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Use of a specific anti-stretch mark cream for preventing or reducing the severity of striae gravidarum. Randomized, double-blind, controlled trial
Abstract
Synopsis
Few studies have tested the efficacy of commercially available cosmetic products for preventing striae gravidarum . Therefore, the objective of this study was to evaluate efficacy on prevention of striae gravidarum using a specific anti‐stretch mark cream containing hydroxyprolisilane‐C, rosehip oil, Centella asiatica triterpenes and vitamin E. A randomized, double‐blind, placebo‐controlled trial was conducted between November 2009 and April 2011. Pregnant women were included and classified as treated group (emollient and moisturizer containing hydroxyprolisilane C, rosehip oil, Centella asiatica triterpenes and vitamin E) and control group (cream without the active ingredients). Overall incidence of stretch marks during pregnancy was 33.3% for the control group and 37.6% for the treated group (n.s.). Severity of previous stretch marks significantly increased in the control group during the study (17.8%, P = 0.001), but not in the treated group (6.3%, ns). In women who developed new stretch marks during the study, there was a significantly greater ‘difference in severity’ (between baseline and maximum severity) in control group vs. treated group (0.47 [0.57] vs. 0.14 [0.60], P = 0.031). In women without previous striae, incidence of these marks was significantly lower for the treated group patients compared with control group (5.6% vs. 35%, P = 0.031, OR : 9.2 [95% CI : 1.0–83.3]). The use of the anti‐stretch mark product is proved to be effective in reducing severity of the striae during pregnancy, prevents the appearance of new striae and halts progression of those already present. In women who had no striae at baseline, use of the anti‐stretch mark cream was more effective than placebo in preventing new stretch marks.
... Preventative treatments have met with limited success. Creams that contain Centella asiatica extract, especially Trofolastin cream, are best supported by data for the prevention or reduction of the severity of SG (Table 2; García Hernández et al., 2013;Mallol et al., 1991). Centella asiatica is a medicinal herb that is thought to increase the production of collagen and elastic fibers (García Hernández et al., 2013). ...
... Creams that contain Centella asiatica extract, especially Trofolastin cream, are best supported by data for the prevention or reduction of the severity of SG (Table 2; García Hernández et al., 2013;Mallol et al., 1991). Centella asiatica is a medicinal herb that is thought to increase the production of collagen and elastic fibers (García Hernández et al., 2013). Mallol et al. (1991) demonstrated that Trofolastin cream with Centella asiatica extract, α-tocopherol, and collagen-elastin hydrolysates that is applied daily from gestational week 12 until delivery significantly reduced the incidence of SG compared with placebo. ...
... Mallol et al. (1991) demonstrated that Trofolastin cream with Centella asiatica extract, α-tocopherol, and collagen-elastin hydrolysates that is applied daily from gestational week 12 until delivery significantly reduced the incidence of SG compared with placebo. Both Mallol et al. (1991) and García Hernández et al. (2013) found that creams that contained Centella asiatica significantly reduced the intensity and/or severity of SG among women who did develop SG. García Hernández et al. (2013) also demonstrated that the severity of previous striae significantly increased in the patient group treated with placebo but did not change in the patient group treated with Centella cream. ...
Background: Striae gravidarum (SG) are atrophic linear scars that represent one of the most common connective tissue changes during pregnancy. SG can cause emotional and psychological distress for many women. Research on risk factors, prevention, and management of SG has been often inconclusive.
Methods: We conducted a literature search using textbooks, PubMed, and Medline databases to assess research performed on the risk factors, prevention, and management of SG. The search included the following key words: striae gravidarum, pregnancy stretch marks, and pregnancy stretch. We also reviewed citations within articles to identify relevant sources.
Results: Younger age, maternal and family history of SG, increased pre-pregnancy and pre-delivery weight, and increased birth weight were the most significant risk factors identified for SG. Although few studies have confirmed effective prevention methods, Centella asiatica extract, hyaluronic acid, and daily massages showed some promise. Treatment for general striae has greatly improved over the last few years. Topical tretinoin ≥0.05% has demonstrated up to 47% improvement of SG and non-ablative fractional lasers have consistently demonstrated 50 to 75% improvement in treated lesions of striae distensae.
Conclusion: Overall, SG has seen a resurgence in research over the last few years with promising data being released. Results of recent studies provide dermatologists with new options for the many women who are affected by these disfiguring marks of pregnancy.
... Consequently, women may use these products during pregnancy, many of which are considered cosmetic products [34] incurring significant expense [4]. However, the effectiveness of many products is unclear [35] due to the limited amount of research undertaken to date. A recent Cochrane Review [36] which included six trials involving a total of 800 women, found no high-quality evidence to support the use of any of the topical preparations identified in the review for the prevention of stretch marks during pregnancy. ...
... Similar results were found for cocoa butter lotion [49]. Cocoa butter is also present in some of the 'other products' used by women in this study and the effectiveness of these and the many other commercially available products used by women remains uncertain [35]. Some women may also have used cocoa butter lotion to prevent worsening of pre existing striae based on our finding of its use by women who developed stretch marks both prior to pregnancy and during the current pregnancy. ...
... The Fig. 6 Consideration to participate in a future trial by gravida majority of women using a product were applying it once a day, which concurs with advice to women participating in some studies [3,49,51,58]. However, some advocate application at least twice a day [35]. ...
Background
Stretch marks (Striae gravidarum) are a cutaneous change occurring commonly during pregnancy. A variety of products are available and promoted as ways to prevent or reduce their development, but it is not clear what products are used most commonly. The objective of this study was to identify topical products used during pregnancy to prevent or reduce the development of striae gravidarum. We also explored issues around application of the product, cost incurred and influences on women’s decisions to use a product.
Methods
In this cross sectional, descriptive survey we collected data from 773 women, via a paper (n = 707) or online (n = 66) questionnaire. Due to missing data in the online survey, 753 women at 36 weeks gestation or more were included in the analyses. Descriptive and inferential statistical analyses were undertaken.
Results
Most respondents (n = 589, 78.2 %) indicated that they used a product to prevent or reduce the development of stretch marks during their current pregnancy. A large range of products were used and more than one third of women (n = 210, 36.5 %) had used two or more products. Bio-oil was the most frequently used product (n = 351, 60.9 %) and it was also the most frequently used product among women who used only one product (n = 189, 32.8 %).
