! scars.
What is interesting to underline is that the com-
bined use of injec tion and topi ca! application
(GRO UP A) provided superior res ults (+ 57%,
p< 0.05) co mpared with the topica! treatme nt
only (GROUP B).
On the other side the topica! treatment (GROUP
B ), co mp a red to PL ACE BO (GROUP C) ,
showed to pe rform an interesting activity both
on the deratoglyphic pattern and on the collagen
bundles organization (+ 32%, p
Biweekly in-office injectoble treotment of strioe distensoe vs o /ong-term doily use of topico/ vitomin C
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Author Address:
Pierfrancesco Morganti
Via Innocenzo Xl, 41 - 00165 Rome ltaly
Tel. +39.6.9286261
Fax +39.06.9281523
E-mail: info@mavicosmetics.it
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