Stretch marks (striae) are asymptomatic, harmless skin lesions. They affect about 90% of adults, with 50% acquiring them during pregnancy. Several treatment options can improve the appearance of stretch marks, but none will remove them entirely. Most fade on their own with time and patience. Rarely, stretch marks can herald internal medical problems that require additional testing.
Stretch marks are harmless skin lesions that commonly affect the buttocks, abdomen, and breasts.
Rapid weight gain that breaks the collagen fibers in the skin, inherited defects in collagen production, and excess cortisol levels that break down collagen cause them.
Women are more prone to stretch marks, but risk factors include family history, high BMI during pregnancy, and delivering large babies.
Though most over-the-counter treatments are largely ineffective, camouflage creams, self-tanner, and hyaluronic acid offer some benefits.
Professional treatments, such as laser, micro-needling, microdermabrasion, chemical peels, surgery, radiofrequency, and ultrasound, can help fade stretch marks.
What are stretch marks?
Stretch marks are depressed linear areas of the skin that most often develop on the buttocks, abdomen, breasts, and hips. Most cases are asymptomatic, but some patients may experience soreness or itchiness. Initially, stretch marks may appear as red, purple, or pink raised linear areas that fade, flatten, and depress over time.
What causes stretch marks?
Rapid stretching of the skin followed by sudden weight loss causes stretch marks. This rapid stretching breaks the collagen fibers in the skin's dermis. Common causes include:
- Rapid weight gain
- Breast implants
Certain medications and medical conditions predispose patients to stretch marks. For example, patients with inherited conditions, such as Ehlers-Danlos syndrome and Marfan syndrome, develop stretch marks because of a defect in collagen. In addition, using steroid medications (creams, pills, or injections) and Cushing's syndrome leads to excess cortisol, which causes collagen breakdown.
What are the risk factors for developing stretch marks?
Certain risk factors can predispose a patient to develop stretch marks. However, simply having these risk factors does not guarantee that someone will get them. Risk factors include:
- Family history of stretch marks
- High BMI before pregnancy
- Delivering large babies
How are stretch marks diagnosed?
Dermatologists can diagnose stretch marks with a physical exam. In addition, doctors may ask about eating habits and diet, family history, medications, and medical conditions. If the doctor suspects internal causes for the stretch marks, further testing may be required.
What treatments are available for stretch marks?
No miracle treatment completely removes stretch marks, but many can help improve their appearance. Often, they fade over time without treatment. For those who don’t want to wait it out, seeking treatment from a board-certified dermatologist or plastic surgeon is an option.
Prescription topical retinoids, like Retin A or Tazorac, stimulate collagen production to help improve the appearance of stretch marks with consistent use. However, many may find retinoid creams irritating. Furthermore, retinoids should be avoided during pregnancy or while breastfeeding.
Many minimally invasive procedures help fade stretch marks:
Lasers help by fading the color from pinkish-red to white (pulsed dye laser), repigmenting the white areas (excimer laser), and stimulating collagen production to fade them (fractional CO2 laser).
Microneedling utilizes a device containing numerous tiny needles to puncture the skin repeatedly and stimulate collagen production, which fades stretch marks.
Microdermabrasion and chemical peels remove the top layer of skin to help fade new stretch marks.
Some people may opt for a tummy tuck, a surgical procedure that removes the excess abdominal skin with stretch marks.
Radiofrequency and ultrasound both stimulate collagen production to fade stretch marks. However, each treatment method will require multiple sessions and patience — it takes time to improve them.
Are OTC remedies helpful?
Many over-the-counter treatments have been touted as a cure for stretch marks. These treatments include cocoa butter, vitamin E, shea butter, and olive oil. However, there is a lack of good data to support these claims.
There are a few topicals that can help stretch marks. For example, camouflage creams and self-tanners can cover stretch marks to make them less noticeable. When applied daily to new stretch marks, hyaluronic acid may also help.
Are stretch marks preventable?
In some instances, people can prevent stretch marks. A healthy diet and regular exercise are a good start. These habits help one maintain an ideal BMI and prevent rapid weight loss and gain that results in stretch marks. Avoiding yo-yo, fad, or crash diets that cause rapid weight loss is a good preventative measure.
Most people have stretch marks. They are benign conditions that do not require treatment. However, if they make you self-conscious, you should seek treatment from a board-certified dermatologist or plastic surgeon. Your doctor will help you decide the best treatment options for your particular case.