Conclusions
Many women apply one of the many products available to prevent or reduce the development of striae gravidarum. Bio-oil was the most commonly used product identified in this study. There is a need for high-quality evidence on the effectiveness of Bio-oil and other products.
... It can appear at any stage of life and is associated with a genetic predisposition in some cases. It is also common during adolescence (27%) and pregnancy (60-90%) as a result of a combination of mechanical and hormonal factors (increased steroid hormones) (García Hernández, Madera González, Padilla Castillo, & Figueras Falcõn, 2013). In addition, stretch marks can cause itching and reduced skin moisture causing the mother too often to scratch. ...
... Skin elasticity is an essential factor, so preventive treatments should maintain and enhance fibroblast stimulators' dermis structure and healing agents by increasing collagen and elastin fibers production (Bylka et al., 2013). Anti-stretch mark cream effectively reduces the severity of striae, striae development and prevents striae during pregnancy (García Hernández et al., 2013). Gotu kola leaves contain triterpenes which function as collagen-forming. ...
Stretch marks result from mechanical factors, namely stretching of the skin due to the development of subcutaneous structures (interstitial adipose tissue) or biochemical factors (the presence of excessive glucocorticoids that inhibit fibroblast activity and proliferation). There is no truly effective treatment for removing striae once they have formed. This study evaluates the effectiveness of administering Gotu Kola Extract (Centella asiatica) on the stretch mark. This paper was a Quasi-Experimental study with a pretest-posttest design. This study was conducted at the Independent Practice Midwife (IMP) Zummatul Atika in October-December 2020. The population was postpartum mothers (days 0-6) with stretch marks. Meanwhile, there were 12 respondents by purposive sampling technique. The independent variable was Gotu kola extract lotion, while the dependent variable was stretch marks with ratio data. Collecting data with a structured interview to gather the characteristics of respondents and participant observation to evaluate changes (number of stretch marks, color, moisture, and skin condition) in stretch marks before and after intervention during one month. The Gotu kola extract lotion was made in the pharmacy laboratory of PGRI Adi Buana University Surabaya within several stages. The data analysis used the paired T-test, and the result showed p= 0.000, indicating a significant difference before and after the intervention. This study concludes that administering Gotu Kola Extract (Centella asiatica) lotion effectively reduces skin pigmentation and lines in stretch marks, increases skin moisture, and refines skin texture.
... Ponadto stosowane są wyciągi roślinne z wąkroty azjatyckiej (Centella asiatica), które dzięki obecności azjatykozydu stymulują fibroblasty do produkcji nowych włókien kolagenowych, a także kwas hialuronowy, zwiększający nawilżenie skóry, oraz regenerującą włókna kolagenowe krzemionkę organiczną. Zalecane jest wykonanie około 4-6 zabiegów w odstępach co 2-4 tygodnie oraz przeprowadzanie 1 zabiegu raz w miesiącu przez 3-6 miesięcy w celu podtrzymania efektu [28]. Przeprowadzono również badania kliniczne skuteczności leczenia rozstępów czerwonych za pomocą mezoterapii igłowej z wykorzystaniem roztworu kwasu hialuronowego, uzyskując łagodną poprawę wyglądu zmian (25-50%) [18]. ...
... Po 15 miesiącach terapii wykazano zahamowanie rozszerzania się rozstępów w grupie kobiet z niewielkimi rozstępami oraz brak pojawiania się rozstępów na brzuchu u kobiet w ciąży. Wyciąg z wąkroty azjatyckiej uznano za skuteczny w przeciwdziałaniu powstawania rozstępów i hamowaniu rozwoju zmian już istniejących [28]. ...
... Despite the presence on the pharmaceutical market, a large number of topical drugs, to date there is no standard treatment of stretch marks, the evidence of the clinical efficacy of most funds is limited [11,33,41,42]. Increasing the elasticity of connective tissue is one of the main objectives of topical therapy of stretch marks along with increased collagen production, anti-inflammatory and rehydration of the skin, which in turn contributes to the elasticity of the skin and its hydration [6,43]. ...
... In the main group, the severity has not changed. Among patients in the control group, had a more severe course of the newly emerging stretch marks in comparison with the group of patients treated with the above therapy [8,33,34,35,42]. ...
... Despite the presence on the pharmaceutical market, a large number of topical drugs, to date there is no standard treatment of stretch marks, the evidence of the clinical efficacy of most funds is limited [11,33,41,42]. Increasing the elasticity of connective tissue is one of the main objectives of topical therapy of stretch marks along with increased collagen production, anti-inflammatory and rehydration of the skin, which in turn contributes to the elasticity of the skin and its hydration [6,43]. ...
... In the main group, the severity has not changed. Among patients in the control group, had a more severe course of the newly emerging stretch marks in comparison with the group of patients treated with the above therapy [8,33,34,35,42]. ...
The article presents literature data on the methods of correction of linear atrophy of the skin (striae). This pathology is widespread in both sexes. The decline in the quality of life in this disease occurs largely due to the presence of a cosmetic defect. To date, there is no universal therapeutic approach for the correction of stretch marks. In this article available literature data on the problem of linear atrophy of the skin has been summarized.
... A randomized, double-blind, placebo-controlled study in pregnant women indicates that the severity of stretch marks can be reduced by topical application of emollient and moisturizer containing hydroxyprolisilane C, rose hip oil, Centella asiatica triterpenes, and vitamin E. [22] It seems that moisturizers are the critical component of topical preparations for the treatment of stretch marks and it is questionable, if there is an add-on effect of other ingredients. [23] In a prospective randomized open trial, microdermabrasion was found to be as effective as the daily application of topical 0.05% tretinoin cream in the reduction in the severity of early stretch marks. ...
... Topical treatment cannot prevent the occurrence of stretch marks under specific circumstances such as pregnancy. [16][17][18][19][20][21][22][23] Laser treatment is a physical tool used in the improvement of stretch marks with a focus on early stretch marks [ Table 1]. Owing to its physical characteristics, represented mainly by the 1064-nm wavelength and dye pumped laser, these lasers are very safe. ...
Stretch marks are one of the most common benign cutaneous lesions and encountered esthetic problems. Striae rubrae and striae albae can be differentiated on the basis of clinical appearance. Histologically, disturbances of the dermal fiber network and local expression of receptors for sexual steroids have been detected. The epidermal changes are secondary. Prevention of stretch marks using topical ointments and oils is debatable. Treatment of striae rubrae by lasers and light devices improves appearance. Microneedling and non-ablative and fractionated lasers have been used. This review provides an overview on current treatment options with a special focus on laser treatments.
