ABSTRACT
Therapy Once SG have formed, there are treatment options. Topical tretinoin 0.1% cream has been shown to reduce the appearance of SG/SD when used on early lesions (striae rubra) (6). It is important to note that once striae have become white and atrophic, topical tretinoin was shown to have no benefit in a double-blind, placebo-controlled study (7). Topical tretinoin (Retin A) works by binding to cytoplasmic proteins and nuclear receptors of keratinocytes and altering downstream gene transcription. The end biologic effect is to regulate the growth and differentiation of keratinocytes (8). In addition to regulating keratinocyte proliferation, topical retinoids have been shown to decrease fine wrinkling, increase dermal collagen, and repair elastin fiber formation (9). Improvement in the appearance of SD/SG is most likely the result of this particular biologic effect. Tretinoin is pregnancy category C. Its use is contraindicated during breast-feeding, which makes it difficult to use during the early stages of SG. The side effects of tretinoin therapy are erythema, desquamation, and photosensitivity limited to the application site.
