101 Series Skin

101 Series: What Are Stretch Marks?

Lauren Baer March 30, 2021

Medically, they’re harmless! That’s the good news. Sometimes referred to as striae, striae gravidarum, striae distensae and striae atrophicans, stretch marks can develop during puberty, pregnancy or intense muscle-building when the body is in an accelerated growth phase or under accelerated biological changes. Once they appear, the marks do not typically go away fully and tend to stay there for a long period. While not physically painful, stretch marks may affect a person’s confidence and self-esteem, and potentially cause emotional discomfort.

While skin, often perceived as the largest organ of the body, has a profound ability to expand and contract as needed, the underlying tissue structure is susceptible to damage if stretched too far or too quickly. When the middle layer of skin (dermis) stretches too quickly over a sustained period of time, the dermal network, primarily comprised of collagen and elastin fibers, is disrupted. As a result, when the skin goes to create new collagen and elastin under accelerated conditions, the fibers are not arranged in the right orientation and the elastin, which typically helps skin bounce back after stretching, has difficulty doing its job. The rapid overstretching of skin tissue leads to the development of stretch marks. Often, the stretch marks will appear red or purplish as the underlying blood vessels show through. Over time, their color fades to a whitish or silvery tone as the blood vessels heal.

So, why might you get stretch marks and not someone else? The truth is, you, me, any gender, and nearly all ages and skin types can get stretch marks but there’s an imprecise reason as to why some people get them and others do not. Factors that may impact how prone someone is to developing stretch marks include genetics, certain hormone levels, younger age, family history, increased pre-delivery weight, and increased birth weight. Those who are more dependent on steroid medications and topical steroidal creams also tend to develop stretch marks more easily because the steroid hormones weaken collagen fibers, making them more likely to break.

Not fond of your stretch marks? Their appearance can be improved by non-invasive topical treatments, like retinoids, when treated in the early phases. However, according to scientists at the University of Michigan, there are no products that can actually repair the damaged elastic fiber network, so it’s best to focus on preventing or preserving the elastin rather than trying to repair it. Late-stage, fully formed stretch marks are still treatable with more sophisticated and invasive techniques like micro-needling, laser therapy, enhanced platelet-rich plasma therapy, etc. There are also plenty of other anecdotal, home-remedy treatments which can possibly keep your skin looking healthy but their effectiveness for preventing or treating stretch marks are debatable.

References:

1. Farahnik, B., et al. “Striae gravidarum: Risk factors, prevention, and management.” International journal of women’s dermatology 3.2 (2017): 77-85. [PUBMED]
2. Wollina, Uwe, and Alberto Goldman. “Management of stretch marks (with a focus on striae rubrae).” Journal of cutaneous and aesthetic surgery 10.3 (2017): 124. [PUBMED]
3. Suh, Dong-Hye, et al. “Treatment of striae distensae combined enhanced penetration platelet-rich plasma and ultrasound after plasma fractional radiofrequency.” Journal of Cosmetic and Laser Therapy 14.6 (2012): 272-276. [PUBMED]
4. Braude, Peter, and Diana Hamilton-Fairley. “Hormonal changes during puberty, pregnancy and the menopause.” Obstetric and gynecologic dermatology. London: Mosby Elsevier (2008). [PUBMED]
5. Wang F, et al. “Marked disruption and aberrant regulation of elastic fibres in early striae gravidarum.” British Journal of Dermatology. 173.6 (2015): 420-30. [PUBMED]
6. https://www.medicalnewstoday.com; Accessed on March 23, 2021.