... Massage with either Trofolastin cream or Verum ointment is associated in small RCTs with a decrease in the development of SG [134]. A small randomized trial showed that a specific anti-stretch mark cream (emollient and moisturizer containing hydroxyprolisilane C, rosehip oil, Centella asiatica, triterpenes, and vitamin E) had a small effect in reducing severity (but not the incidence) of striae during pregnancy [135] (see Chapter 43 in Maternal-Fetal Evidence Based Guidelines). ...
... Examples of Safe and Unsafe Physical Activities During PregnancyThe following activities are safe to initiate or continue a : Source: Adapted from Committee Opinion No. 650, Obstet. Gynecol.,126,[135][136][137][138][139][140][141][142] 2015. ...
... 1. Enhancing production of collagen A Topical treatments: Tretinoin (trans-retinoic acid), Centella asiatica extract creams [10] . Centella asiatica extract creams: Is thought to stimulate fibroblasts, increasing the production of collagen and elastic fibres [11] . Hyaluronic acid creams: Stimulate fibroblast activity and collagen production [12] . ...
... For SD treatment, various laser parameters have been examined, alone or in combination with other treatment methods. Topical treatments have only mild effects and cannot prevent stretch marks in specific circumstances such as pregnancy [12,[42][43][44][45][46]. As already mentioned in the introduction, many therapies are used for SD; the most recent is represented by laser and light therapies, particularly fractional lasers [36]. ...
A large part of the world’s population suffers from Striae distensae (SD) or stretch marks, which create physical and psychological discomfort in people. We evaluate the SD clinical improvement by using a non-ablative fractional Nd:YAP 1340 nm laser. The research was performed on 25 patients of both sexes, with a mean age of 31 ± 13.09 years. Each patient underwent from a minimum of 3 to a maximum of 4 treatments, with an Nd:YAP (1340 nm) medical device, every four weeks, with 3- and 6-month follow-up, in these areas: back, abdomen, breast, flanks, lower limbs, buttocks, and thighs. Manchester Scar Scale assessed stretch marks improvement. Side effects, patient pain, and SD overall appearance improvement were also recorded for all patients. Digital photographs measured the aesthetic results. Treatment was well-tolerated (pain score 1.08 ± 0.76) by all patients. There were no long-term side effects, and 88% of patients revealed an SD excellent improvement showing good aesthetic results achieved by the treatment. The total mean pretreatment Manchester Scar Scale score decreased from 13.80 (±1.58) to 10.36 (±1.70) after 3 months (p < 0.01) and to 8.36 (±1.07) after 6 months (p < 0.01). An Nd:YAP (1340 nm) laser seems to be a safe and effective treatment, showing a higher security profile with no side effects.
... 4 On the other hand, topical use of combination cream containing hydroxyprolisilane C, rosehip oil, Centella asiatica triterpenes and vitamin E has been reported to prevent the development and reduce the intensity of striae with no harmful fetomaternal e ects associated. 64 However further studies are necessary to con rm this promising treatment option in pregnancy. ...
Objective:
We sought to know the efficacy and safety profile of topical products for use during pregnancy.
Methods:
We used PubMed, Embase, and Cochrane Library to review literature on topical products and pregnancy.
Results:
A majority of pregnant women develop skin changes, including physiological or hormonal changes, worsening of preexisting skin conditions, or the appearance of new dermatoses during pregnancy. Most pregnant women are concerned about the availability of treatments options with good safety profiles, especially for skin and hair treatments, to maintain their appearance and health. Although most of the treatments are recommended to be used after delivery, there are some alternatives to prevent and treat skin lesions during pregnancy.
Conclusion:
The most current and comprehensive information about the efficacy and safety profile of topical products in pregnancy are necessary.
... Stretch mark dapat muncul pada setiap tahap kehidupan dan dapat terkait dalam beberapa kasus untuk predisposisi genetik. Striae juga sering terjadi selama masa remaja (27%) dan kehamilan (antara 60%-90%), sebagai akibat dari kombinasi faktor mekanis dan hormonal (peningkatan hormonsteroid) (García Hernández et al., 2013). Akibat peregangan kulit selain Strecth mark yaitu timbulnya rasa gatal, dan kelembapan kulit berkurang, yang menyebabkan ibu sering menggaruk sehingga menimbulkan bekas luka pada kulit dan membuat kepercayaan diri ibu berkurang akibat bekas dari stretch mark. ...
Perubahan Kulit terjadi pada kehamilan, salah satunya adalah stretch mark . Strecth mark disebabkan oleh hiperdistensi pada kulit. Peregangan kulit membuat kepercayaan diri ibu berkurang. Daun pegagan (centella asiatica) memiliki kandungan triterpen yang mampu meningkatkan metabolism lisin, prolin dan asam amino sebagai pembentuk kolagen. Tujuannya adalah Meningkatkan pengetahuan dan pemberdayaan masyarakat tentang pemanfaatan centella asiatica/daun pegagan sebagai upaya memudarkan Stretch Mark pada ibu Nifas. Pengabdian dilakukan selama 1 bulan. Pertama pemberian pengetahuan terkait centella asiatica, selanjutnya demonstrasi ektraks centella asiatica dengan Teknik maserasi, selanjutnya evaluasi pemakaian hasil ektraks gel centella asiatica yang di aplikasikan selama 1 bulan. Terdapat peningkatan pemahan ibu terkait pemanfaatan centella asiatica, mampu membuat ekstrak centella asiatica dan terdapat pemudaran stretch mark pada beberapa ibu yang telah dipantau. Pengabdian pada masyarakat ini berbasis hasil penelitian sebelumnya, sehingga dapat diaplikasikan untuk membantu permasalahan stretch mark yang dialami oleh ibu dengan pemanfaatan herbal yang ada di lingkungan sekitar masyarakat.
... Поэтому мы фокусируемся на лечении именно красных стрий. Так, результаты рандомизированного двой ного слепого плацебо-контролируемого исследования с участием беременных женщин показали, что выраженность стрий может быть уменьшена путем местного применения смягчающего и увлажняющего средства, содержащего гидроксипролизилан С, масло шиповника, тритерпены Centella asiatica и витамин Е [14]. ...
