Comparative Analysis of Laser Therapies for Striae Distensae: Fractional CO₂ vs Combined Q-Switch Nd:YAG

BACKGROUND Striae, or stretch marks, are dermal scars caused by skin stretching, including striae rubrae (SR) and striae albae (SA), which are difficult to treat. Various lasers, including fractional carbon dioxide (CO₂) and Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, have shown varying success rates. This study compared the efficacy of fractional CO₂ laser alone and in combination with Q-switched Nd:YAG laser in treating SR and SA. MATERIAL AND METHODS In each patient fractional CO₂ laser was applied alone to the randomly selected 4 striae distansae (SD) on one side of the body in Group 1 (n: 49), and Q-Switch Nd:YAG laser combined with fractional CO₂ laser was applied sequentially to the other 4 SD on the opposite side of the body in Group 2 (n=49). The number of SR, scores for color, vascularity, and atrophy were recorded. The largest measurable SD width and length were calculated. Global Aesthetic Improvement Scale score (GAIS), patient's subjective satisfaction score, and tolerability score were evaluated. RESULTS Group 2 showed greater improvement in vascularity, atrophy, and SD dimensions compared to Group 1, but no significant differences in color. Reduction in SR count and GAIS scores was significantly higher in Group 2. CONCLUSIONS Combination treatment appears to be more effective in improving vascularity, atrophy, and the width and length of SD, resulting in higher patient satisfaction. We recommend to use Q-Switch Nd:YAG laser for the early stage of unmature SR and add fractional CO₂ laser for especially resistant markedly atrophic SA lesions after Q-Switch Nd:YAG laser.