Striae distensae (SD) are disfiguring skin condition causing cosmetic troubles and psychological distress. 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 3 equal groups with contralateral side in each patients
is the control. Group A treated with PRP, group B received PRP + subcision while group C received PRP + combined peeling (GA70% + TCA35%). Primary outcome included clinical improvement, patients' satisfaction and Dermatology Life Quality Index (DLQI). Striae measurement, skin biopsies are also assessed. Very much improvement was achieved in 28%, 44%, 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 and0.4). 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 is more effective and gives a higher therapeutic response than PRP alone. Moreover, the subcision has superior efficacy in striae albae and safer in darker skin types. This article is protected by copyright. All rights reserved.