Striae may form on the skin due to a number of factors: rapid weight gain, muscle hypertrophy, endocrinopathies, breast enlargement, as a side effect of long-term topical use of strong corticosteroids. However, in some rare circumstances, striae can develop as a complication due to the use of tissue expanders. This cosmetic defect develops most often on the skin of the thighs, abdomen, mammary glands in women and the shoulders in men. Striae of pregnancy are a common cosmetic skin defect. The development of striae is associated with stretching and rupture of connective tissue in susceptible individuals against the background of influence of genetic and hormonal factors. The appearance of striae gravidarum does not have a significant effect on the health of patients, however, a cosmetic defect caused by the appearance of striae can generate psychoemotional (psychoemotional) stress and lead to a decrease in quality of life. The striae development occurs in certain stages. The initial period of striae development – red (immature) striae – is characterized by the absence of changes in the epidermis and signs of inflammation in the dermis. The appearance of white (mature) striae is accompanied by the architectural distortion of elastic fibre net and changes in the viscoelastic properties of the affected skin, which becomes much less elastic. The correction of striae requires topical treatment that help moisturize and soften the skin, stimulate the processes of collagen production, as well as physiotherapy techniques. However, many of them have contraindications for use during pregnancy. The article discusses the issues of the use of cosmetic products that can be used during pregnancy.
... ratamento e prevenção das estrias, tais como, a manteiga de cacau, a centella asiática, óleo de amêndoas, lanolina, estearina, trietanolamina, glicerina e colágeno hidrolisado (LOPES, 2017;RIBEIRO et. al., 2015;COSTA, 2016;WANG et. al., 2015;BUCHANAN;FLETCHER;REID, 2010;MOORE;KELSBERG;SAFRANEK, 2012;SOLTANIPOUR, et. al., 2014;TAAVONI et. al., 2011;HERNÁNDEZ et. al., 2013). ...
... ratamento e prevenção das estrias, tais como, a manteiga de cacau, a centella asiática, óleo de amêndoas, lanolina, estearina, trietanolamina, glicerina e colágeno hidrolisado (LOPES, 2017;RIBEIRO et. al., 2015;COSTA, 2016;WANG et. al., 2015;BUCHANAN;FLETCHER;REID, 2010;MOORE;KELSBERG;SAFRANEK, 2012;SOLTANIPOUR, et. al., 2014;TAAVONI et. al., 2011;HERNÁNDEZ et. al., 2013). ...
... ratamento e prevenção das estrias, tais como, a manteiga de cacau, a centella asiática, óleo de amêndoas, lanolina, estearina, trietanolamina, glicerina e colágeno hidrolisado (LOPES, 2017;RIBEIRO et. al., 2015;COSTA, 2016;WANG et. al., 2015;BUCHANAN;FLETCHER;REID, 2010;MOORE;KELSBERG;SAFRANEK, 2012;SOLTANIPOUR, et. al., 2014;TAAVONI et. al., 2011;HERNÁNDEZ et. al., 2013). ...
... ratamento e prevenção das estrias, tais como, a manteiga de cacau, a centella asiática, óleo de amêndoas, lanolina, estearina, trietanolamina, glicerina e colágeno hidrolisado (LOPES, 2017;RIBEIRO et. al., 2015;COSTA, 2016;WANG et. al., 2015;BUCHANAN;FLETCHER;REID, 2010;MOORE;KELSBERG;SAFRANEK, 2012;SOLTANIPOUR, et. al., 2014;TAAVONI et. al., 2011;HERNÁNDEZ et. al., 2013). ...
... These include peptic ulcer (4), diarrhea (5), fl atulence (5), convulsions (6), and cognitive impairment (7). For cosmetic purposes, C. asiatica has been reported to ameliorate bruising, to retard loss of skin elasticity (8,9), to improve postpartum stretch marks (10), to reduce skin wrinkling (11), and to promote wound healing (12). The active ingredients of C. asiatica are several pentacyclic triterpenoids and their glycosides including asiatic acid, asiaticoside, madecassic acid, and madecassoside which collectively comprise 2-8% dry weight of the plant (13) and are responsible for the medicinal actions (3) of cosmetics (14). ...
Centella asiatica has many applications in cosmetics, including wrinkle treatments, but its effectiveness remains to be clarified. This systematic review study aimed to demonstrate the efficacy and safety of C. asiatica for reducing facial wrinkles. PubMed, Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of clinical trials, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Thai Library Integrated System, and Thai university database/journals were searched until May 2019. Five double-blinded randomised controlled trials, including 172 Asian females, were included. Endpoints were wrinkling measured by visual score, image analysis, and participant satisfaction. Two placebo-controlled studies applied gel/creams containing C. asiatica or asiaticoside for 12 w to periorbital skin. Two studies applied tretinoin or Pueraria mirifica contralaterally and by network meta-analysis C. asiatica appeared more effective than P. mirifica but possibly less than tretinoin. Asiaticoside applied as a lipstick for 8 w reduced lip wrinkling. Skin hydration was markedly raised by C. asiatica but not tretinoin. One study reported 10 adverse events for C. asiatica and 35 for tretinoin. Cochrane risk of bias was generally low, reporting was weak, and lack of C. asiatica standardization prevents general application. From the reported data, it is possible to conclude that C. asiatica improved lip and periocular wrinkles, and may replace retinoids if its long-term safety is established and C. asiatica is standardized.
... Ülkemizde yürütülen deneysel bir çalışmada, acıbadem yağı ile 15 dakikalık masajın SG oluşumunu azalttığı saptanmıştır (22). İspanya'da yapılan RKÇ'da, kuşburnu yağı içeren nemlendirici kremin SG şiddetini azalttığı, SG oluşumunu önlediği ve mevcut olanlarında ilerlemesini de durduğu kanıtlanmıştır (23). Bu çelişkili sonuçlar bize halen SG'u önleyici ya da mevcut SG'u iyileştirici ya da şiddetini azaltıcı esansiyel yağların etkisini inceleyen iyi tasarlanmış RKÇ'lara ihtiyaç olduğunu göstermektedir. ...
Gebelikte oluşan bazı yapısal ve fonksiyonel değişiklikler kadının fiziksel ve ruhsal sağlığını olumsuz yönde etkileyerek kadının yaşam kalitesini azaltabilmektedir. Bu makale ile aromaterapi kullanarak gebelik sürecindeki semptomların önlenmesi, azaltılması ya da iyileştirilmesi üzerine yürütülen kanıt temelli çalışmaların incelenmesi amaçlanmıştır. Konuyla ilgili literatür incelendiğinde, gebelerde aromaterapinin bulantı, kusma, yorgunluk, enerji düzeyi, anksiyete, öfke, parasempatik sinir aktivitesi, stria gravidarum, kaşıntı ve sırt ağrısı üzerine etkisini inceleyen çalışmalara ulaşılmıştır. Bu sonuç gebelikteki semptomlar üzerine aromaterapinin etkisiyle ilgili yüksek kaliteli randomize kontrollü çalışmalara gereksinim olduğunun göstergesidir.
