Prevention and treatment for stretch marks

Are you spinning your wheels over striae?

Ahhh, stretch marks. Those dreaded angry red, purple or pink squiggles that typically show up over hip bones, on thighs and underarms, or across bellies, breasts and bottoms. When you’re pregnant, you’re more susceptible because of inevitable weight gain. So what’s a gal to do?

Unfortunately, there’s no proven way to prevent stretch marks, also known as striae. “There is a strong genetic component to developing striae. This fact makes the condition inevitable in most women predisposed to develop them,” says Dr. Jeffrey L. Puretz, an obstetrician and gynecologist with Women’s Care Florida, Lakeland OB-GYN and Polk County Medical Association member.

It’s an old wives’ tale that stretch marks can be prevented with pure lanolin or Palmer’s, a lotion with cocoa butter, says Lisa Birket, practice manager and laser specialist at Lakeland’s True MD. There is anecdotal evidence that keeping the skin moisturized can help prevent stretch marks, but it hasn’t been scientifically proven in controlled studies, experts say.

Stretch marks appear when the skin is torn. Itchiness is common. The marks can be caused by pregnancy, puberty-related growth spurts, weight gain or loss, bodybuilding, and some medical conditions. 
Although they are red, purple or pink initially, they fade to a white or silvery hue, often with deep indentations.

Dr. Puretz makes the distinction that the risk factor for pregnant women is a large amount weight gain, not necessarily a rapid weight gain. Managing “most weight gain or loss means using common sense with regards to proper diet and exercise,” he says. “Weight gain is needed during pregnancy. The amount of weight is set by your physician or midwife and varies for each patient.”

Experts do recommend lotions, some for comfort and some for hydration. “I recommend patients use a lotion for comfort that includes moisturizer if needed,” says Dr. Puretz. “I also recommend not spending a lot of money on anything they use since nothing seems to alter the course.”

“I recommend that my pregnant patients and teenage patients who are genetically prone to them keep their skin moisturized,” agrees Dr. Mary Sheu, an assistant professor and associate residency director in the Department of Dermatology at Johns Hopkins School of Medicine, Baltimore, Md.

Dr. Sheu says that tears occur in the collagen layer of the skin if it expands too fast. “Additionally, prolonged stretching of the skin may cause release of inflammatory chemicals that cause breakdown of collagen and elastic tissues,” she says.

Natural hormonal shifts and genetic factors (if your parents were prone to them, you probably are too) also play a role in producing these occasionally wrinkled scars. And certain medications, especially steroid creams and oral steroids, if used for long periods of time, can increase the risk of stretch marks, Sheu points out.

Although there’s no way to guarantee you won’t get them during the teenage years, or during pregnancy when you have little to no control over your expanding body and hormones, the best general solution for bypassing stretch marks is to avoid gaining weight too quickly, says Dr. Joel Schlessinger, an Omaha-based dermatologist and cosmetic surgeon, and president of This advice also applies to rapidly packing on pounds of muscle; however, the average exerciser need not worry, and keep in mind that staying active will help you prevent packing on pounds of fat. If you’re planning to have a baby, Schlessinger advises eating a nutritious, balanced diet and exercising before, during and after to promote weight gain (and loss) that’s healthy and gradual.

Once stretch marks are in place, there’s no way to get rid of them for good, but you can take steps to minimize their appearance. Birket recommends Sciton laser procedures, a combination of SkinTyte and fractional resurfacing that encourages collagen growth. “We do a combination of tightening and resurfacing to allow your body to build collagen to take place of stretch marks,” she describes. “Getting to the bottom of the stretch marks is the goal.”

Depending on how deep and pronounced the stretch marks, multiple visits may be required for treatments totaling between $500 and $2,000. “Everyone’s skin is different. There is really no exact science,” she says.

For the initial phase, Schlessinger frequently works with Intense Pulsed Light to improve the redness of stretch marks, and Sheu recommends Pulsed Dye Laser treatments. Fractionated ablative and fractionated non-ablative lasers can help to reduce the appearance of red and silvery white stretch marks, Sheu adds. “The best results are seen with multiple sessions.”

Topical retinoids (Retin A and the generic equivalent, tretinoin, along with tazarotene and adapalene) can help to reduce the appearance of red stretch marks, Sheu says. They are not as helpful once the stretch marks have turned silvery white. (Pregnant women should consult their doctor before using topical retinoids, as the oral variety has been shown to cause birth defects.)

For a quicker and less expensive fix, try “covering” your stretch marks with an over-the-counter sunless tanning lotion or spray, or a professional faux tanning session at a salon. But skip the actual sunbathing, as stretch marks themselves are less likely to tan and can end up looking more prominent, and the ultraviolet rays can further damage your skin. If you’re not interested in a golden glow, you can also purchase a concealer that matches your skin tone to make the marks all but invisible.

If you choose to wait it out, stretch marks will eventually diminish. “They will fade over time,” adds Dr. Puretz. “This can take anywhere from months to up to two years.”



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