Microneedling with autologous platelet rich fibrin versus microneedling with autologous platelet rich plasma in treatment of abdominal stretch marks: a randomized comparative study.

Striae distensae (SD), commonly known as stretch marks, are a common dermatological condition with challenging therapeutic interventions and varying outcomes. The current study aims to compare the clinical response, efficacy, side effects, and safety of microneedling (MN) with autologous platelet-rich fibrin (PRF) versus MN with autologous platelet-rich plasma (PRP) in treating abdominal stretch marks. Thirty patients (27 females and 3 males) with bilateral abdominal SD were underwent both MN with PRP and MN with PRF in a randomized split-abdomen design, with session performed every month for a total of three sessions. Clinical efficacy was assessed by two independent dermatologists using the Davey score, the Global Aesthetic Improvement Scale (GAIS), measurement of the width of widest striae, and patient satisfaction score. Blinded evaluation was conducted by comparing pre- and post-treatment photographs. 3-mm punch biopsy specimens were taken from the same lesion sites pre-treatment and one month after the last session and were stained by hematoxylin and eosin (H&E) to subjectively assess histopathological changes and treatment efficacy. Both treatment modalities induced significant clinical improvement with PRF sides demonstrating superior results. However, when comparing both methods, no statistically significant difference was observed between them regarding Davey score, width of the widest striae, GAIS, and patient satisfaction. In conclusion: The combination of MN with PRF appears to be a promising therapeutic modality with better patient satisfaction compared to MN with PRP in the treatment of SD. Moreover, PRF is inexpensive, simple to produce and is made naturally without the need of biochemical additives.