Stretch Marks

Stretch marks are very common and are rarely a sign of a significant medical problem.

Stretch marks (striae distensae) appear as linear streaks on the skin that has been overstretched, and they run perpendicular to maximum lines of tension in the skin.

Stretch marks begin as flat red lines, and they appear as slightly depressed white streaks over time. They tend to occur near the armpits, on the thighs, abdomen, chest, buttocks, and groin, and they are more common in obese individuals and during pregnancy. Their appearance is similar to changes seen on the surface of rubber balloons that have been over-inflated. They are rarely painful.

Stretch marks may also occur as a side effect of certain medications and because of certain diseases.

There is some controversy over the precise mechanism by which striae occur. There seems to be damage to the elastic fibers of the dermis (the deeper layer of the skin) accompanied by inflammation which eventually results in atrophic scar-like changes.

• Excessive physical stretching of the skin appears to induce these changes.
• There are several clinical situations that will predispose the skin to the formation of striae, such as:
  • rapid and excessive increase in body mass (weight gain),
  • the excessive use of topical or systemic glucocorticoid drugs (steroids),
  • Cushing's disease (overproduction of glucocorticoids by the adrenal gland),
  • puberty,
  • Marfan syndrome and Ehlers-Danlos syndrome (two uncommon genetic diseases),
  • excessively large breasts or breast implants, and
  • pregnancy.

Excessive rapid weight gain and pregnancy are the two most common risk factors. Other risk factors include the conditions described above that predispose the skin to develop stretch marks.

Striae are rarely painful or itchy. They do not produce troublesome symptoms. They begin as linear red streaks and eventually mature into linear white lines.

Since stretch marks are quite common, most people are familiar with their appearance. They are identifiable on visual inspection by patients and doctors.

There is a wide variety of treatments to get rid of stretch marks, but none of them seem to be particularly valuable in preventing or treating this condition.

• Medical professionals generally agree that there is no good medical evidence that any creams or ointments will produce any sustained improvement in the appearance of stretch marks.
• The use of physical modalities such as lasers, ultrasound, and microneedling holds some promise, but currently, there is little compelling evidence that any treatment is safe and effective.

No, there is no evidence that any home remedies can improve the appearance of stretch marks.

As the striae mature, they become less apparent but they rarely disappear. They do not cause any health problems.

Aside from maintaining a normal weight and avoiding the long-term use of potent topical steroids under occlusion (wrapping and securing the skin after application of steroid preparations) or oral steroid drugs, little can be done to prevent stretch marks from developing.