Both PRP and carboxytherapy are relatively effective and their efficacy is comparable in treatment of POH. Carboxtherapy is simple and slightly more effective modality and well tolerated than PRP. We believe that both modalities are promising but not the ideal solutions of the POH problem which is caused by multifactorial etiology.

Needling therapy is an easy, safe, and economic method and considered as a suitable modality in management of striae.

Striae distensae (SD) are disfiguring skin condition causing cosmetic troubles and psychological distress. The aim was to compare the efficacy and safety of platelet‐rich plasma (PRP) versus its combination with subcision or medium‐depth peeling (glycolic acid 70% followed by trichloroacetic acid [TCA] 35%) for SD treatment. Seventy‐five female patients with SD were divided into three equal groups with the contralateral side in each patients represented the control group. Group A treated with PRP, group B received PRP + subcision while group C received PRP + combined peeling (GA 70% + TCA 35%). Primary outcome included clinical improvement, patients' satisfaction, and Dermatology Life Quality Index (DLQI). Striae measurement, skin biopsies were also assessed. Very much improvement was achieved in 28%, 44%, and 36% in groups A, B, and C respectively. The combined groups (B and C) showed significantly higher patients' satisfaction and DLQI than group A (p = 0.03), (p < 0.0001). A significant decrease in all striae measurements was achieved with all groups (p < 0.001); however, groups B and C showed more decrease (p = 0.2 and 0.4). A highly significant decrease in the mean number of sessions was found in group B (p < 0.0001). All groups demonstrated improvement in dermal collagen deposition, which was higher in the combined groups. Side effects were mild and well tolerated. The combination of PRP with subcision or peeling was more effective and offered a higher therapeutic response than PRP alone. Moreover, the subcision has superior efficacy in striae albae and safer in darker skin types.

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