... Roślina ta skutecznie zatrzymuje procesu fotostarzenia się skóry, zapobiega pojawieniu się i rozwijaniu cellulitu oraz rozstępów. Potwierdzają to badania Garcia Hernandez i wsp, którzy przeanalizowali skuteczność kremów zawierających triterpeny z Centella asiatica [16]. Wąkrota azjatycka wykazuje również działanie antyoksydacyjne. ...
Korean skin care is becoming more and more popular in Poland. This is related to an interesting approach to everyday complexion care, consisting of 10 steps. Korean cosmetics, whose active ingredients have not previously been widely used in European products, are now available in Poland and are their popularity continues to grow. The
aim of this study was to evaluate popular active ingredients used in cosmetics from Korean manufacturers that are available on the Polish market were analysed in view of their use, effectiveness and possible side effects. After randomly selecting 10 products of several types and identifying their active ingredients, a review of literature on these substances available in the databases of scientific articles was carried out. This article discusses ingredients such as the pennywort, aloe vera, snail slime, Korean ginseng, bee venom and arbutin. The presented study results confirm beneficial effects on the skin and safety of use. Understanding the effect on the skin of active ingredients of Korean cosmetics and possible side effects caused by them allows for safe and effective use both by the cosmetologists and in home care.
... Preventative treatments have met with limited success. Creams that contain Centella asiatica extract, especially Trofolastin cream, are best supported by data for the prevention or reduction of the severity of SG. 12 The application of almond oil, olive oil, or cocoa butter consistently failed to significantly lower the incidence of SG compared with placebo group. Two studies did find that when olive oil or almond oil were applied with a massage daily, they were associated with a lower incidence of SG development. ...
Abdominal stretch marks found during pregnancy may be indicative of poor skin elasticity. One who does not have stretch marks may have better skin elasticity and may be less likely to tear perineal and vaginal tissue during vaginal delivery. Striae gravidarum (SG) is a common phenomenon of stretch marks observed during pregnancy that may be an indicator of poor skin elasticity. The type and amount of collagen in connective tissue are considered to determine the individual’s elastic index. The skin surface is made up of a complex network of crossing thin lines. The two-dimensional relationship between primary and secondary lines determines the skin texture and its grade of irregularity. SG is caused by changes in the structural connective tissue due to a hormonal elect on the alignment and reduced elastin and fibrillin in the dermis. Severity scoring of SG was observed using the numerical scoring system of Atwal. This score provides a rank based on observation of four areas in which SG is most commonly observed (abdomen, hips, buttocks, and breast).
... Benzer şekilde Osman ve ark.'nın 8 ve Ersoy ve ark.'nın 9 çalışmalarında da krem kullanımının SG'yi önleyici bir yöntem olmadığı bulunmuştur. Ülkemizde yürütülen bu üç çalışmanın aksine García Hernández ve ark.10 , krem kullanımının yeni SG oluşumunu engellediğini ve mevcut SG'nin şiddetini azalttığını belirtmiştir. Bu çalışmanın primer amacı kadınların SG'yi önlemek için kullandıkları tamamlayıcı terapileri belirlemek ve etkinliğini incelemek, sekonder amacı ise SG oluşumunda etkili olabilecek risk faktörlerini ortaya koymaktır. ...
Background and Design: Striae gravidarum (SG) has been reported to be associated with various factors, but the role of complementary therapies in the prevention of SG is still not well understood. The aim of this study was to determine complementary therapies for prevention of SG.
Materials and Methods: This descriptive research was conducted on 120 pregnant women in a maternity clinic at a university hospital. Of 120 women, 49 were going through the last trimester and 71 were going through their first postpartum 24 hours. Data were collected using a 25-item-questionnaire through face-to-face interviews between June and July in 2016. Obtained data were evaluated by using descriptive statistics, chi-square test and the Kruskal-Wallis test.
Results: 90.8% of women had SG. For the prevention of SG, 46.7% of women used massage, a manipulative body-based complementary therapy, 55.2% used oils, 28.6% used creams and 8.0% used a mixture of creams and oils for massaging. 42.9% of women started to use complementary therapies in their first trimester. Half of the women stated that they had received information about complementary therapies. A significantly lower rate of women using massage had SG compared to those not using massage (p=0.023).
Conclusion: It was concluded that nearly half of the women used massage for the prevention of SG. In addition, massage application was found to reduce the occurrence of SG.
... Atlikdami tyrimą, išsiaiškinome, kad 26 tiriamųjų oda [17] buvo normali, 13 -sausa, 6 -riebi, 15 -mišri. Moterys, kurioms būdinga riebi ir natūrali oda, strijų profilaktikai dažniau vartojo cheminius preparatus, o turinčios sausą ir mišrią odą pirmenybę atidavė natūraliems aliejams (1 pav). ...
Straipsnyje nagrinėjamas natūralių aliejų ir cheminių priemonių (pramoniniu būdu pagamintų kosmetinių kremų ir losjonų), skirtų nėščiųjų strijų prevencijai, efektyvumas. Pateikiama MEDLINE duomenų bazėje skelbiamų 6 mokslinių šaltinių, analizuojančių nėščiųjų strijų profilaktikos galimybes, duomenų metaanalizė. Pastebima, kad iki šiol duomenys apie natūralių aliejų ir cheminių preparatų, skirtų nėščiųjų strijų atsiradimo profilaktikai, yra prieštaringi, trūksta išsamesnių tyrimų. Šio straipsnio autorių atliktame tyrime dalyvavo 60 vieną ar kelis kartus gimdžiusių moterų, nėštumo metu strijų profilaktikai naudojusių preparatus: natūralius aliejus arba cheminius preparatus. Tiriamosios buvo suskirstytos į dvi grupes: I grupėje buvo moterys, naudojusios natūralius aliejus, II grupėje - naudojusios kosmetinius kremus ir losjonus (cheminius preparatus). Kiekvienoje grupėje buvo po 30 tiriamųjų. Duomenys rinkti apklausos būdu. Analizuojant duomenis pastebėta, kad ir aliejų, ir cheminių priemonių prevencinis strijų atsiradimo poveikis panašus, reikšmingo skirtumo nėra. Natūralūs aliejai labiausiai mažino strijų atsiradimo galimybę grupėje, kurioje nėščiųjų amžius daugiau kaip 36 metai, o cheminiai preparatai labiausiai mažino strijų atsiradimo galimybę grupėje nėščiųjų, kurių amžiaus nuo 26 iki 35 metų, tačiau statistiškai patikimų įrodymų negauta. Cheminės priemonės ir aliejai, kaip profilaktikos priemonės, yra efektyvesni, kai nėštumo metu svorio priaugama pagal normas arba per mažai, tačiau ir šis teiginys statistiškai nepatvirtintas. Ateityje, atliekant panašaus pobūdžio tyrimus, reiktų į tyrimą įtraukti daugiau nėščiųjų.
