What are stretch marks?

Most of us know what a stretch mark looks like but do we fully understand what it is, how it came about or how it is treated. Stretch marks may appear after repeated over-stretching of the skin over weak connective tissue.Stretch marks appear as long, narrow streaks, stripes or lines that develop on the skin and which differ in colour from the skin around it. They are extremely common and are the result of a sudden stretching of the skin. Anyone can develop stretch marks, although women are more affected than men. Stretch marks can appear as red or purple due to blood vessels showing through the tears in the dermis, depending on the skin colour, and which fade over time into silvery pale or darker lines
Here are some key points about stretch marks:

  • The occurrence of stretch marks ranges from 40-90%, depending on race, age and sex.
  • Both men and women are affected by stretch marks.
  • Approximately 70% of girls develop stretch marks during puberty.
  • Approximately 40% of boys develop stretch marks during puberty.
  • Stretch marks can arise during pregnancy, puberty, after rapid weight gain, as a result of various medical conditions or after using certain medications.
  • Stretch marks often appear from the 25th week of pregnancy.
  • Common areas for stretch marks to arise include the stomach, breasts, hips, upperback, buttocks, thighs and upper arms.
  • Cocoa butter is not effective in preventing stretch marks.
  • Laser therapy has proven effective for stretch mark removal.

More Information

Stretch marks are not medically dangerous, however they be of significant cosmetic concern for some individuals to the extent that their quality of life is affected. They can be disfiguring, causing emotional and psychological distress, especially during puberty.

This type of dermatological scarring is particularly challenging and tends to occur with:

  • Pregnancy
  • Puberty
  • Obesity
  • Sudden weight gain
  • Weightlifting
  • Numerous medical conditions
  • Certain therapeutic interventions.

What are Stretch Marks?

The skin is made up of three layers: the first layer is the epidermis and this is the outermost layer, the second or the middle layer is called the dermis and the deepest layer is thesubcutaneous or hypodermis and this is the fatty layer. Stretch marks occur in the dermis when the connective tissue is stretched beyond the limits of its elasticity. The sudden stretching causes the dermis to tear which creates deeper skin layers to show through, forming the stretch marks.Stretch marks are more likely to develop and to appear more extreme where there are high levels of circulating cortisone, or where cortisone is used topically. Cortisol, the stress hormone produced by the adrenal glands is converted into cortisone, which weakens elastic fibres in the skin.

The skin structure of stretch marks is qualitatively and quantitatively different compared to healthy skin. The altered appearance of the skin reflects structural modifications in the dermis.

Pregnancy

Skin changes are common in pregnancy with stretch marks occurring in over 70% of pregnant women, usually after 25 weeks of gestation.Preliminary research in women undergoing a second Caesarian section has revealed that the greater the severity of stretch marks in pregnancy the more likely it is that intraperitoneal adhesions are present, which may complicate the second C-section or other abdominal surgery.

Hormones are produced during pregnancy that soften pelvic ligaments and increase their flexibility. Hormones also soften skin fibres, giving an increased risk of stretch marks. Stretch marks appear on the abdomen as the baby grows and sometimes occur in the skin covering the thighs and breasts.

Puberty

The body goes through rapid growth cycles during puberty which can cause the development of stretch marks. In males, stretch marks commonly arise on the shoulders and back, while females typically develop stretch marks on the hips, thighs and breasts.

Rapid Weight Gain

Stretch marks usually arise when a person rapidly gains weight, such as when bodybuilders and athletes dramatically increase muscle and body mass over a short period of time.

Medical Conditions

Medical conditions such as Cushing’s syndrome and Marfan syndrome can lead to the development of stretch marks. Marfan syndrome is a genetic condition that causes weakness and decreased elasticity in body tissues. Cushing’s syndrome can cause stretch marks as it isthe overproduction of cortisol, the stress hormone, which can lead to rapid weight gain, especially in the abdominal area, in addition to causing the skin to feel fragile, thin and more susceptible to bruises, scarring and infection. Cushing’s syndrome is three times more common in women than in men, but can be successfully treated in most cases. Ehlers-Danlos syndrome (EDS) is a rare inherited condition that interferes with the development of structural proteins in the skin which can also cause stretch marks.

Tretinoin Rream (Retinoic Acid)

Studies have shown that the topical application of Tretinoin significantly improves the clinical appearance of early stretch marks.
Tretinoin helps to rebuild collagen, which makes stretch marks look more like “normal” skin.

Laser Therapies

Laser treatments can provide safe and effective reduction in the appearance of stretch marks. Laser therapies work by using specific wavelengths to stimulate growth of collagen, elastin or reduce the over-production of melanin in the skin.

For early stretch marks, usually red or purple in colour, BBLtm or IPL based lasers have proven to be effective whereas fractional laser treatments are usually done for older stretch marks which are white or silver in colour. At Dermology we combine a few procedures according to the appearance of the actual stretch mark.Clinical improvements to stretch marks have been obtained with the following devices in studies by potentially stimulating new collagen and elastic fiber synthesis: