Dermatologists weigh in on this common problem and help you get comfortable in the skin you’re in
Stretch marks are quite common. Sometimes called by the medical term “stria,” stretch marks are not an unusual topic of conversation in both the gynecologist’s and dermatologist’s office. “Approximately 90 percent of pregnant women, 70 percent of adolescent females and 40 percent of adolescent males develop stretch marks,” says Dr. Rebecca Laguaite, obstetrician-gynecologist at Touro Infirmary.
The stretch mark is considered a dermal scar from damage to the elastin and collagen in the skin. Dr. Mary Lupo, a dermatologist, describes them as initially having a pinkish to purplish hue and when they are older, having a whitish or silvery-white color.
Stretch marks can occur almost anywhere on the body. “The abdomen and buttocks are the most common, but you can see them on the upper thighs and upper arms, and women can get them on their breasts,” says Lupo. Men can be affected as well. “It is usually associated with rapid growth in a young man, rapid weight gain or extreme body building,” says Lupo. Maintaining a healthy
weight is your best defense, but it does not guarantee that you won’t get them.
Stretch marks can appear at all times of life, and they do not always have a known cause. “One sees stretch marks when the skin is stretched rapidly, which does damage to the elastin fibers of the skin,” says Lupo. Even a healthy behavior like exercising can result in stretch marks. “We tend to see stretch marks if someone is working out and gets rapid muscle growth that stretches the skin,” says Lupo. Anabolic steroids, for instance, will build muscle rapidly and cause the skin to stretch too much, which could potentially
cause stretch marks.
During pregnancy, being cognizant of weight gain can help. “Try not to gain over 30 pounds, and [if you do] to gain it more gradually so it decreases your risk,” says Lupo. If you are obese, 10 pounds of weight gain is normal. There is not a lot you can do for prevention. “Stretch marks can occur even if you gain a normal amount of weight during pregnancy because of the rapid growth
of the belly during the prenatal course,” says Laguaite. Moderation is key. “We recommend focusing on meat, protein and vegetables
and staying away from additional snacks and carbohydrates,” says Laguaite. Do not deprive yourself though. If you do snack between meals, you should focus on vegetables and fruit as a natural sugar, says Laguaite.
Stretch marks are not dangerous in and of themselves, but in rare cases they can be associated with medical issues. While they are
typically a cosmetic issue, “severe stria can be associated with certain endocrine abnormalities like diseases of the adrenal glands or excessive cortisol in the body. I usually recommend a metabolic workup,” says Lupo. By having an open dialogue with your physician, you can get to the bottom of the problem.
Stretch marks do not have to be permanent. “The earlier you treat them, the better the response,” says Lupo. Of course, this is a personal choice and not a medical necessity. “When they are in the red, violet or purplish stage, patients get nice results from aggressive protocol with Retin-A, which is a vitamin A derivative that is primarily used for acne and aging, but it stimulates the
collagen production, which will replace the damaged elastin tissue and make the stretch marks less noticeable,” says Lupo. Retin-A is considered an at-home treatment that anyone can do with a prescription from their dermatologist. “I give every patient a six-week trial of Retin-A before I do a procedure because a good 20 to 30 percent do not need a procedure if they can follow the Retin-A protocol,” says Lupo. Cocoa butter and vitamin E have been suggested as reducing the appearance of stretch marks, but not everyone has success with these athome remedies. Dermatologic societies say that sometimes the motion of massaging the stretch marks in a circular fashion can improve the appearance. Dr. Deirdre Hooper, a dermatologist at Audubon Dermatology, recommends Maderma to help the redness go away faster.
Microdermabrasion and Fraxil have had success on some patients as well. “Microdermabrasion is a noninvasive treatment that involves removal of the top layers of the skin, but the rubbing action of the machine infuses the skin with certain things to stimulate collagen production over time,” says Lupo. “It is safe for all skin types and is a less expensive alternative to Fraxil.” Everyone has their own preference. “Fraxil is nonablative, noninvasive but a deeper treatment that is more aggressive and tolerable but not painless,” says Lupo. With Fraxil, patients get results quicker with fewer treatments.
Other laser treatments can be considered as well. “Photo laser can significantly improve the appearance,” says Laguaite. Ask your doctor to show you before and after photos and testimonials about the procedure that interests you. “Pulsed dye laser can be used to fade more quickly and a fractional resurfacing laser with three to five monthly treatments can improve red or white stretch marks by about 40 percent,” says Hooper. Treatment is individualized based on whether your stretch marks are mild or severe as well as your personal medical history, needs and expectations. “The best treatment is fractional resurfacing,” says Hooper.
If you are not overly concerned, you may just elect to let time pass and see what happens. “Stretch marks tend to fade over time, but some women, depending on their skin type and skin structure, may have them for the rest of their lives,” says Laguaite. Remember that beauty comes from inside and external flaws can be managed.