Differences in clinical features and risk factors for striae distensae in Black and White women

Striae distensae (SD) are a common condition, which can appear differently across skin colors and for which effective treatments remain limited. SD have several risk factors, including pregnancy, obesity, growth spurts, and several pathologic conditions. Few studies have examined whether there are skin color differences regarding SD in their clinical presentation, risk factors, and associated comorbidities. To evaluate the clinical features, risk factors, and associated comorbidities of SD among Black and White women. This was a two-part study involving a telephone questionnaire followed by an in-person clinical assessment with standardized photographs. One hundred forty-three women (75 Black, 68 White) completed the survey, and 66 women (33 Black, 33 White) completed the in-person clinical assessment. Black and White women in the study were found to be similar in age, SD duration, parity, pregnancy-associated weight gain, and family history. Black women, on average, had a greater number of SD than White women (118 versus 76, p = 0.01). Striae were typically white and skin-colored among Black women, but white and violaceous among White women (p = 0.02). Black women were more likely to have involvement of the lower legs (p = 0.04), axilla (p = 0.05), and buttocks (p = 0.002) than White women. Compared to Black women, urinary incontinence was more commonly reported among White women, though this did not reach statistical significance (p = 0.07). There was a significant association between smoking and SD in White women (p = 0.003), but not in Black women. Additionally, Black women were more likely to use creams to diminish the appearance of their striae. While the etiology, prevalence, and risk factors of SD may be similar between Black and White women, there may be important skin color differences in SD clinical features and medical comorbidities. Larger studies are needed to further characterize the relationship between SD and medical comorbidities such as urinary incontinence and pelvic floor dysfunction. The study of this relationship may advance understanding of SD pathogenesis and provide pathways for targeted therapies. More studies are needed to determine the role of SD evaluation as a screening tool to help predict the risk of the development of pelvic floor dysfunction.