NEW TOPICAL SILICONE FORMULATION FOR TREATING STRIAE DISTENSAE 85 (4,26–28). The initial infl ammatory, pruritic plaques evolve into stable, atrophic hypopig- mented streaks that can be considered fi nal scar tissue following the prior infl ammatory changes. Anti-infl ammatory and pro-infl ammatory growth factors play a role in the tran- sition of SD, and many believe that a disruption of the TGF-β growth factor messenger Figure 6. Three-dimensional pho t ographic comparison of abdominal SD before and after 1-mo treatment with the topical product on one side (A) and no treatment on the other side (B). There is signifi cant improve- ment in the overall appearance of SD on the side treated with the topical product (C). By contrast, the side left untreated (D) does not show improvement. Figure 7. Three-dimensional photo graphic comparison of thigh SD before and after 1-mo treatment with the topical product on one side (A) and no treatment on the other side (B). There is moderate improvement in the overall appearance of SD on the side treated with the topical product (C). By contrast, the side left untreated (D) does not show improvement.

JOURNAL OF COSMETIC SCIENCE 86 pathway may be involved in striae formation (15,29). Decreased expression of collagen and fi bronectin genes has also been associated with striae (30). Vi tamin C has also been shown to work well on stretch marks in prior literature (14,20). Vitamin C is an antioxidant used extensively in topical cosmeceuticals and moisturizers to prevent UV damage and improve skin quality (31). There is very strong evidence from an immunohistochemistry level that vitamin C is a potent stimulator of collagen and elastin production in the treatment of stretch marks (20). Vitamin C also stimulates col- lagen synthesis, which promotes wound healing. In scar treatments, topical application of vitamin C, in combination with silicone or HA, has also been shown to improve scar appearance (23,32,33). HA has been shown to improve SD in prior literature (17). It is also implicated in fetal scarless healing. In fetal wounds, there is a prolonged elevation of high–molecular weight HA, whereas in adult wounds, there is transient elevation of low–molecular weight HA. Furthermore, HA receptor expression is elevated 2- to 4-fold in fetal fi broblasts, suggest- ing HA helps facilitate rapid fi broblast migration, which can help in improving SD as it does with scars (34). Al oe vera has also been shown to improve SD (12,16). It has a long history of use in traditional medicine as a “healing plant” (35). Animal and clinical studies have shown that treat- ment with whole aloe vera gel or extracts leads to accelerated wound healing (35–37). Figure 8. Three-dimensional photo g raphic comparison of buttock SD before and after 1-mo treatment with the topical product on one side (A) and no treatment on the other side (B). There is mild improvement in the overall appearance of SD on the side treated with the topical product (C). By contrast, the side left untreated (D) does not show improvement.