Background. Over time, the striae rubra develop into striae alba that appear white, flat, and depressed. It is very important to determine the optimum striae management. In order to evaluate the effectiveness of these therapies, objective measurement tools are necessary. Objective. The aim of this study is to evaluate if ultrasonography and PRIMOS can be used to obtain an objective assessment of stretch marks type and stage; furthermore, we aim to apply these techniques to evaluate the efficacy of a topical treatment. Methods. 20 volunteers were enrolled with a two-month study. A marketed cosmetic product was used as the active over one body area. The controlateral area with stretch marks was treated with a “placebo” formulation without active, as a control. The instrumental evaluation was carried out at the beginning of the trial (baseline values or ), after 1 month ( ), and at the end of the study ( ). Results. PRIMOS was able to measure and document striae distensae maturation; furthermore, ultrasound imaging permitted to visualize and diagnose the striae. Statistical analysis of skin roughness demonstrated a statistically significant reduction of Rp value only in a treated group. In fact, the Rp value represented a maximum peak height in the area selected. These results demonstrated that after two months of treatment only the striae rubra can be treated successfully. Conclusions. This work demonstrated that the 22MHz ultrasound can diagnose stretch marks; PRIMOS device can detect and measure striae distensae type and maturation. Furthermore, the high-frequency ultrasound and the 3D image device, described in this work, can be successfully employed in order to evaluate the efficacy of a topical treatment. 1. Introduction Striae Distensae or stretch marks (SDs) are a well-recognized, common skin condition that rarely causes some significant medical problems but is often a significant source of distress for those affected [1]. SDs arise from progressive or rapid stretching of the dermis (1) and appear along cleavage lines perpendicular to the direction of greatest tension in areas with the most adipose tissue [2, 3]. The classic anatomical sites affected include the abdomen and breasts for pregnancy-related striae, the outer thighs or lumbosacral regions in adolescent boys, and the buttocks, thighs, upper arms, and breasts in adolescent girls [2, 4]. Causes of SD are not clear, and a number of theories have been proposed. Many authors had shown that mechanical effect of stretching is the main cause, leading to the rupture of the connective tissue
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