Stretch Marks – What Causes Them and How Can They Be Treated?

Stretch marks, also known as striae or stretch scars, are a common but often bothersome skin issue associated with rapid skin stretching. Women frequently encounter stretch marks during and after pregnancy, but they can also appear in other situations involving rapid weight changes, such as gaining or losing weight.

Stretch marks occur when the skin's elastic collagen fibers stretch due to rapid growth, causing damage to the skin layers. In the early stages, stretch marks can be red or blue in color, but over time they fade to pale or yellowish hues. Their texture may either protrude or be sunken compared to the surrounding skin, making them visibly noticeable. Although stretch marks do not impact physical health, they can cause aesthetic concerns and affect self-esteem, as many find them unpleasant in appearance.

How Do Stretch Marks Form?

Stretch marks primarily form due to rapid skin stretching, particularly affecting the middle skin layer known as the dermis, where most of the skin's collagen fibers are located. Pregnancy and its associated hormonal changes, especially the increase in estrogen and cortisol, influence skin elasticity and reduce collagen production. When the skin stretches rapidly, the dermis tears, creating scar-like lines on the skin's surface. Initially, these tears appear as colored streaks, but as the skin gradually repairs itself, the marks fade.

Types and Stages of Stretch Marks

Stretch marks can be categorized into different types and stages based on their appearance, structure, and developmental phases. In most cases, stretch marks go through two distinct stages: the acute phase (striae rubra) and the mature phase (striae alba).

• Striae Rubra: This is the initial phase of stretch marks when they are still fresh and typically appear red, bluish, or purple in color. Blood vessels are visible through the skin, giving the marks a bright color. In the striae rubra phase, the marks may be slightly raised and even itchy. This is also the stage when the marks are most responsive to treatments, as the fresh scar tissue reacts more quickly to interventions compared to mature scars.
• Striae Alba: As stretch marks develop and mature, they transition to the striae alba phase, where the marks become white, pale, or yellowish. In the mature phase, the blood vessels have receded from the scar area, causing the color to fade and the scar to partially flatten. This is a more permanent stage, and reducing the appearance of these marks is more challenging compared to treating fresh marks.
• Keloid and Hypertrophic Scars: In some cases, stretch marks can become particularly raised and thickened, leading to hypertrophic or keloid scars. Keloid scars extend beyond the original wound area and may continue to grow, whereas hypertrophic scars remain within the boundaries of the original injury. Both types of scars can be cosmetically challenging, and reducing their appearance may require professional treatments.

Stretch marks can appear in various forms and shades, and their appearance and treatment options depend largely on the stage of development and individual skin type's response to scarring. Understanding these types of stretch marks can help in choosing the right treatment method and minimizing their visibility.

How to Treat Stretch Marks?

Here are various treatment methods that can improve the condition of stretch marks and prevent them from worsening:

• EXION Fractional: This treatment combines monopolar radiofrequency (RF) and artificial intelligence with microneedling to deliver energy precisely into the deeper layers of skin affected by stretch marks. The treatment helps to tighten the skin, improve its texture, and reduce fibrotic tissue.
• Laser Treatment: Utilizes laser technology to stimulate skin regeneration and collagen production. Especially suitable for stretch marks in the striae rubra phase.
• Retinoid Creams: Vitamin A-based creams that stimulate the renewal of skin cells. Not recommended during pregnancy.
• Chemical Peels: Removes the outer layers of the skin, which can reduce unevenness and promote the formation of new skin cells.
• Silicone Gel or Patches: Forms a protective barrier on the skin and smooths raised scars, such as keloids and hypertrophic scars.
• Collagen Supplements: Oral supplements that can improve skin elasticity, supporting the fading of stretch marks.
• Massage Therapy: Regular massage increases blood circulation and can soften the scar, making it less visible.
• Cryotherapy: Reduces inflammation and may help minimize scar tissue growth, especially for keloids.

These treatment methods can help fade and smooth stretch marks, but their effectiveness may vary from person to person.