Woman checking cellulite on her legs isolated on white background

Most of what’s out there on stretch mark removal is more myth than fact. Fortunately, with the right information you are not completely helpless against stretch marks, whether you’re experiencing pregnancy stretch marks or stretch marks arising from other causes. Read on for the latest information on how to remove stretch marks safely.

The facts about stretch marks

Stretch marks, also called striae, are streaks or lines in the skin, usually indented. Initially they can range in colour from pink or red to purple, blue or black. Over time they fade and take on a lighter colour. Eventually they may appear to be an almost silvery white in lighter skin or a bronze colour in darker skin.

Most often stretch marks are found on the abdomen, breasts, buttocks, hips and thighs. However, they can sometimes also be seen on arms, and other parts of the legs and body. Some people even experience stretch marks that cover large portions of their bodies. Although both men and women of any age can have stretch marks for a variety of reasons, they are particularly common in pregnant women. They are also associated with obesity and quick weight gain.

Stretch marks are not physically harmful and they are not considered to be a health issue. Even so, many people who have them find them problematic, or even distressing. Because becoming a mother is already such a tremendous transition, pregnancy stretch marks can feel very upsetting to women who experience them.

Causes of stretch marks and risk factors

Woman getting anti cellulite treatment
Woman getting stretch mark treatment

Just as their name suggests, stretch marks are caused by the stretching of the skin. How severe they are depends on several things, including your genetic makeup, your cortisone levels and how much stretching stress your skin experiences. Here’s how these factors work together to cause stretch marks.

There are three important layers that make up your skin: the outer layer or epidermis, the middle layer or dermis, and the deepest inner layer, also called either the hypodermis or subcutaneous. The dermis is the home of collagen in your skin, a key structural protein. The dermis also houses blood and lymph vessels, sweat and sebaceous glands and nerve endings. During periods of normal growth your dermis is equipped to handle the changes your body undergoes. The strong connective fibers from your body’s collagen stretch slowly, accommodating the growth without tearing.

However, during times of growth or weight gain that is too sudden and during pregnancy, the dermis can’t handle the stress, and this is when stress marks happen. Stretch marks arise when the connective tissue of the dermis is stretched beyond its natural elasticity. As the dermis stretches too far it tears, and this in turn causes the inner layers of the skin to show through. This inverted scar is the stretch mark.

Fresh stretch marks appear brightly coloured and reddish or purplish because the blood vessels of the inner layer of skin are showing through the torn dermis. As the dermis heals, the stretch marks fade. This happens as the blood vessels contract, revealing the pale layer of fat while underlies the skin. This transition in appearance can take years.

Cortisol is a stress hormone that your adrenal glands produce and your body turns into cortisone. Cortisone weakens the skin’s elastic fibers, so stretch marks are both more likely to happen, and more likely to have an extreme appearance in bodies with high levels of cortisone. This also applies to people who use cortisone medications or creams topically, so be aware of this risk factor, especially if you are pregnant.

One final note on corticosteroids. Occasionally, inappropriate or prolonged use of corticosteroid lotions and creams can cause stretch marks. These medications are often used to treat eczema. The stretch marks you see in these cases are not like the typical bright red stretch marks you see arising from weight gain or pregnancy; these look more like late-stage, faded stretch marks.

These are caused by losing collagen in your skin over the long term—a side effect of the corticosteroid use. Collagen is a critical structural protein that is used all over your body, but cosmetically you will notice it most in your skin. Collagen is what provides your skin’s elasticity, and when it is missing you can lose a youthful appearance, or experience stretch marks.

Although anyone can develop stretch marks, there are certain risk factors which indicate you may be more likely to get them:

• Being female
• A family or personal history of stretch marks
• Pregnancy, especially in younger woman, as being older in pregnancy appears to be a protective factor against stretch marks
• Obesity
• Rapid weight loss or gain
• Use of corticosteroids
• Breast enlargement surgery
• Cushing’s syndrome – this condition includes the overproduction of cortisol and resulting rapid weight gain and thinning skin
• Ehlers-Danlos syndrome (EDS) – this rare genetic disorder disturbs the skin’s structural proteins
• Marfan syndrome – this genetic condition causes decreased elasticity and weakness in the tissues of the body

Although stretch marks are not typically thought of as a medical problem, any condition that disturbs you greatly is something you must cope with. See your doctor if the stretch marks cover major portions of your body or if your skin’s appearance concerns you. Your doctor can help you understand the causes of the stretch marks and explore treatment options.