... This may be explained by the fact that almond kernel contains large amounts of fat soluble vitamins such as vitamin E, because vitamin E, a strong antioxidant, contributes significantly to reducing the extent and severity of skin pathological complications [83]. Consistent with this argument, some studies reported vitamin E-contained emulsions and creams to be effective in preventing and relieving stretch marks [84]. Moreover, the presence of flavonoids and phenolic compounds, as antioxidant compounds, in bitter almond confirms prophylactic and relieving effects on stretch marks-induced skin complications. ...
... 69,70 Other studies showed mixed results. 23,69,[71][72][73] There is insufficient evidence to recommend any preventative modality. ...
Background:
Striae distensae (SD) are aesthetically troublesome to patients and therapeutically challenging.
Objective:
Herein, the authors comprehensively review the literature pertaining to the history, pathogenesis, clinical presentation, clinical rating scales, and laboratory, imaging, and histologic features of SD.
Methods and materials:
A review of PubMed, MEDLINE, Scopus, Embase, and Google scholar was conducted, including literature published from 1773 to August 6, 2016.
Results:
The authors identified 68 articles that met inclusion and exclusion criteria.
Conclusion:
There are few randomized controlled trials evaluating the long-term efficacy and safety of various topical and energy-based devices. Based on clinical and anecdotal experience, both nonablative and ablative fractionated lasers have shown modest SD improvement compared with other treatment modalities (including Excimer laser, CuBr laser, pulsed dye laser, and 1,064-nm Nd:YAG laser). In the authors' experience, 1,540-nm nonablative fractionated laser is a worthy first-line modality for the treatment of SD. Future researchers may consider greater focus on enhanced study design, including larger, long-term split-body, or split-SD head-to-head randomized comparative trials with objective outcome measures and end points, such as biopsy and molecular studies demonstrating increased collagen and elastic fibers that correlate to clinical improvement.
... However, the observed positive effect might be a result of the massage itself rather than cosmetics' ingredients [10][11][12]. On the basis of the results of a randomized double-blinded study, Garcia Hernández et al. proved effectiveness of anti-striae emollient and moisturizer containing hydroxyprolisilane C, rosehip oil, Centella Asiatica triterpenes and vitamin E [24]. Our study showed that systematic use of cosmetics at least twice per day significantly reduces the risk of striae occurrence. ...
Introduction:
Striae are the most frequently occurring pathology of connective tissue during pregnancy. According to the statistical data, 70-90% of women suffer from striae gravidarum.
Aim:
To assess effectiveness of topical products and massage used by pregnant women in striae gravidarum prophylaxis.
Material and methods:
The questionnaire study was conducted among 299 women who were maximum 6 months after delivery at term. The questionnaire included questions concerning age, occurrence of striae gravidarum during pregnancy, their location, week of gestation when the lesions appeared and used striae prophylaxis as well as its effectiveness in respondents' opinion.
Results:
Analysis of the correlation between striae gravidarum occurrence and use of different types of cosmetics showed that this kind of prophylaxis is effective when applied at least twice a day (63.7% vs. 77.6%). No correlation between the type of cosmetics and presence of striae was observed (p > 0.05).
Conclusions:
Use of prophylactic measures like skin emollients and oils with the appropriate frequency significantly reduces the risk of striae gravidarum occurrence.
... In a randomized, double-blind, placebo-controlled trial, Garc ıa Hern andez et al. enrolled 183 women, who applied the cream containing centella triterpenes twice a day to the abdomen, thighs, hips, buttocks and breasts starting in the 12th week of pregnancy. 31 The incidence of SG was similar between the treatment and placebo groups (38% vs. 33%, respectively). However, among women who developed SG, the severity of lesions remained stable with treatment, while worsening with placebo. ...
Striae gravidarum (SG), or stretch marks developing during pregnancy, affect up to 90% of women. While not medically dangerous, SG can be disfiguring, causing emotional and psychological distress. However, studies specifically addressing the prevention of SG, especially during pregnancy, are sparse. Furthermore, the molecular pathogenesis of SG is unclear and may differ from that of striae from other causes. Considering these factors, we review topical modalities that have been used specifically for preventing SG during pregnancy. We identify two major strategies (endpoints) for these modalities, including 1) preventing the de novo development of SG, and 2) reducing the severity of SG that have recently developed. We also identify risk factors for the development of SG and suggest that pregnant women with these risk factors are an appropriate target population for prevention. In reviewing the literature, we find that there is limited evidence that centella and possibly massage with bitter almond oil may prevent SG and/or reduce their severity. There is weak evidence that hyaluronic acid prevents SG. Tretinoin holds promise for reducing the severity of new-onset SG, but its use is limited by its pregnancy category. Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce. Furthermore, available topical modalities generally lack strong evidence from rigorous, well-designed, randomized controlled trials with ample numbers of subjects. Thus, further research is necessary to better elucidate SG pathogenesis, which may lead to effective prevention modalities.This article is protected by copyright. All rights reserved.
Striae distensae are atrophic linear scars that generally develop in the connective tissue due to various physiological states, such as pregnancy. Striae gravidarum are a subtype of striae distensae that develop in pregnant women. Mechanical stress, the pregnancy hormonal environment, younger maternal age, primigravidas, higher maternal body mass index, and higher weight gain in pregnancy have been described as risk factors. Many different therapeutic modalities have been tried. In this chapter, we describe the different treatment options for striae distensae and we discuss their efficacy according to the stage of their evolution.
