Stretch marks

Stretch marks

Scarring of the skin due to rapid stretching

Stretch Marks
Stretch marks on the abdomen.
Synonyms	Striae, striae distensae, striae gravidarum (pregnancy-related)
Pronounce	N/A
Field	Dermatology
Symptoms	Off-color linear streaks on the skin, itching or burning sensation in some cases
Complications	Psychological distress, cosmetic concerns
Onset	Gradual, often during periods of rapid growth or hormonal changes
Duration	Can fade over time but do not completely disappear
Types	N/A
Causes	Rapid skin stretching, hormonal changes, pregnancy, obesity, weight gain, puberty, corticosteroid use, genetic factors
Risks	Pregnancy, adolescence, obesity, rapid weight changes, genetic predisposition
Diagnosis	Clinical examination
Differential diagnosis	Atrophic scars, dermal fibrosis, linear scleroderma
Prevention	Limited evidence; some topical treatments may reduce risk
Treatment	Laser therapy, microdermabrasion, topical retinoids, chemical peels
Medication	Tretinoin, hyaluronic acid, glycolic acid
Prognosis	Benign; usually fade but do not disappear completely
Frequency	Common (affects 50–90% of pregnant women, adolescents, and individuals with rapid weight changes)
Deaths	N/A

Stretch marks, medically known as striae, are a form of scarring that appears on the skin when it undergoes rapid stretching. These marks often have an off-color hue, initially appearing reddish, purplish, or pink, and gradually fading to a lighter shade over time. While they are harmless and pose no health risks, they can cause cosmetic concerns and psychological distress.

Stretch marks commonly occur during puberty, pregnancy, rapid weight gain or loss, bodybuilding, and certain medical conditions. In pregnancy, they are referred to as striae gravidarum. These marks are most frequently found on the abdomen, breasts, thighs, hips, lower back, and buttocks.

Signs and Symptoms

Stretch marks vary in appearance depending on their age, location, and cause. The common features include:

• Initial phase – Reddish, purplish, or pink streaks that may be itchy or have a slight burning sensation.
• Later stage – The marks fade to a lighter, almost silvery or white color with a slightly sunken texture.
• Common locations – Abdomen, breasts, thighs, hips, buttocks, upper arms, and lower back.
• Texture – May feel slightly raised in the early stages and become flattened over time.

Causes and Risk Factors

Stretch marks are caused by the tearing of the dermis, the skin's middle layer, due to rapid expansion or contraction. This process disrupts collagen and elastin fibers, leading to scarring.

Common Causes

• Pregnancy – Expansion of the abdomen and hormonal changes contribute to striae gravidarum.
• Puberty – Rapid growth spurts can cause stretch marks, particularly on the thighs, hips, and breasts.
• Rapid weight gain or loss – Sudden changes in body size stretch the skin beyond its elastic capacity.
• Bodybuilding – Quick muscle growth can lead to skin tearing, particularly in the shoulders and arms.
• Hormonal changes – Increased levels of cortisol can weaken skin elasticity.
• Corticosteroid use – Long-term use of steroid creams, lotions, or pills can reduce skin elasticity.
• Genetic predisposition – A family history of stretch marks increases the likelihood of developing them.

Medical Conditions Linked to Stretch Marks Some medical conditions can make individuals more prone to developing stretch marks:

• Cushing’s syndrome – High cortisol levels cause excessive skin stretching.
• Marfan syndrome – A connective tissue disorder affecting skin elasticity.
• Ehlers-Danlos syndrome – A genetic condition that weakens collagen production.

Diagnosis

Stretch marks are diagnosed clinically through visual examination. In most cases, additional testing is not required unless an underlying condition is suspected.

Prevention

There is limited evidence that topical treatments effectively prevent stretch marks. However, some measures may help reduce their severity:

• Maintaining a stable weight – Avoiding rapid weight gain or loss may prevent excessive skin stretching.
• Hydration and a balanced diet – Keeping the skin moisturized and consuming a nutrient-rich diet with vitamins A, C, E, and zinc may support skin health.
• Regular exercise – Helps maintain skin elasticity and promotes healthy blood circulation.
• Topical applications – Some lotions containing hyaluronic acid, cocoa butter, and vitamin E claim to help, though scientific support is limited.

Treatment

There is no universally effective treatment to completely remove stretch marks. However, some options can reduce their appearance:

Topical Treatments

• Tretinoin (Retin-A) – A topical retinoid that may stimulate collagen production and improve early-stage stretch marks.
• Hyaluronic acid – May promote skin hydration and elasticity.
• Glycolic acid – An exfoliant that can improve skin texture and appearance.

Procedural Treatments

• Laser therapy – Stimulates collagen production and helps reduce discoloration.
• Microdermabrasion – Removes the top layer of skin to improve skin texture.
• Chemical peels – Use acids to exfoliate and regenerate the skin.
• Carboxytherapy – Involves injecting carbon dioxide under the skin to stimulate circulation (limited evidence for effectiveness).

Pregnancy-Related Stretch Marks (Striae Gravidarum)

During pregnancy, up to 90% of women develop stretch marks due to hormonal changes and skin stretching.

Factors that increase the likelihood of striae gravidarum:

• Younger maternal age
• Genetic predisposition
• Higher birth weight of the baby
• Excessive weight gain during pregnancy

Despite numerous marketed creams and oils, no treatment has been definitively proven to prevent pregnancy-related stretch marks.

History and Cultural Significance

Throughout history, various cultures have developed remedies to prevent or treat stretch marks:

• Ancient Greece and Rome – Used olive oil for skin hydration.
• African and Middle Eastern cultures – Applied frankincense and shea butter.
• Modern skincare – Includes a wide range of commercial products with mixed results.

Gallery

• 

  Striae gravidarum in a pregnant woman at 38 weeks.

• 

  Stretch marks from pregnancy >1 year postpartum.

• 

  Normal stretch marks in a teenage male

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  Stretch marks in a female breast

• 

  Striae distensae on an obese male

See Also

• Skin elasticity
• Scarring
• Pregnancy-related skin conditions
• Dermatology
• Connective tissue disorders

External Links

• Mayo Clinic – Stretch Marks
• American Academy of Dermatology – Stretch Marks

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