Comparison of the Efficacy of Nanofat Grafting With Microneedling in the Treatment of Striae Distensae: A Pilot, Randomized, Controlled, Investigator‐Blind Clinical Trial

Background

Striae distensae (SD) are a common cosmetic concern for many patients. So far, there is no definitive and markedly effective treatment for SD. Considering the histological similarities of SD and scars, and the effectiveness of nanofat in scar treatment, nanofat could be a potential treatment of SD.

Objectives

To assess the effect of nanofat in the treatment of SD.

Methods

In this randomized, investigator‐blinded, intrapatient split‐body clinical trial, patients with bilateral SD received a single session of nanofat grafting on one side of the body and three monthly sessions of microneedling on the contralateral side. Participants were evaluated at baseline and at months 1, 2, and 5 after the initial treatment session for Global Aesthetic Improvement Scale (GAIS), texture improvement, striae width, patient satisfaction, pain severity, and adverse events.

Results

Twenty patients completed the study. Both nanofat and microneedling gradually improved the aesthetic appearance of the striae lesions over treatment sessions ( p < 0.001). At follow‐up, more nanofat‐treated lesions were rated as “very much improved” than microneedling‐treated lesions, although the between‐group difference was not statistically significant ( p = 0.242). The texture of striae gradually improved by both treatment regimens ( p < 0.001); nevertheless, the effects of treatments were not statistically different ( p = 0.39). Also, treatments gradually improved striae width during treatment sessions ( p < 0.001), but the effectiveness of treatments was not significantly different ( p = 0.16). Post‐inflammatory hyperpigmentation (PIH) developed in 40% of microneedling‐treated patients, but none of the nanofat‐treated striae cases (0%) developed PIH ( p = 0.003). Patient satisfaction was not significantly different between groups ( p = 0.77).

Conclusion

In this pilot study, nanofat grafting and microneedling produced comparable improvement in SD, with no significant differences in the main efficacy outcomes. The lower PIH incidence with nanofat should be interpreted cautiously. Larger adequately powered trials are needed to confirm these preliminary findings.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20140212016557N10