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Abstract Striae rubrae, a prevalent dermatological disorder, do not pose any substantial medical complications. However, they can bring great distress to those who are affected. They are linear scars on the skin that are accompanied by thinning of the outermost layer of the skin. SD is often a superficial issue, but in cases of significant severity, it can lead to tearing and ulceration in the event of an accident or severe stretching. The precise mechanism behind the development of striae remains unclear; however, it is believed that mechanical, hormonal, and genetic factors may contribute to their formation. These symptoms occur in obese patients and in other clinical situations such as pregnancy, Cushing’s syndrome, and the use of topical corticosteroids. Presently, the treatment alternatives that are accessible are not sufficient. These choices involve the use of topical medicines such tretinoin 0.1% cream and tretinoin 0.05% cream mixed with 20% glycolic acid. The recent combination of microneedling and PRP treatment has shown remarkable improvement in skin lesions, characterized by a substantial rise in collagen and elastic fibers deposition, as well as enhanced proliferative activity in the epidermis of individuals with striae rubrae. However, there is a scarcity of studies that assess the processes responsible for the combined therapeutic effectiveness of microneedling and PRP. The Fractional CO2 laser, although there are fewer preliminary researches, it demonstrates significant potential in rebuilding the skin and thereby improving striae rubrae. Carboxy therapy is a minimally invasive procedure that involves the transcutaneous administration of CO2 to treat striae rubrae. While it has few side effects, it is less effective compared to other procedures. Further studies are needed to determine the optimal usage and achieve the best results. In this study, we conducted a comparison between three methods across three groups. There were twenty participants in each group, and each group completed six sessions. We observed that the combination therapy of dermapen-PRP was highly successful in most os cases. When comparing group (A) and group (B), group (A) showed greater improvement in overall measurements (length, width, and number improvement), skin texture, patient satisfaction, and blinded assessment compared to group (B). The difference in overall improvement was statistically significant, but there was no significant difference in skin texture, patient satisfaction, or blinded assessment. group (A) demonstrated superior outcomes compared to group (C) across all measures, with statistical significance. When comparing group (B) and group (C), there was no significant difference in the overall improvement. However, group (B) demonstrated superior outcomes compared to group (C) in terms of patient satisfaction, physician assessment, and skin texture, with statistically significant findings. Conclusively, our study affirms that microneedling-PRP is a secure, efficient, uncomplicated, cost-effective option that merits recognition. It is imperative to promote more research and clinical trials to tackle this cosmetic issue that affects a significant portion of women globally. |