Pregnancy stretch marks in focus

Fighting against damaged skin and skin stretch marks
Fighting against damaged skin and stretch marks

While the mechanics of pregnancy stretch marks are not unique, the associated factors and causes may be. Research seems to indicate that pregnancy stretch marks may be related to the following factors:

• Maternal age
• Changes in hormone levels
• Genetic makeup
• Inherited defects
• Maternal BMI pre-pregnancy
• Maternal BMI at time of delivery
• Gestational age at delivery
• Baby’s birth weight
• Alcohol consumption during pregnancy
• Water intake during pregnancy
• Family history of stretch marks

Prevention and treatment of stretch marks

There are endless mentions of butters, creams, gels, lotions, and oils in context of stretch marks. However, the research shows that there is no support for any of these methods preventing or treating stretch marks. While it is certainly a good idea to keep the skin well-hydrated and in good condition, there is simply no medical evidence to support the use of these emollients against stretch marks.

Fortunately, laser technology offers one of the best ways to actually treat the appearance of stretch marks. Laser therapies can reduce the appearance of stretch marks for both the acute reddish and older whitish varieties. These work by stimulating the production of collagen and elastin in the skin with heat from intense light. The treatments are non-invasive and provide other benefits, including fat reduction.

The use of tretinoin cream, which contains retinoic acid, is another possibility for fresh stretch marks. It works by helping your skin rebuild collagen, which in turn helps the skin in stretch marks have a more normal appearance. However, retinoic acid can result in congenital defects. For this reason it is dangerous for anyone who is pregnant or breastfeeding. Retin-A is an example of this kind of medication.

Microdermabrasion, a kind of polishing of the skin with tiny crystals to remove the surface layers of skin, can be used to treat very recent stretch marks in particular. Its efficacy against more established stretch marks is less impressive.

There is no fool-proof way to prevent stretch marks, and ultimately getting stretch marks is largely a matter of your genetics. However, there are certain things you can do to reduce your risk:

• Stay at a healthy weight
• If you need to lose weight, do so gradually and healthfully; never yo-yo diet
• Eat a balanced diet that supports healthy skin with vitamins A and C and the minerals silicon and zinc
• When pregnant, plan for and work toward gradual weight gain and eat healthfully throughout
• Drink plenty of water always to support your skin

Seeing a doctor for stretch marks

_Y8A0985-23
One of our laser technicians talking to a Physician Skincare Centre patient.

If you do seek a doctor’s treatment for stretch marks, make sure you are ready for your appointment. Prepare yourself by getting some basic questions for your doctor ready in advance. Here are some possibilities to consider:

• What are the probable causes of my stretch marks?
• Could there be any medical reasons for my stretch marks?
• Should I expect more stretch marks?
• Are there other possible causes for my stretch marks other than the most likely cause you’ve told me about?
• Can I get rid of my stretch marks? What are my treatment options? What are the pros and cons of each possibility?
• What results should I expect from each treatment option?

And remember, your doctor will have questions for you, too. Be ready to answer them as fully as possible. Your doctor will probably want to know these things, at a minimum:

• Have you had periods of rapid weight loss or gain?
• Are you pregnant? Have you ever been?
• When did you first notice the stretch marks?
• Have you had other skin problems?
• Do you have any other symptoms I should know about?
• Are you taking any medications, including vitamins or “natural” supplements?
• Do you regularly use skin creams or lotions with cortisone in them?
• Do you have a family history of stretch marks?
• Do you have a genetic disorder that you know of?

Conclusion

No one likes having marks or blemishes on their skin that make them feel self-conscious. However, thanks to the rapid march of technology and science, there are new treatment possibilities every day. In the past we saw things like stretch marks as something that just had to be borne. Today we know that we have the power to do something about them if we want to—what a welcome change.