The use of cosmetic products during pregnancy is one of the times when there is a considerable risk of side effects. The American Food and Drug Administration has classified many pharmacological drugs used in cosmetic applications as category C since their safety profile during pregnancy has not been sufficiently investigated. It should not be suggested to pregnant women or nursing mothers until the safety of all cosmetic agents has been established. To prove the safety of cosmetic applications, further randomized controlled studies are needed. Furthermore, it is critical for female health care providers to be knowledgeable about the use of cosmetic items and applications during pregnancy, to keep up with current research, and to educate pregnant women.
Introduction: Implementing research results in clinical practice has become a challenge in clinical settings. For this purpose, a study was designed to do the critical appraisal of the published clinical trials on "the effect of herbal medicine on striae gravidarum".
Methods: In this descriptive study, the clinical trials between 1972 and 2019 about the effect of herbal medicine on striae gravidarum , which searched through electronic scientific databases were appraised critically. The lasted edition of the CONSORT checklist (2018) for non-pharmacological treatments was used. The scoring range was 0-45. The articles were scored, and classified into three categories: poor, moderate and good quality. Data were analysed by SPSS software (version 22) using descriptive statistics.
Results: Out of the 14 articles reviewed, the overall compliance of the quality of the reviewed articles with the CONSORT 2018 criteria was estimated as 46%. In general, the greatest weakness was in the participation of stakeholders and then the method of study. The overall mean score of the articles was 20.86±7.18 from a minimum and a maximum of 9-33.
Conclusion: The present study showed that the quality of the clinical trial reports on the effect of herbal products on reducing striae gravidarum is not appropriate. Since the biggest shortcoming was in the method, it is recommended to solve the problems using the views of experts in statistics and research methodology as well as standard tools such as CONSORT for self-evaluation of articles.
Key words: Critical appraisal, Randomized controlled trial, Striae gravidarum
The condition of people’s skin is not only affected by environmental and psychological factors such as diet, sports, sleep and mood, genetic factors also play a very important role. Numerous genes have been identified to have associations with people’s skin color, skin inflammation, skin type, sensitivity, and so on; and many genes are connected to the regulation of the synthesis of functional proteins which are related to the skin condition such as inflammation sensitivity, anti-oxidation, anti-glycosylation, aging, collagen regeneration, moisturizing and etc. In addition, loci polymorphisms are important contributors to the occurrence, development and prognosis of various skin diseases. In terms of skin nutrition, vitamins play an important role in maintaining skin balance, and the deficiency of vitamins may cause dull complexion, lack of luster and the other skin problems. In this paper, we first describe the genes (such as MC1R, ASIP and BNC2) that are related to skin conditions including sun sensitivity, skin moisturizing function, oxidative stress, stretch marks, and skin inflammation. Then we describe the relationships between nutrients (such as vitamin A and vitamin C) and healthy skin. Finally, we design and implement a personalized skin care service consists of genetic testing, personalized nutrition for healthy skin, and personalized skin care cosmetics recommendation.
Vitamin E is a fat-soluble vitamin, discovered in 1922, that presents important physiological functions, including antioxidant, immunoregulatory, anti-inflammatory and neuroprotector capabilities. However, it is extremely sensitive to high temperatures, light, oxygen and alkaline conditions, which, together with its poor water solubility, can limit vitamin E applications.
In this context, encapsulation emerges as a suitable option for the protection of vitamin E, allowing its future incorporation into functional products for the food, cosmetic and pharmaceutical industry. This procedure that, in addition to the protection of vitamin E, also allows its controlled delivery, can be performed by different techniques and using different materials, which should be selected according to the delivery system’s final purpose.
The therapeutic properties of vitamin E have caught the attention of the scientific community in the last decades, with several research works being developed. However, there are still several fields to be explored, which will allow the wider use of vitamin E and the development of new functional products.
Actaea racemosa (AR) also known as Cimicifuga racemosa, is a perennial plant from Ranunculaceae family which was used as traditional remedies in treatment of various condition like rheumatoid muscular pain, headache, inflammation and dysmenorrhea. Actaea racemosa was basically native to Canada and the Eastern United State. This chapter proposed the ethnopharmacological uses of Actaea racemosa, and its phytochemical properties. Specifically, in this article we focused on use of Actaea racemose for menopausal and post-menopausal symptoms management. Electronic databases including PubMed and Scopus were searched for studies on Actaea racemose and its administration in management of menopausal symptoms. Chem Office software was also used in order to find chemical structures. The key words used as search terms were Cimicifuga racemose, Actaea racemose, Ranunculaceae, Black cohosh, Menopausal symptoms. We have included all relevant animal and human studies up to the date of publication. The analysis on Actaea racemose showed various indications for different plant’s extracts. Approximately 131 chemical compounds have been isolated and identified from Actaea racemosa. According to recently studies, the most important chemicals known of the Actaea racemosa are phenolic compounds, chromones, triterpenoids, nitrogen-containing constituents. In addition, in vivo and in vitro studies reported wide range of pharmacological activities for Black cohosh like attenuating menopausal symptoms. Mechanism of action for some ethnomedicinal indications were made clear while some of its activities are not confirmed by pharmacological studies yet. Further investigations on its pharmacological properties are necessary to expand its clinical effective use. Also, additional large clinical trials are recommended for clarifying the effect of Black cohosh.
Centella asiatica (CA) or Gotu cola is an herbal plant from the Apiaceae family with a long history of usage in different traditional medicines. It has long been used for the treatment of various ailments such as central nervous system (CNS), skin and gastrointestinal disorders especially in the Southeast Asia. This chapter focused on the phytochemical constituent and pharmacological activities of CA based on preclinical and clinical studies. Additionally, botanical description and distribution, traditional uses, interactions, and safety issues are reviewed. Electronic databases of Google Scholar, Scopus, PubMed, and Web of Science were searched to obtain relevant studies on the pharmacological activities of CA. Approximately, 124 chemical compounds including triterpenoids, polyphenolic compounds, and essential oils have been isolated and identified from CA. Ethnomedicinal applications of CA mostly include treatment of gastrointestinal diseases, wounds, nervous system disorders, circulatory diseases, skin problems, respiratory ailments, diabetes and sleep disorders in various ethnobotanical practices. Pharmacological studies revealed a wide range of beneficial effects of CA on CNS, cardiovascular, lung, liver, kidney, gastrointestinal, skin, and endocrine system. Among them, neuroprotective activity, wound healing and treatment of venous insufficiency, as well as antidiabetic activity seem to be more frequently reported. At the moment, considering various health benefits of CA, it is marketed as an oral supplement as well as a topical ingredient in some cosmetic products. Additional preclinical studies and particularly randomized controlled trials are needed to clarify the therapeutic roles of CA.
