Stretch Mark Treatment – What Works and What Does Not Work

Since I started this blog, I get more and more questions from friends and acquaintances. One of the hot topics among my peers is stretch marks.

In this article, you can read what I have been able to find out about what striae is, how it arises and what you can do about it. If only I had known this before …

What is stretch marks and how does it arise?

Stretch marks (striae distensae) or skin stretch marks are linear skin lesions that arise when the subcutaneous connective tissue is pulled apart because the part of the body in question grows faster than the skin can maintain (Al-Himdani et al., 2013; Salter & Kimball, 2006).

Striae can in principle develop on any part of the skin that is experiencing relatively rapid growth. Stretch marks often arise:

  • During the accelerated growth in puberty (idiopathic striae atrophicae or puberty), and especially on the thighs, buttocks, lower back and breasts;
  • During pregnancy (striae gravidarum), especially on the abdomen and breasts;
  • With rapid weight gain (especially on the abdomen, thighs, inside of the thighs and the upper arms);
  • With rapid muscle development (as with bodybuilders), especially on the arms, thighs, and breasts.
  • In addition to the speed at which a part of the body grows, the formation of stretch marks depends on your genes, race, age, skin quality and the affected part of the body.

Besides striae distensae there is also striae atrophied, which is not caused by excessive stretching of the skin, but is the result of weakened collagen fibers through prolonged use of (cortico) steroids (such as Prednisone), or by excessive cortisol production that can be caused by numerous different syndromes (such as Cushing syndrome, Ehlers Danlos syndrome, Marfan syndrome, adrenocortical syndrome, Prader Willie syndrome and Cabezas syndrome).

What you can and can not do against stretch marks!

Practically speaking, stretch marks are scars (Zheng et al., 1985; Khunger & Ganjoo, 2013; Liu et al., 2014). This means that once you have stretch marks, they will never disappear completely. The purple-red color that the striae have at an early stage, however, will gradually fade over time and eventually become slightly lighter than your own skin color.

And although cosmetic products promise all kinds of positive results in reducing scars and stretch marks, most of them do not have any scientific evidence for this (Brennan et al., 2012; Korgavkar & Wang, 2015; Ud-Din et al. 2016).

Very logical, if you look at the biology of the skin: damage to the subcutaneous connective tissue simply cannot be eliminated with the smearing of a layer of oil or cream on the outer horny layer. Any improvements that users of these products notice are unfortunately nothing more than the result of a placebo effect or the natural fading process.

So keep this in mind when you plan to buy expensive anti-stretch marks creams! As regards the claims of the famous Bio-Oil praised by Oprah Winfrey (which is still widely used by pregnant women): these have been officially declared nonsense in the United Kingdom and I can only hope that this will happen in other countries will also happen (Hendriks, 2010, Hengeveld, 2009, Brennan et al., 2016).

The prevention or treatment of stretch marks is not so much in cosmetic or pharmaceutical treatments, but especially in addressing the origin factor (s).

If you have stretch marks atrophied, it is useful to treat the underlying disease or to make less use of products with (cortico) steroids. If it concerns striae distensae, then the best advice I can give you is to ensure that you do not grow too fast in width, regardless of whether it is an increase in fat or in muscle mass. Regarding stretch marks that occur during pregnancy, two studies have shown that stretch marks occur more often at a young mother’s age, a high Body Mass Index (BMI), and a weight gain during pregnancy of more than 15 kilos (Atwal et al. al., 2006; Osman et al., 2007). So try not to arrive more than necessary during your pregnancy!

Is there nothing we can do against stretch marks? That is not the case! There are a number of substances for which there is scientific evidence that they can help to prevent or reduce scarring!

From medicinal creams with tretinoin (vitamin A acid), some effect is described in the early stage of stretch marks (Kang et al., 1996). However, this medicine cannot be used to prevent stretch marks that occur during pregnancy: because an overdose of vitamin A is harmful to the unborn child, pregnant women are advised not to put retinoids on their skin during pregnancy ( Kaplan et al., 2015).

Then there is silicon therapy. There is some evidence that this therapy treatment based on silicones in the form of gel or patches may be effective in the treatment of excessive scarring, as is the case with hypertrophic scarring (where the scar is abnormally red and thickened), and in keloid scar formation. (where the scar is not only abnormally red and thickened but also larger than the original wound area) (O’Brien & Jones, 2013). In the case of stretch marks, however, this is often not the case and the process of scarring proceeds in a normal manner; nevertheless, there are indications that silicone therapy can also play a role in the prevention of stretch marks (Ud-Din et al., 2013).

If you have a lot of stretch marks on your lower abdomen after the pregnancy and if there is a skin excess, the surplus skin including unsightly striae can be removed with the help of a tummy tuck. The same applies to stretch marks that are located in other areas where skin excess is present, for example, if you have lost a lot of weight. This can also be corrected with the help of cosmetic surgery. Then choose a well-regarded clinic and doctor!

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