What are the treatment options for striae (stretch marks)?

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From the Guidelines

Stretch marks can be effectively treated with a combination of autologous platelet concentrates (APCs) and other modalities, such as microneedling, intradermal RF, or fractional CO2 laser, which has been shown to improve the appearance of stretch marks and increase patient satisfaction. The use of APCs, also known as platelet-rich plasma (PRP), has been studied in several recent studies, including a 2025 study published in Periodontology 2000 1, which found that combining PRP with other treatments resulted in significant improvements in the appearance of stretch marks, including increased epidermal thickness and decreased perivascular inflammatory infiltrate. Another study from 2025 1 found that combining PRP with fractional CO2 laser resulted in higher degrees of clinical improvement and patient satisfaction compared to combining PRP with pulsed dye laser.

Some key points to consider when treating stretch marks include:

  • The age of the stretch marks, with newer marks responding better to treatment than older ones
  • The type of stretch marks, with red or purple stretch marks (striae rubra) responding better to treatment than white stretch marks (striae alba)
  • The use of combination therapies, such as PRP and microneedling or PRP and fractional CO2 laser, which may result in better outcomes than single modalities
  • The importance of patient satisfaction and quality of life, with treatments that result in significant improvements in the appearance of stretch marks and increased patient satisfaction being preferred.

In terms of specific treatment recommendations, combining PRP with fractional CO2 laser has been shown to be a safe and effective therapeutic regimen for stretch marks 1. This treatment can result in significant improvements in the appearance of stretch marks, including increased epidermal thickness and decreased perivascular inflammatory infiltrate, as well as high patient satisfaction rates. Additionally, microneedling with PRP has also been shown to be an effective treatment for stretch marks, with significant improvements in collagen and elastin fiber deposition and patient satisfaction 1.

From the Research

Treatment Options for Stretch Marks

  • Topical tretinoin (retinoic acid) has been shown to improve the clinical appearance of early, active stretch marks 2
  • The 585-nm flashlamp-pumped pulsed dye laser has been used to treat stretch marks, with improvements in the appearance of striae and increased dermal elastin 3
  • Platelet-rich plasma (PRP) in combination with fractional carbon dioxide laser or pulsed dye laser has been shown to be effective in treating stretch marks, with the combination with fractional CO2 laser being more promising 4
  • Ablative Erbium: YAG fractional laser has been compared to 585-nm pulsed-dye laser for the treatment of stretch marks, with varying success 5

Topical Management of Stretch Marks

  • Topical management of stretch marks includes prevention and therapy of striae rubrae and albae, with various topical products available 6
  • Trofolastin and Alphastria creams have demonstrated level-2 evidence of positive results for their prophylactic use in stretch marks 6
  • Tretinoin has been used therapeutically, with varying results, while cocoa butter and olive oil have not demonstrated any effect 6
  • There is a lack of evidence for each topical formulation, and a structured approach is required for the identification and targeted management of symptoms and signs with the appropriate topical 6

Laser Therapy for Stretch Marks

  • The 585-nm pulsed dye laser has been shown to improve the appearance of stretch marks, with increased dermal elastin 3
  • Fractional carbon dioxide laser has been used in combination with platelet-rich plasma (PRP) to treat stretch marks, with promising results 4
  • Ablative Erbium: YAG fractional laser has been compared to 585-nm pulsed-dye laser for the treatment of stretch marks, with varying success 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 1996

Research

Treatment of striae distensae using an ablative Erbium: YAG fractional laser versus a 585-nm pulsed-dye laser.

Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology, 2014

Research

Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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