Transepidermal retinoic acid delivery using ablative fractional radiofrequency associated with acoustic pressure ultrasound for stretch marks treatment.

BACKGROUND Striae distensae (SD) treatment still remains a therapeutic challenge to dermatologists. Ablative fractional laser and radiofrequency (RF) enhance skin-drug permeability for SD treatment. OBJECTIVE To clinically evaluate the efficacy and safety as well as patient's satisfaction in relation to a method using ablative fractional RF associated with retinoic acid 0.05% cream and an acoustic pressure wave ultrasound (US) in patients with alba-type SD on the breast. METHODS AND MATERIALS Eight patients with alba-type SD on the breast were treated with three step procedure: (1) fractional ablative RF for skin perforation; (2) topical application of retinoic acid 0.05% on the perforated skin; and (3) US was applied to enhance the retinoic acid penetration into the skin. Other eight patients with alba-type SD on the abdominal area were submitted to RF treatment isolated without retinoic acid or US. Three of them were submitted to skin biopsies. RESULTS Three patients with SD on the breast area improved from "severe" to "moderate;" two patients improved from "severe" to "mild;" two patients from "moderate" to "mild;" one patient from "marked" to "mild." Clinical assessment demonstrated significant improvement in the appearance of SD in all patients treated with RF associated with retinoic acid 0.05% cream and US (P = 0.008), with low incidence of side effects and high level of patient's satisfaction. Among the patients treated only with RF, two patients improved from "severe" to "marked;" one patient from "marked" to "moderate;" and one patient improved from "marked" to "mild." Four patients did not show any sort of improvement. Clinical assessment demonstrated no significant improvement in the appearance of SD treated with RF isolated with low incidence of side effects, but low-level of patient's satisfaction. CONCLUSION Ablative fractional RF and acoustic pressure US associated with retinoic acid 0.05% cream is safe and effective for alba-type SD treatment.