Stretch Marks

Home remedies and doctor-prescribed treatments may help diminish the appearance of stretch marks.

Stretch marks, medically known as striae distensae, are an extremely common finding in both men and women who are past puberty. They appear as linear, thinned skin most often found on the breasts, abdomen, hips, and thighs.

• Collagen is a protein underneath your skin that makes it more elastic and supports your skin. Your skin tries to heal any abrupt change or tear in your skin collagen, and in that process, stretch marks may appear on your skin.
• Stretch marks may appear due to the rapid hormonal changes and growth associated with puberty, during pregnancy, or with medical diseases, such as Cushing syndrome.
• Under the microscope, they appear similar to scar tissue.
• No curative treatment has been developed; however, moisturizers, massage, microdermabrasion, and laser resurfacing may improve their appearance.
• The best way to prevent stretch marks is to maintain a healthy weight

Stretch marks may occur during various phases of life, may be related to increased cortisol (a hormone produced by the adrenal glands) secretion or be associated with increased body mass. The most common cause of stretch marks is pregnancy, and pregnancy-associated stretch marks are medically known as striae gravidarum. It is thought that the rapid growth of the baby may play a role in their development, but not all pregnancies produce stretch marks. A relationship between pregnancy, obesity, and increased stretch marks has been reported. In obesity, it is thought that the stretching of the skin with weight gain causes the scars, but stretch marks have also been observed in people who experience a rapid increase in muscle mass with weight lifting. Taking some medications, such as corticosteroids like prednisone, may also produce stretch marks.

Stretch marks do not generally produce any symptoms but have a characteristic visual appearance no matter when they appear or what the cause is.

• They initially appear as raised pink to purple lines longitudinally arranged over the abdomen, lateral upper thighs, inner arms, or upper breasts. With time, the purplish-pink color lightens and they appear as silvery lines on the skin, similar to a scar.
• The purplish-pink scars are termed striae rubra, while the silvery lines are termed striae albae.
• Stretch marks can also occur in dark-complected people where they appear as dark-brown lines, which are termed striae nigrae.
• In short, stretch marks are scars that are permanent once formed.
• Slightly raised stretch marks can be itchy, especially early new marks

It is not necessary to seek medical care for stretch marks when they occur around puberty or pregnancy. The development of stretch marks is normal at these times. However, if stretch marks occur spontaneously without any relationship to life events, they may indicate the onset of another disease state, such as Cushing's disease. In this case, it would be worthwhile to consult a physician who may recommend an assessment by an endocrinologist.

The treatment for stretch marks is limited, and there is no curative treatment. The most invasive therapies for stretch marks involve physician-administered laser surgery. Improvement in stretch marks with laser therapy is accomplished by wounding the scarred skin and hoping that the newly healed skin will have a more normal, cosmetically acceptable appearance. Medical reports of Nd: YAG laser, radiofrequency devices, and fractional photothermolysis have shown some degree of improvement in stretch mark appearance but not resolution.

The earlier the stretch mark is treated, generally the better the result. Red immature stretch marks are more amenable to treatment than those that have matured to a silvery white. This is because the reddish stretch marks are still healing, and the healing can be modified by intervention. Sometimes, camouflage (the use of cosmetics) is the best option to hide the scars.

A spa treatment for stretch marks is the use of microdermabrasion. Microdermabrasion uses a spray head to bombard the skin with tiny salt crystals, baking soda, or aluminum particles to literally sand the skin, a process medically known as exfoliation. While microdermabrasion can temporarily smooth any rough skin around the stretch mark, it cannot remove the stretch mark or make the scar permanently smooth.

A variety of products can be purchased over the counter for improving the appearance of stretch marks.

• There are anecdotal stories of cocoa butter, emu oil, vitamin E, and other oils aiding in the prevention and treatment of stretch marks.
• Another option is an over-the-counter moisturizing cream for stretch marks containing onion extract with hyarolunic acid and centella asiatica, which is in development.
• The most common dermatologist-recommended treatment for stretch marks is massage. Massaging the skin in a circular motion with oil on the finger to reduce friction is helpful in stretching the skin collagen and elastin, making it more pliable and more normal appearing.

The prevention of stretch marks is challenging. It appears that stretch marks do not occur when the stretching of the skin is gradual rather than abrupt. Thus, rapid changes in body size should be avoided if possible. Since stretch marks represent small scars, the rapid growth of the body can result in the tearing of the skin and more stretch marks.

Slower changes in body size may allow the skin to adjust more gradually. People with better skin elasticity and less rigid collagen are less likely to develop stretch marks, but it is not possible to modify these skin characteristics at present.

The outlook for stretch marks is excellent, as their appearance typically improves with time, and treatment is not required. The presence of stretch marks during pregnancy has been associated with pelvic relaxation, resulting in prolapse of the pelvic organs with advancing age. Other medical associations, outside of endocrinologic diseases such as Cushing's syndrome, have not been demonstrated.