Many myths and legends surround Stretch Marks medically known as Striae Distensae.
These are benign lesions that often fade with time, but if they become widespread, they tend to become a cosmetic problem. They are very common in women, adolescent children and often develop during pregnancy. There is a genetic component to the etiology as well, but not a lot is known about them and they remain one of the many medical mysteries locked away in the dermatology X-Files folder.
In this concise article, I will try and demystify this mystery and present some treatment options that might help you in managing these stubborn marks.
Some questions immediately spring to mind:
- There are hundreds of creams and devices floating around in the market that claim stretch mark busting properties, but do they really work?
- Do any evidence-backed modalities exist that have shown positive outcomes?
- Any self-treatment options?
- Is there a holistic approach?
- Are they permanent?
Let’s get ready to re-open the stretch mark X-Files.
What are Stretch Marks: They are linear bands of scar tissue formed in areas of dermal damage (deeper layer of skin tissue) caused by progressive stretching. They were first described in the 1800’s.
Pathology: Believe it or not, stretch marks actually start off as inflammation. The minute blood vessels of the skin show similar inflammatory changes. When viewed under the microscope in the later stages they show a picture of scar tissue with curled and branched elastic and collagen fiber. Having said that, it seems reasonable to assume that early treatment of stretch marks will result in higher success rates, rather than treating older marks composed of permanent scar tissue.
What do they look like: They appear as thin (1-10 mm wide) linear pinkish lesions, often raised in very early stages and are sometimes itchy. Over time the lines take on a bluish-reddish tint and in the last stages they become flat smooth thin whitish steaks.
Where they are usually found: Predominantly over the abdominal, thigh, breast and the buttock area.
What causes them: Please see table below
What makes them worse: Rapid tides of weight gain and weight loss, lack of good nutrition, oral steroids, or a prolonged use of topical steroids, aging skin, dry skin and eczema, dry climates, an ongoing untreated illness, infections, malignancy, dehydration and vitamin deficiencies.
Can you prevent them from happening: Women are more prone to get stretch marks and there is no way to prevent them except by staying fit, keeping your skin from drying out, taking care of your nutrition and overall health. Early intervention, especially after pregnancy, is the best thing one can do, since young stretch marks respond well to treatment.
My suggestion is not worry or obsess about them, this will create unnecessary stress. Remember, unless there is an underlying cause, they will fade with time and are harmless.
Treatment Options: Evidence of a sure shot treatment or set protocol for erasing stretch marks is scant. The core principal is early treatment, where the primary goal is rebuilding collagen and elastin, keeping skin well hydrated and maintaining good nutrition.
It has been demonstrated by various clinical studies that early marks will respond to topical retinoids.
Clinical data and literature reveal that other modalities such as Laser treatment, Intense Pulsed Light, Esthetic Ultrasound, Chemical Peels/Microdermabrasion, Mesotherapy and Microneedling may help induce collagen/elastin rebuilding and decrease chances of scar tissue formation. All these modalities may help, studies show variable results and outcome depends on the length, age, stage, and area of marks. No one option is superior to the other.
Clinical studies have been conducted using the aforementioned modalities, but let’s not forget that some of these treatment options come with heavy price tags. Be sure to discuss all your options with a professional and go in with realistic expectations in case you decide to go with these modalities.
In the world of natural medicine, regular massaging of oils rich in Vit.E & A, Vit. C & D and creams rich in actives that reduce inflammation, control factors of inflammation, deliver anti-oxidants, provide deep moisturization and nutrients that will help promote dermal healing and regeneration may prove to be very beneficial.
What can you do at home: Always keep a good quality moisturizer (preferably containing vitamins and anti-oxidants) by your side, since dryness worsens stretch marks. Avoid soaps and body washes that will add to the dryness. Stay healthy and eat a fresh clean diet. Weight management is an important aspect of the home or self-care aspect of stretch marks.
I also suggest Ayurvedic massage. This has consistently shown great benefit for centuries.
It’s better to adopt a more holistic approach since there is no miracle eraser that will wipe them out.
And remember- TREAT THEM EARLY.
Stay Well & Stay Informed
Dr.Ansul N K Cuticonscious
- Rook & Ebling, 3rd Edition
- Roxburgh’s, 15th Edition
- Lasers in Dermatology, S.W.Lanigan
- IPL Applications, Dr.Ansul N K
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