Background:
Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date.
Objective:
To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum.
Materials and methods:
Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study.
Results:
Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts.
Conclusion:
The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.
Background
Striae distensae are common dermal lesions that progress through two different stages: the striae rubra, which appears to be erythematous, and striae alba, which is characterized by a hypopigmented feature. The clinical characteristics between striae distensae stages and normal skin remain unknown.
Objectives
We aimed to investigate the clinical characteristics according to stages of striae distensae in terms of their biophysical properties, using objective noninvasive measurements in comparison with adjacent normal skin.
Methods
Sixty‐one healthy female subjects with striae distensae were included as follows: 30 with striae rubra and 31 with striae alba on the abdomen and thighs. Hydration of the epidermis and dermis, skin color brightness, and Erythema index were measured. Skin elasticity, roughness, and dermal echo‐density of the skin with striae distensae and adjacent normal skin were also measured.
Results
Hydration of the epidermis and dermis showed no significant difference between the skin with striae distensae and normal skin. Brightness of skin with striae alba and normal skin was significantly higher than that of skin with striae rubra. Erythema index of skin with striae rubra was significantly higher than that of skin with striae alba and normal skin. Skin with striae rubra and striae alba had a rougher surface than normal skin. Elasticity and dermal echo‐density were significantly lower in striae distensae skin.
Conclusions
Striae rubra and striae alba had similar biophysical properties in terms of skin hydration, elasticity, roughness, and dermal density. Moreover, striae distensae have less elasticity, more roughness, and lower dermal density than normal skin.
Skin manifestations during pregnancy are common and diversified. This review will focus on the most important entities to be recognized by obstetricians. These are, on the one hand, physiological changes, where unnecessary investigations should be avoided, and on the other, the specific dermatoses of pregnancy. These develop electively in pregnancy, and they are currently grouped into three disorders: polymorphic eruption of pregnancy, atopic eczema of pregnancy, and pemphigoid gestationis. Arguments for recognition of these are presented including detection of anti-BP180 antibodies. Follow-up and treatment depend on the precise diagnosis. Risks in fetal prognosis may occur in rare pemphigoid gestationis cases.
Copyright © 2015 Elsevier Ltd. All rights reserved.
Objective
To assess the influence of different factors on the presence of striae prior to pregnancy as well as the development of new lesions during and after pregnancy.
Subjects and methods
An observational epidemiologic study was carried out on the prevalence and incidence of striae gravidarum and stretch marks in pregnant women. Data from 519 pregnant women were registered, including obstetric history, family history of striae gravidarum, weight prior to pregnancy, skin type, Fitzpatrick skin phototype, and current use of body creams and lotions. A multivariate analysis was used to determine the factors associated with the incidence of striae gravidarum during current pregnancy.
Results
The prevalence of pre-pregnancy stretch marks was 85.5%, mainly observed in patients with a first pregnancy (OR = 2.6), body mass index ≥ 25 (OR = 2.2), and family history of striae gravidarum (OR = 2.1). The overall incidence of striae gravidarum during pregnancy was 36.8% and most of these patients had a body mass index ≥ 25 (OR = 2.2) and were younger (< 30 years old; OR = 1.9). Risk analysis of all the variables registered indicated a higher risk of striae gravidarum in women who were overweight prior to pregnancy (OR = 1.8), those aged under 30 years (OR = 2.4), and those with previous pregnancies (OR = 4.3).
Conclusions
Prevention of striae gravidarum should be recommended in all cases, with special emphasis on younger women and those who are overweight or obese due to their higher risk for the development of these marks during pregnancy.
The purpose of this study was to identify risk factors associated with striae gravidarum (SG).
A cross-sectional study of 112 primiparous women delivering at a private teaching hospital was conducted. Participants were assessed during the immediate postpartum period for evidence of SG. Presence and severity of SG were compared to characteristics of women using t tests and Chi-square tests.
Sixty percent of the study participants had developed SG. Women who developed SG were significantly younger (26.5 +/- 4.5 vs 30.5 +/- 4.6; P < .001) and had gained significantly more weight during pregnancy (15.6 +/- 3.9 vs 38.4 kg +/- 2.7; P < .001). Birthweight (BW), gestational age at delivery, and family history of SG were associated with moderate/severe SG.
Maternal age and weight gain during pregnancy are associated with SG. BW, family history of SG, and gestational age at delivery are associated with moderate/severe SG.
Synopsis
A prophylactic antistriae cream ( Centella asiatica extract, α‐tocopherol, and collagen‐elastin hydrolisates) was assessed by a double blind trial in 80 pregnant women.
In the placebo group 22 women (56%) presented striae, whereas in the treated group only 14 women (34%) developed striae in this pregnancy; this difference was significant ( p < 0.05; χ ² test). An arbitrary score was designed to assess the intensity of striae (from 0 to 3); this score was 1.42 ( sd 0.5) in the treated group and 2.13 ( sd 1.32) in the placebo group and this difference was also significant ( p = 0.014; Mann–Whitney test).
In women with a history of striae during puberty, the active cream induced a significant absolute prevention in 89% of the cases whereas in the placebo group all the women developed striae ( p = 0.00014; χ ² test).
The mechanism of action of the total triterpenoid fraction extracted from Centella Asiatica (TTFCA) was evaluated using human skin fibroblasts cultures as the experimental system. In particular its influence on the biosynthesis of collagen, fibronectin and proteoglycans was considered. The presence of TTFCA (25 micrograms/ml) does not seem to affect cell proliferation, total protein synthesis or the biosynthesis of proteoglycans in a significant way. A statistically important increase was observed in the percentage of collagen and, as revealed by immunofluorescence measurements, in cell layer fibronectin. This effect on collagen and fibronectin may help to explain the action of TTFCA in promoting wound healing, and suggests an interesting working hypothesis for its action on basal endothelia.
The study of 15 abdominal striae in women aged 25 to 57 shows important histological modifications in the skin. The collagen is fragmented and the ground substance is abundant. Fibroblasts are globular, quiescent, and lose all signs of fibrillar secretion. In the light of the recent biochemical data, our results suggest that the striae are the consequence of fibroblastic dysfunction, due to abdominal distension. Comparison with scarred and normal skin indicate that striae are a special entity belonging to the group of connective dystrophies.
Risk factors for the development of striae gravidarum
- Osman