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Evaluation of the severity of striae distensae using the new scoring system

  • Alviera Yuliandra Amal ,
  • Imam Budi Putra ,
  • Nelva Karmila Jusuf ,
  • Khairina Nasution ,


Background: Striae distensae (SD) is a harmless skin disorder that can cause cosmetic and psychological problems. Until now, no easy-to-use, useful and non-invasive method can be used to determine the severity of SD. The scoring system can be used as a guide for selecting and administering effective therapy for striae distensae. This study aimed to assess the severity of striae distensae using INA score.

Methods: This research was a descriptive observational study with a cross-sectional approach involving 72 female health workers at the Universitas Sumatera Utara Hospital. The diagnosis of stretch marks is made through history and physical examination. We did the whole body examination for scoring of striae distensae. This research has been approved by the Research Ethics Commission of the Universitas Sumatera Utara.

Results: A new scoring system, namely the INA score, to assess the severity of striae distensae at the mammae, axilla, abdomen, femoral, gluteus, and popliteal locations. The assessment of the INA score based on the entire region of the study subjects was obtained at a mild degree (54.2%). The characteristics of majority of the subjects were in the age range of 18-25 years (93.1%) and had a family history of striae distensae (54.2%). The distribution of the majority of striae distensae locations is in the femoral and gluteus region (47.2%). Based on each region, the majority of the subjects had striae distensae with severe degree in the mammae (20.8%), abdomen (8.3%), femoral (90.3%), gluteus (94.4%), and popliteal (22.2%);. In comparison, the axilla was dominant with a moderate degree (5.5%).

Conclusion: The new scoring system named INA score assesses the severity of striae distensae at the mammary, axillary, abdominal, femur, gluteus and popliteal locations.


  1. Bertin C, Lopes-DaCunha A, Nkengne A, Roure R, Stamatas GN. Striae distensae are characterized by distinct microstructural features as measured by non-invasive methodsin vivo. Ski Res Technol. 2013;20(1):81–6. Available from:
  2. Youssef SES, El-Khateeb EA, Aly DG, Moussa MH. Striae distensae: Immunohistochemical assessment of hormone receptors in multigravida and nulligravida. J Cosmet Dermatol. 2017;16(2):279–86. Available from:
  3. Keen MA. Striae distensae: what’s new at the horizon? Br J Med Pract. 2016;9(3).
  4. Sipahutar SA, Jusuf NK, Putra IB. The association between waist-hip ratio index and Striae distensae. Bali Med J. 2021;10(3):1111–4.
  5. Aryunisari CG, Putra IB, Jusuf NK. The relationship between age of menarche with striae among female students. Bali Med J. 2020;9(1):400. Available from:
  6. Ross NA, Ho D, Fisher J, Mamalis A, Heilman E, Saedi N, et al. Striae Distensae: Preventative and Therapeutic Modalities to Improve Aesthetic Appearance. Dermatologic Surg. 2017;43(5):635–48. Available from:
  7. Kasielska‐Trojan A, Antoszewski B. Do body build and composition influence striae distensae occurrence and visibility in women? J Cosmet Dermatol. 2017;17(6):1165–9. Available from:
  8. Atef A, Moustafa R. Expression of Estrogen Receptor Beta in Striae Distensae of Different Sites of the Body. J Clin & Exp Dermatology Res. 2015;06(06). Available from:
  9. Elbuluk N, Kang S, Hamilton T. Differences in clinical features and risk factors for striae distensae in African American and white women. J Am Acad Dermatol. 2009;60(3):AB56. Available from:
  10. Lakhani DR, Prakash DC, Tiwari DS, Purohit DS, Paliwal DV, Mathur DDK, et al. Scoring System in Dermatology: A Review. IOSR J Dent Med Sci. 2016;15(07):89–99. Available from:
  11. Atwal GSS, Manku LK, Griffiths CEM, Polson DW. Striae gravidarum in primiparae. Br J Dermatol. 2006;155(5):965–9. Available from:
  12. Davey CMH. Factors Associated with the Occurence of Striae Gravidarum. BJOG An Int J Obstet Gynaecol. 1972;79(12):1113–4. Available from:
  13. Wollina U, Goldman A. Management of stretch marks (with a focus on striae rubrae). J Cutan Aesthet Surg. 2017;10(3):124–9. Available from:
  14. Putra IB, Jusuf NK, Amal AY. A pilot study of new scoring system severity of striae distensae. Bali Med J. 2022;11(3):1915–8. Available from:
  15. Hague A, Bayat A. Therapeutic targets in the management of striae distensae: A systematic review. J Am Acad Dermatol. 2017;77(3):559-568.e18. Available from:
  16. Putra IB, Jusuf NK, Aryunisari CG. Correlation between body mass index with striae in female adolescent. Bali Med J. 2020;9(3):773. Available from:
  17. Ellysa T, Jusuf N. Analisis faktor risiko terjadinya stretch mark. Fakultas Kedokteran Universitas Sumatera Utara; 2021.
  18. Tung JY, Kiefer AK, Mullins M, Francke U, Eriksson N. Genome-Wide Association Analysis Implicates Elastic Microfibrils in the Development of Nonsyndromic Striae Distensae. J Invest Dermatol. 2013;133(11):2628–31. Available from:
  19. Tengku NN, Jusuf NK. Tingkat Pengetahuan dan Sikap Mahasiswa Mahasiswi Angkatan 2017 terhadap Stretch Marks di Fakultas Kedokteran Universitas Sumatera Utara. Scr SCORE Sci Med J. 2022;3(2):125–31. Available from:

How to Cite

Amal, A. Y., Putra, I. B. ., Jusuf, N. K. ., & Nasution, K. . (2023). Evaluation of the severity of striae distensae using the new scoring system. Bali Medical Journal, 12(2), 1287–1290.




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Alviera Yuliandra Amal
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Imam Budi Putra
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Nelva Karmila Jusuf
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Khairina Nasution
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