Efficacy of platelet‐poor plasma gel in combination with fractional CO2 laser in striae distensae: A clinical, histological, and immunohistochemical study

Background Platelet‐poor plasma gel is a semi‐solid plasma formulation that recently recommended as autologous bio‐filler for treatment of atrophic dermal scars. Aim To compare the therapeutic efficacy and safety of intradermal injection of plasma gel in combination with fractional CO2 laser versus fractional CO2 laser alone in striae distensae (SD). Patients and methods This study included 36 SD patients treated by three sessions (one session/1.5 months) of fractional CO2 laser on all SD lesions following intradermal injection of plasma gel on one side and saline (as placebo) on the other side. Results Significant clinical improvements associated with remarkable narrowing of SD lesions and prominent enhancement of skin texture were observed on both treatment sides. Obviously, higher degrees of clinical improvements of SD lesions were reported following combined therapy with fractional CO2 laser and plasma gel rather than fractional CO2 laser monotherapy. However, post‐inflammatory hyperpigmentation (PIH) was reported more frequently with fractional CO2 laser monotherapy. Histopathological and immunohistochemical examinations revealed significant epidermal improvement, and homogenization, and orientation of dermal collagen bundles as a result of both therapeutic procedures. Conclusion Plasma gel in combination with fractional CO2 laser could be considered a promising novel treatment modality for SD. Plasma gel not only improves the efficacy of fractional CO2 laser but also decreases the frequency of PIH.