Various lasers have recently been reported as effective treatment modalities for striae distensae, but pigmentary alterations are a major concern to the darker skin type. The Thermage (Therma Cool TC; Thermage Inc, Hayward, CA) is a radiofrequency device for the lifting of face and neck, and there is no report of using it for striae distensae. The purpose was to evaluate the effectiveness of the Thermage in combination with pulsed dye laser. Thirty-seven patients with abdominal striae distensae were treated with the Thermage and 585-nm pulsed dye laser in the first session at baseline. An additional two sessions of pulsed dye laser were performed at Weeks 4 and 8. Thermage was used at fluences of 53 to 97 J/cm2 and pulsed dye laser at fluences of 3.0 J/cm2 with 10-mm spot. Skin biopsies were taken of nine patients. In the subjective assessment, 89.2% of the patients showed "good and very good" to overall improvement, and 59.4% were graded as "good and very good" in elasticity. All of the nine specimens showed an increase in the amount of collagen fibers, and increased elastic fibers were found in six specimens. The Thermage and pulsed dye laser appear to be an effective treatment for striae distansae.