• Stretch Marks

    (Striae)

    Definition

    Stretch marks are red, whitish, or purple streaks in the skin. Stretch marks are most often associated with pregnancy or other periods of rapid weight gain. They may also be associated with conditions such as Cushing's syndrome, adrenal gland disease, or Marfan syndrome.
    Stretch marks usually become less noticeable over time. Certain treatments may also help decrease their appearance.

    Causes

    Stretch marks occur when skin is stretched. The elastic fibers just below the skin tear. This tear leaves streaks of indented skin. The stretch marks may appear red or purple and eventually turn whitish in color. The elastic fibers are also weakened by hormones such as cortisone. The hormones are present during pregnancy, with rapid weight gain, or certain medical conditions. Certain medications may also raise your cortisone.
    Pregnant Woman
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    Stretch marks are common in pregnancy.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Factors that may increase your chance of stretch marks include:
    • Gender: female
    • Family history of stretch marks
    • Pregnancy
    • Being overweight or obese
    • Rapidly gaining or losing weight
    • Using corticosteroid medicines
    • Certain medical conditions, such as adrenal gland disorders

    Symptoms

    Stretch marks are red or purple streaks that are slightly indented. They are most common on the stomach, thighs, buttocks, and breasts but may also occur in other areas. The stretched skin may also be dry or itchy.

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    If the cause of stretch marks is not obvious your doctor may look for other causes. These tests may include:
    • Blood tests for cortisol levels
    • Imaging studies

    Treatment

    Most stretch marks fade over time without treatment. Some people may want faster results or deeper fading of stretch marks. In general, the current treatments are limited and unsatisfactory.
    Talk with your doctor about the best treatment plan for you. Factors that will affect your treatment options include:
    • Age of stretch marks
    • Convenience of treatment—may require multiple sessions
    • Cost—usually not covered by medical insurance
    • Your expectations
    Treatment options include the following:

    Medicines

    Tretinoin cream (Retin-A, Renova) may help to lessen the appearance of stretch marks. It is most effective on stretch marks that are less than six weeks old and still red or pink in color.
    It should not be used during pregnancy.

    Laser Therapy

    Laser therapy can stimulate the growth of collagen and elastin. It may decrease the appearance of stretch marks.
    • Pulsed dye laser therapy—may reduce the redness of new stretch marks. The laser may also alter skin color on darker skin tones.
    • Nonablative fractional photothermolysis
    • Excimer laser—best for older stretch marks. It may make the lighter color of the stretch marks match more closely in color to the skin around them.

    Prevention

    There are no proven methods for preventing stretch marks. Staying within recommended weight gain guidelines during pregnancy may help. If you are not pregnant, keeping your weight at normal levels is also a good idea.
    Lotions have not been proven to prevent stretch marks. They may be helpful to moisturize and soothe itchiness.

    RESOURCES

    American Congress of Obstetricians and Gynecologists http://www.acog.org

    American Academy of Dermatology http://aad.org

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Canadian Dermatology Association http://www.dermatology.ca

    References

    Elsaie ML, Baumann LS, Elsaaiee LT. Striae distensae (stretch marks) and different modalities of therapy: an update. Dermatol Surg . 2009;35(4):563-73.

    Changes in your body during pregnancy: second trimester. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/pregnancy-newborns/your-body/changes-in-your-body-during-pregnancy-second-trimester.html. Updated February 2011. Accessed February 21, 2013.

    Common symptoms, signs and laboratory changes in pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated January 23, 2013. Accessed February 21, 2013.

    Mom and baby skin care. American Academy of Dermatology website. Available at: http://www.aad.org/media-resources/stats-and-facts/prevention-and-care/mom-and-baby-skin-care. Accessed February 21, 2013..

    Stretch marks (striae). New Zealand Dermatological Society DermNet NZ website. Available at: http://www.dermnetnz.org/dermal-infiltrative/striae.html. Updated December 18, 2012. Accessed February 21, 2013.

    Treatments of discomforts of pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated January 23, 2013. Accessed February 21, 2013.

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