Abstract / Summary
Background and objective. Striae distensae are very common linear dermal scars with a documented impact on quality of life. In their mature phase (striae albae), which is atrophic and hypopigmented, response to medical treatment is limited. We aimed to review the evidence on micropigmentation as chromatic camouflage of mature striae and to propose a referral protocol with a dedicated patient-information layer. Methods. Narrative review (SANRA) of PubMed and Google Scholar up to September 2026, with every reference verified by DOI or PMID. Recommendations without specific evidence are labelled as the authors' proposal. Results. No clinical series measuring outcomes of micropigmentation in striae was identified; specific evidence is limited to technical descriptions. Support comes, by extrapolation, from camouflage of hypopigmented scars, with retrospective series and a systematic review reporting level III–IV evidence. Micropigmentation corrects colour contrast, not atrophy or texture. Skin-tone pigments may darken irreversibly with short-pulse lasers, so energy-based treatments should precede camouflage. An indication matrix, contraindications, a referral algorithm and an extended patient information sheet are proposed. Conclusions. Micropigmentation may be offered as camouflage of stable white striae once medical treatment has reached its limit, with explicit expectations and in authorised healthcare centres. The proposed timing criteria are expert opinion. Preprint, not peer reviewed. Conflict of interest: both authors hold management positions at the Instituto Nacional de Micropigmentación, a centre that performs the procedure described. Spanish version: https://doi.org/10.5281/zenodo.23067923