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Stretch Marks


 Stretch marks are known medically as striae distensae. They can affect anyone who has had a growth spurt during the teenage years, a rapid weight gain or loss, and with pregnancy. When they occur with pregnancy, they are also called striae gravidarum.

Signs And Symptoms

Stretch marks are visible on the surface of the skin as thin, red, parallel lines, however they are the result of tearing the dermal fibers as well as loss of elastic fiber and collagen from the dermal layer. The dermal layer is the middle or second layer of the skin. They occur when the skin is stretched quickly, as with rapid weight gain. The stretched skin becomes thin and silvery. The marks can resemble scars. Stretch marks have no symptoms other than the appearance of the marks themselves.

Causes And Risk Factors

The exact cause of stretch marks is unknown, however, they are thought to have a genetic component. Individuals with a strong family tendency to form stretch marks are more likely to form stretch marks. They most often appear when there are increased levels of hormones creating changes throughout the body. It is thought that as many as 90 percent of women will form stretch marks at some time in their lives. Men, can also form stretch marks. They often occur in males, during an adolescent and teen period of rapid growth in height and weight. Rapid increases in muscle mass, such as those seen with weight-lifting and body-building, are frequently associated with the formation of striae in males.

Prenatal distension of the abdominal wall itself isn’t entirely the reason that stretch marks occur during pregnancy. The hormonal changes that occur with pregnancy have a significant role in the formation of striae gravidarum. As the hormones shift and change during pregnancy, they interact with the skin – the result is stretch marks. It is common for pregnant women to have the striae form on the breasts, buttocks and thighs, as well as the abdomen. Because stretch marks are primarily caused by hormonal changes in the body, it can be difficult to prevent them.

Treatment

 Stretch Mark Cream

The best time to treat stretch marks is early and often, before they have time to fade into a more permanent state, according to Dr. Eric Berstein, Clinical Associate Professor at the University of Pennsylvania. Stretch marks usually start out as red lines, but may start out pink, reddish-brown, brown, or dark brown, depending on skin tone when they appear. Over time the marks will slowly fade to a silvery color, and be less noticeable.

CAUTION: Consult your physician before starting any treatments, especially during pregnancy. Potential risks and benefits of any treatment in any individual should be assessed before starting any treatment.  No topical treatments available over the counter are effective for the treatment of stretch marks.

Treatment methods include:

Corticosteroid creams: These may help to minimize the appearance and formation of stretch marks. Stretch marks start with inflammation in the skin, and corticosteroid creams help reduce inflammation.

Alpha-hydroxy acid-containing creams: These help in remodeling the skin’s collagen, improving the overall appearance.

Retinoid creams: They aren’t just for acne anymore. These improve the overall appearance of the skin by remodeling the skin’s collagen. They can reduce the appearance of stretch marks that are less than a few months old and are still pink or red. In one study, by Advances in Therapy, new moms who applied tretinoin cream 0.1 every day for three months shortened their abdominal stretch marks by 20 percent.

Vascular laser: A vascular laser is the most effective treatment method for red and purple stretch marks. They promote the growth of healthy, new collagen. Laser treatment may also reduce the inflammation, preventing further damage to the skin and halting the formation of new stretch marks. The laser targets swollen and inflamed blood vessels.

Fractionated laser: This type of laser may be the best choice for older, silvery or white stretch marks. It triggers the growth of new collagen and healthy tissue by targeting the skin surrounding the stretch marks, making the skin smoother and the stretch marks less noticeable.

Intense Pulsed Light Laser (IPL): This type of laser improves the appearance of pink or red stretch marks by reducing the color changes, and is effective on older marks. It does not improve textural variations in the skin.

Microdermabrasion/chemical peels: These treatments remove the top layer of dead skin cells. They can improve the texture and tone of your skin after multiple treatments. These options don’t penetrate deep enough to reach the dermal layer where the stretch marks have formed.

Surgery: With a tummy tuck or breast reduction, stretch marks may be removed along with the tissue. These surgeries are costly and carry the risks of major surgery and anesthesia. They should not be performed just for removal of stretch marks.

There are countless creams available over the counter that promise to eliminate or minimize stretch marks. There is little evidence that they are effective. A 2008 study published in the British Journal of Obstetrics and Gynecology found that cocoa butter is no more effective than a placebo. Other studies with other creams show similar results.

Home Remedies: The remedies described here have not been shown to be of benefit in research studies, and safety has not been established. Mentioning them here is not an endorsement.

  • Apply a mixture of coconut and vitamin E oils. They contain antioxidants and fatty acids.
  • Eat foods rich in vitamin E and zinc, both of which are important to healthy skin cells. Do not take large doses of vitamin E and zinc supplements; too much is dangerous. Discuss it with your doctor before using any supplements of any kind.
  • Make a scrub of ½ teaspoon salt, 1 tsp. honey, and I tsp. glycerin, gently massage into the stretch marks, then rinse off.

Coconut Oil

Your Questions Answered

  1. My mother has bad stretch marks and now I do, too, but my sister didn’t get them. Why?
    Stretch marks do run in families, but not everyone will be affected the same way.
  2. Do men get stretch marks? 
    Men can get stretch marks, especially with rapid weight gain and body-building.
  3. Will bleach fade stretch marks?
    No, and harsh chemicals should not be applied to skin.
  4. Will stretch marks get worse with another pregnancy? 
    It is possible to form new stretch marks.
  5. Are there oral medications to get rid of stretch marks?
    No.

Article Written By Sheila M. Krishna M.D., FAAD

Dr. Krishna is a board certified dermatologist. She received her undergraduate degree at the Massachusetts Institute of Technology, where she double majored in biology and foreign languages and graduated with Phi Beta Kappa honors. She is fluent in both English and Spanish. Dr. Krishna received her medical degree at the David Geffen School of Medicine at the University of California, Los Angeles, where she was a member of the Alpha Omega Alpha Medical Honor Society. She completed her dermatology residency at the Virginia Commonwealth University in Richmond, Virginia, and she served as Chief Resident in the Department of Dermatology. She completed an additional research year at UCLA with Dr. Lloyd Miller, where she gained expertise in research methods and protocol design and execution. Dr. Krishna is a Fellow of both the American Academy of Dermatology (AAD) and the American Society for Mohs Surgery (ASMS). Dr. Krishna practices in San Diego, California where she treats adults and children for skin conditions. Dr. Krishna was selected as a Top Doctor by her peers in San Diego in 2017. Website - https://www.sheilakrishnamd.com/

Article Reviewed By Natalia Kerr, Licensed Esthetician/Facial Specialist

Natalia Kerr is a licensed esthetician/facial specialist. She graduated from Orange Technical College in 2019 with her diploma in Facial Specialty. She is passionate about skincare and skin health, and has continued her education since graduation by attending various seminars, trainings, and trade shows. She struggled with acne for many years throughout her middle and high school years, and knows the damage to self-confidence that comes with it. This inspired her journey into the world of skincare, and she currently owns and practices at Skin by Natalia in Orlando, Florida. Website - https://skin-by-natalia.square.site/

More Information For The Public

Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/stretch-marks/basics/symptoms/con-20032624
 
American Academy of Family Physicians: http://www.aafp.org/afp/2003/0915/p1165.html

References

  1. US Dept. of Health and Human Services, Office of Women’s Health: http://www.womenshealth.gov/pregnancy/you-are-pregnant/body-changes-discomforts.html
  2. Al-Himdani,S. et al. Striae distensae, a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol 2014 March;170(3):527-47
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