Is sublative the best for stretch marks vs laser, or are there better treatments? (Photos)

Question

Stretch marks are given rapid growth in teenager and are still red. Please do not show pictures on any public place. Thanks.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

John Laura, DO · Answer

I recommend a combination of fractonal co2 or fractional RF and PRP microneedle for stretch marks for best results.

Davin Lim, MBBS, FACD - Account Suspended · Answer

You have colour in your stretch marks, hence I would start of with vascular lasers, then possibly with RF eMatrix or even RF microneedling after. New stretch marks are easier to treat than older ones. For new stretch marks (red-purple-pink), my treatment of choice is V BEAM vascular laser combined Stratamark. This can reduce stretch mark colour and width by up to 50% or more. With new stretchmarks you have a window by which V BEAM or vascular lasers are effective- take that window- if you miss that window, older stretch marks are much harder to treat, and will require breaching the skin barrier. 
  
 
  
For resistant old stretch marks there is no miracle cure if skin rolling and Stratamark fail. My preferred option for old, white, silvery- papery stretch marks is a combination of CO2 fractional laser, or with INFINI RF and PRP. I also use Fraxel ReStore 1550, and also lasers in the 1440 to 1540 wavelength. Of all the methods I find microneedling with RF energy and PRP the best, as it has the lowest rate of skin colour changes, and the fastest healing time. Results wise, it outperforms CO2 laser! Still not a miracle cure. In some patients with laxity and stretch marks I combine RF using eMatrix and TCA peels followed by daily application of Stratamark. Many combinations are possible depending on the skin type and laxity as well as downtime and budget. 
  
 
  
The truth is that stretch mark treatments are HIGHLY variable, depending on your own immune system, your skin type and the age of the stretch marks. Some get a 30% improvement, others up to 80%. Regardless of the treatment multiple sessions are need – anywhere from 3 to 8 sessions, always use a cream (Stratamark) as the foundation of treatment – much like one would use a sunscreen prior to laser treatments on the face. An assessment is the very first step for high level laser-energy based treatments. Regards,
  
Dr Davin Lim, Laser and aesthetic dermatologist.
  
Brisbane, Australia.

Is sublative the best for stretch marks vs laser, or are there better treatments? (Photos)

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