Stretch or striae marks commonly occur during puberty and pregnancy. Please read the article to know the causes, symptoms, risk factors, and management of this cosmetically concerned disease
Striae are visible linear scars, which form due to overstretching of the skin. It usually occurs due to dermal damage in overstretched skin. Many factors play a role, like hormones (corticosteroids), mechanical stress, and genetic predisposition. It usually develops between the age of 5-50 years.
During puberty, striae appear in areas where there is a rapid increase in size. The most common sites are the axillae, outer aspects of the thighs, and the lumbosacral regions. In boys, thighs, and buttocks, and in girls, the breast is the common site. In women, striae appear more common in the abdomen post-pregnancy.
Early lesions may be raised and irritable, but sooner they become flat, smooth, and livid red or bluish (striae rubra) in color. They are commonly irregularly linear, several centimeters long, and 1 mm to 10 mm wide. Usually, after some years, they fade and become inconspicuous. The lesions may become atrophic, with the skin surface showing a fine, white and wrinkled appearance known as striae alba.
Stretching of the skin causes stretch marks. The severity of the stretch marks is affected by several factors, including,
Degree of stress exerted on the skin.
The level of cortisol hormone (it is produced from the adrenal gland, which weakens the elastic fibers of the skin) also plays a role.
Oral Prednisolone or other corticosteroid therapy.
The usage of anabolic steroids is more common among adolescents now, especially those who are participating in competitive sports and bodybuilding.
All stretch marks do not look alike, and they vary depending on the cause, how long you had them, where it is present on the body, and the type of skin the person has. The common differences include:
Serrated lines or streaks on the abdomen, hips, breasts, buttocks, and other places of the body.
Some lines cover large areas of the body.
The color of the stretch marks with pink, black, blue, red, or purple streaks.
The bright streaks will fade to a lighter color.
Anyone can get stretch marks, but certain factors can increase the likelihood of getting them; they are:
Females are more prone to get stretch marks.
When pregnant, and especially if you are young.
Having a family or personal history of stretch marks.
Increase or lose weight.
When you rapidly grow in adolescence.
Undergoing breast enlargement surgery.
Due to the presence of genetic disorders such as Cushing's syndrome or Marfan syndrome.
Exercising and usage of anabolic steroids.
Before starting treatment, other causes of striae should be ruled out, like stopping the intake of exogenous anabolic steroids if an individual is using it, and Cushing syndrome should be ruled out by doing serum cortisol level.
Most striae that appear during late childhood or adolescence tend to become less prominent with time. The striae associated with oral Prednisolone or other systemic corticosteroid therapy and Cushing syndrome can be larger and more widely distributed over the body.
Striae have no medical consequence, but they are usually distressing to affected persons. Stretch marks tend to regress spontaneously to some degree with time, but with the use of topical treatment, recovery can be made faster.
Local application of Tretinoin (0.025% or 0.05%) once daily for three to six months may help in some patients.
Other options are PRP - platelet-rich plasma with dermaroller, pulse dye laser (585 nm), and 308 nm excimer laser.
Plastic surgeons and skin doctors use lasers or other treatments to fade stretch marks. It helps the skin make more collagen:
Fractional CO2 laser therapy - It helps to smooth out the old, white striae or stretch marks. It has been shown that women's stretch marks are more faded after five sessions when compared to others who used topical creams with Tretinoin and glycolic acid.
Pulsed dye laser therapy - It is a painless procedure with a blast of light used on the new, red stretch marks. The energy from the light calms down the blood vessels under the skin that could cause the marks to fade.
Microdermabrasion - It uses tiny crystals to rub the top layer of the skin. It is said that this treatment helps to fade the new, reddish stretch marks when it is combined with skin peels.
Excimer laser therapy - It exposes striae or stretch marks to the targeted UVB (ultraviolet B) light. It is said that this treatment is completely safe, and treatments for 1 to 4 months can correct the pigment problems from stretch marks.
Chemical peels - It is an acidic solution that burns and peels off the top layers of the skin to remove the damaged and dead skin cells, thus boosting the new skin growth. This treatment only improves the stretch marks but will not completely get rid of them.
Tummy tuck cosmetic surgery - When this surgery is done, it also removes the skin with stretch marks. But this surgery could leave scars, and they are often costly and painful.
Ultrasound - It works like radiofrequency treatments. Ultrasound sends sound waves deep into the skin to jumpstart collagen production.
Radiofrequency - Ituses radio wave energy to make collagen by triggering the body with heat. It is said that this treatment is safe and helps to improve stretch marks, but scientists are still under research.
Home Remedies for Stretch Marks:
Creams, oils, and other skin ointments help to prevent and treat them. And some of the home remedies help to fade or hide stretch marks. They are,
Body makeup and self-tanner helps to hide stretch marks.
Cocoa butter, olive oil, shea butter, vitamin E oil, and other moisturizers make the skin feel softer, but it is still unclear if they help prevent stretch marks.
On massaging bitter almond oil into the skin on the bellies during pregnancy, stretch marks are faded.
Stretch marks can be prevented, but there is no guarantee that it gets prevented. The best way to lower the chances of avoiding stretch marks is to stay at a healthy weight. Even during pregnancy, consult the doctor about a regular exercise plan and having a healthy diet. Centella and hyaluronic acid ingredients help to prevent stretch marks.
Stretch marks form due to rapid stretching of the skin beyond its limit of elasticity in conditions like rapid weight gain, pregnancy, puberty, Cushing’s syndrome, etc., followed by subsequent weight loss.
Itchy stretch marks result from the healing of the tiny tears in the skin’s layer that had formed due to excessive stretching and is a normal healing response.
Stretch marks can appear in any person. Whether slim or fat, rapid weight gain and subsequent weight loss over a short period can result in stretch mark formation.
Though lack of nutrients directly does not increase the risk of stretch mark formation, lack of proteins, zinc, and vitamins essential for skin like vitamin C, E, and D can lead to poor skin health.
Stretch marks do not go away completely. With time they fade away with improved appearance.
Stretch marks are scar tissues. Exercise cannot help remove or fade scar tissues.
Stretch marks appear deep red or pink to purple in the initial phases. With time they fade and become pale, appearing silvery or whitish.
Maintaining a healthy body weight during pregnancy may (not in all cases) minimize stretch mark formation.
Stretch marks cannot be cured completely. However, they fade away with time without any treatment. Some available treatment options to improve the appearance of stretch marks are,
- Tretinoin cream.
- Fractional photothermolysis.
- Pulsed dye laser therapy.
- Chemical peels.
- Ultrasound therapy.
Though these cannot completely remove stretch marks, Tretinoin cream and Silicone gel are found effective in improving stretch mark’s appearance.
Laser skin resurfacing therapy, chemical peels, Glycolic acid, Silicone creams, and microdermabrasion help lighten the stretch marks.
Last reviewed at:
23 May 2022 - 4 min read
Query: Hello doctor, I have stretch marks on my inner thighs and buttocks area. When I sit for about 30 minutes, the stretch marks hurt (in the scale of 1-10, the pain is around 8). So, I have to stand up once in a while. More and more stretch marks appear when they hurt and they hurt too. It is very unco... Read Full »
Query: Hi doctor, I am a 28 year old male. I weigh 91 kg and my height is 5'10". Currently, I am on no medication. I have stretch marks almost all over my body and have been having this for the last 6-7 years. The stretch marks are present on my stomach, shoulder blades, forearm intersection, lower back... Read Full »
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