Non-ablative fractional 1540-nm Er:glass laser for the treatment of striae gravidarum: a case series.

Background and objectives: Striae gravidarum (SG) is a form of striae distensae for which no single modality reliably and completely corrects the lesions, and high-level evidence remains limited. This study evaluated the clinical outcomes and safety of the 1540-nm non-ablative fractional Er:glass laser (NAFL) for SG and aimed to add real-world data in Chinese (Fitzpatrick III-IV) women. Patients and methods: We retrospectively reviewed the first cohort of consecutive postpartum women with abdominal SG who began 1540-nm NAFL treatment in our department on 31 March 2022. Efficacy was independently graded by three dermatologists who were blinded to treatment details, using a quartile improvement scale (0-3) and the 5-point Global Aesthetic Improvement Scale (GAIS); the three ratings were averaged, and inter-rater agreement was assessed with the intraclass correlation coefficient (ICC). Patient-reported satisfaction (5-point unipolar scale), pain, and adverse events were also recorded. Results: Eight patients were analyzed. The mean quartile improvement score was 1.79 ± 0.78 (corresponding to mild-to-moderate improvement) and the mean GAIS was 2.29 ± 0.88 (between "improved" and "much improved"). Inter-rater agreement was good to excellent (ICC = 0.82 and 0.93, respectively). All patients reported satisfaction with the outcome. Adverse events were limited to tolerable intraprocedural pain, transient erythema, subcutaneous petechiae (1 patient), and post-inflammatory hyperpigmentation (3 patients), all of which resolved. Conclusion: In this small, uncontrolled series, the 1540-nm NAFL appeared to be well tolerated and may provide cosmetic improvement in SG. These preliminary observations require confirmation in larger, controlled studies.