It isn't a stretch (pun intended) to say no one wants
stretch marks on any part of their body. Once these grooved,
tread-like marks show up, the quest to find something,
anything to get rid of them begins. As you might imagine,
I receive an amazing number of emails asking me which
products or medical procedures really get rid of stretch
marks. I'm sure the volume of these questions is in direct
response to the assortment of advertisements promising
to smooth out these strange bodily striations. In the
world of cosmetics, a consumer's burning desire to have
flawless skin always leads to hype and myths about what
products can and can’t work. And bogus products for stretch
marks abound.
Products that lead women to waste their money and hope
for an improvement in the appearance of stretch marks
include StriVectin-SD, Mederma, Vita-K Solution, Magia
Bella, Maternity Solutions, ScarSof Scar Softening Cream,
Phytomer, Decleor, Mustela, and Caudalie. Despite the
ads you've seen and the claims you’ve heard about these
products, none of them have substantiated evidence they
can make a positive impact on the formation or prevention
of stretch marks, but of course, that never stops the
cosmetics industry from trying to convince you otherwise.
Medically speaking, stretch marks are called striae distensae.
While we know a lot about stretch marks, there is still
a great deal not yet fully understood about their cause
and restoration (Source: www.emedicine.com/derm/topic406.htm).
Here’s what is known:
Stretch marks occur when skin is abnormally distended
or stretched for a period of time, such as from pregnancy
or weight gain, causing the skin's support structure (in
the form of collagen and elastin) to break down or rupture.
In fact, the visibly curled ends of stretch marks are
actually bands of elastin broken beneath the skin. Essentially,
stretch marks are a scar that has formed from the inside
out, rather than scarring that occurs when skin is externally
wounded. There appears to be a genetic tendency toward
them, but the exact link is not clear. It is speculated
that the way each person's skin heals is a good indicator
of the depth and severity of stretch marks they may eventually
see. A person whose skin heals well with minimal scarring
can expect less obvious stretch marks, while skin that
heals poorly (or slowly) or tends to develop raised or
thickened scars can generally expect stretch marks that
are more pronounced.
It may surprise you to know that in the United States
it is estimated that 90% of pregnant women, 70% of adolescent
females and 40% of adolescent males have stretch marks.
There does not seem to be an ethnic tendency toward stretch
marks, as all races can be affected. Individuals with
fair to light skin typically have pink-tinged stretch
marks while the same marks on darker skin tones tend to
take on a deeper pigmentation than the skin surrounding
them. Discoloration from these marks does fade over time,
but regrettably, the striated appearance rarely returns
to its original smooth appearance.
Is there anything you can do to improve or eliminate
the appearance of stretch marks? First of all, you need
to know that, despite numerous cosmetic products (StriVectin-SD
being the most heavily advertised) making claims of being
able to fade, prevent, or eliminate stretch marks, that
just isn't possible. There are no cosmetic ingredients
that can change the structure of skin in a way that would
raise the indentations back to where the skin level used
to be. However, there is research showing tretinoin (the
active ingredient in Retin-A, Renova, or in generic form)
can have a positive effect. Because tretinoin can stimulate
elastin synthesis, remodel collagen in the dermis, and
improve skin’s texture and color, it can be a strong (though
not curative) ally for improving the appearance of stretch
marks. A 0.05% or 0.1% concentration of tretinoin is recommended,
and the best results are seen when this drug is used at
the first signs of stretch marks. Typical improvement
is 20%, which isn't necessarily exciting, but may still
be worth the effort and expense (Sources: Advances in
Therapy, July/August 2001, Volume 18, Issue 4, pages 181–186;
and Dermatology Nursing, Volume 16, Issue 6, December
2004). The dilemma for expectant mothers is that tretinoin
cannot be used during pregnancy, and is also contraindicated
if the mother-to-be intends to breastfeed her baby.
Other than topically applying tretinoin there are other
medical cosmetic corrective procedures that can have very
good results. These methods include chemical peels and
non-ablative laser treatments. Studies have been conducted
using Intense Pulsed Light (IPL) and Pulsed Dye Laser
(PDL) treatments emitting 585 nanometers (nm) of light.
Results after five sessions were labeled as a clinical
improvement, with microscopic analysis showing improvement
in the length, depth, and coloration of stretch marks.
This type of laser carries a low risk of side effects
and complications when operated at appropriate treatment
parameters and time intervals. (Sources: Dermatologic
Surgery, December 2002, page 1124; Dermatologic Clinics,
January 2002, pages 55–65) but they are not recommended
for use on darker skin tones (including African-American)
because of the risk of hyperpigmentation (Source: Dermatologic
Surgery, May 1999, page 368). Cost for a series of treatments
can run upwards of $2,500 depending on how your skin responds
and what the average fees are in your area.
Beyond non-ablative lasers, you can also consider a series
of chemical peels. Trichloroacetic acid (TCA) peels may
be of some help for improving the appearance of stretch
marks when used at the proper concentration (typically
20% TCA) and applied by a dermatologist or cosmetic surgeon
skilled in the use of this type of peel. A benefit of
TCA peels (and the reason it can help improve the appearance
of stretch marks) is their skin-tightening effect. Because
TCA peels penetrate further than AHA or BHA peels, they
are believed to have a greater ability to stimulate collagen
and elastin for the depth of damage seen in stretch marks.
As you may recall, deep damaged strands of these skin-supporting
substances are chiefly responsible for the emergence of
stretch marks.
One more myth to bust: you may have heard that specific
moisturizing ingredients such as cocoa butter, vitamin
E, or other various plant oils can prevent or reduce the
appearance of stretch marks. As soothing and moisturizing
as these ingredients are, they have no impact on how stretch
marks are formed. Stretch marks are not caused because
skin is dry or needs a special supplement. Rather stretch
marks develop far below the skin's surface due to extreme
strain, stress, and trauma that eventually breaks down
the skin's support structure. No moisturizer in the world
can prevent that kind of injury and damage to the skin
from taking place.
Additional sources for this article: www.emedicine.com;
Your Best Face: Looking Your Best Without Cosmetic Surgery
by Brandith Irwin, M.D., Hay House, 2002, page 124; and
Dermatologic Surgery, October 1999, page 773).