The use of topical tretinoin has yielded variable results, and some of the studies had proven the inefficacy of the vitamin A derivative in the treatment of SD,25,26 but most of the patients included in these early studies presented with old lesions that had evolved into whitish atrophic scars.25 More recently, tretinoin has been shown to improve the clinical appearance of stretch marks during the active stage (striae rubra), although with not much effect during the mature stage (striae alba).27 In the same study, 22 patients applied 0.1% tretinoin (n=10) or a placebo (n=12) daily for 6 months to the affected areas. Patients were evaluated monthly in a physical examination and using analysis of biopsy specimens of stretch marks obtained before and at the end of therapy in comparison with untreated normal skin. Targeted stretch marks in patients treated with tretinoin had a decrease in mean length and width of 14% and 8%, respectively, compared with an increase of 10% and 24%, respectively, in patients who received the placebo. Rangel and colleagues conducted an open multicenter study in Mexico on 20 women with stretch marks after pregnancy. They all applied tretinoin (retinoic acid) cream 0.1% daily for 3 months to pregnancy-related stretch marks in the abdominal area. Efficacy was evaluated according to analysis of one preselected target lesion, which was rated on a 6-point scale (−1=worse to 4=cleared). All target lesions decreased in length by 20%, and they demonstrated efficacy of tretinoin as a modality for treating SD of pregnancy.28
The use of topical tretinoin has yielded variable results, and some of the studies had proven the inefficacy of the vitamin A derivative in the treatment of SD,25,26 but most of the patients included in these early studies presented with old lesions that had evolved into whitish atrophic scars.25 More recently, tretinoin has been shown to improve the clinical appearance of stretch marks during the active stage (striae rubra), although with not much effect during the mature stage (striae alba).27 In the same study, 22 patients applied 0.1% tretinoin (n=10) or a placebo (n=12) daily for 6 months to the affected areas. Patients were evaluated monthly in a physical examination and using analysis of biopsy specimens of stretch marks obtained before and at the end of therapy in comparison with untreated normal skin. Targeted stretch marks in patients treated with tretinoin had a decrease in mean length and width of 14% and 8%, respectively, compared with an increase of 10% and 24%, respectively, in patients who received the placebo. Rangel and colleagues conducted an open multicenter study in Mexico on 20 women with stretch marks after pregnancy. They all applied tretinoin (retinoic acid) cream 0.1% daily for 3 months to pregnancy-related stretch marks in the abdominal area. Efficacy was evaluated according to analysis of one preselected target lesion, which was rated on a 6-point scale (−1=worse to 4=cleared). All target lesions decreased in length by 20%, and they demonstrated efficacy of tretinoin as a modality for treating SD of pregnancy.28
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