Decoding Stretch Marks: A Comprehensive Guide

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Kirsten A. Schuster, MD, JD; Iulianna C Taritsa, BA; Samuel J Lin, MD, MBA, FACS

In the captivating world of beauty and skincare, where every day brings new trends and innovations, one common yet enigmatic concern often takes center stage – stretch marks. These subtle, yet sometimes stubborn, marks have long been a topic of curiosity for those on a quest for flawless skin.

What are stretch marks?

Stretch marks, also known as striae, are linear scars that often appear on the abdomen, buttocks, thighs, breasts, and hips. Initially appearing as red or purple, stretched, flat lines, these marks fade into more permanent pale, wrinkled scars (Oakley & Patel, 2023). Although more common in females, these streak-like skin changes affect up to 90% of people (Al-Himdani et al, 2014).

What causes stretch marks?

Caused by dermal stretching, stretch marks often develop with growth spurts, pregnancy, rapid weight gain or loss, and rapid muscle growth. However, not everyone who goes through these changes will develop stretch marks. Genetics, hormones, and changes in the skin’s collagen and elastic tissue are thought to play a role (Oakley & Patel, 2023). In addition, stretch marks may appear as a side-effect of some medications including steroids, injectable contraceptives (e.g. Depo Provera), and anti-retroviral protease inhibitors (e.g. indinavir) (Lohande & Mysore, 2019; Oakley & Patel, 2023). Patients should be aware that medications can cause rapid weight changes or may affect skin quality such as chemotherapies, prolonged antibiotic courses, and neuroleptics (Oakley & Patel, 2023) may result in striae afterward.

Are stretch marks a sign of anything dangerous/worrisome?

Although benign in themselves, stretch marks are seen in conditions such as Cushing’s (hypercortisolism) Marfan syndromes, chronic liver disease, and diabetes (Elsaie et al., 2009; Liu et al., 2014). If you notice other symptoms including sudden weight gain, excessive hairiness, excessive thirst, brittle bones, or easy bruising, please see your preferred physician for a full evaluation.

Do stretch marks go away or diminish on their own (including when someone loses weight)?

Over time, stretch marks will often improve and become less noticeable. Like other scars, however, they will often not completely disappear (Oakley & Patel, 2023). While lifestyle measures including a healthy diet, adequate hydration, and exercise have been recommended to prevent stretch mark formation, the limited evidence available suggests that diets and weight loss do not affect diminishing already existing striae (Cleveland Clinic, 2022; Schwingel et al, 2003).

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How do you get rid of stretch marks?

Many treatment options are available to help you make stretch marks less noticeable. These range from topical at-home treatments (e.g. tretinoin, hyaluronic acid, retinoids) to in-office procedures including laser therapy, light therapy, chemical peels, collagen injections, microneedling, radiofrequency therapy, and microdermabrasion. No single modality, however, has proven completely effective. Each alternative has its own side effects and efficacy may depend on the type of striae and patient skin tone (Al-Himdani et al., 2013). Please consult with your preferred board-certified dermatologist or plastic surgeon to see if any of these options are right for you.

References

Al-Himdani S, Ud-Din D, Gilmore S, Bayat A. Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol 2014;170:527.

Cleaveland Clinic (2022) Stretch Marks. https://my.clevelandclinic.org/health/diseases/10785-stretch-marks

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

Liu L, Ma H, Li Y. Interventions for the treatment of stretch marks: a systematic review. Cutis 2014;94:66.

Lokhande AJ & Mysore V. Striae distensae treatment review and update. Indian Dermatol Online J 2019;10:380.

Oakly AM & Patel BC (2023). Stretch Marks. In StatPearls. StatPearls Publishing. Retrieved Oct 7, 2023 from https://www.ncbi.nlm.nih.gov/books/NBK436005/.

Schwingel AC, Shimura Y, Nataka Y, Kazunori O, Tanaka K. Exercise and striae distensae in obese women. Med Sci Sports Exerc 2003;35:33.

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