So you’ve recently lost weight! Congratulations, that’s wonderful! Time to break out your new bathing suit and head to the beach. But before you dare to bare your new slimmer physique, you’d love to get rid of the unsightly squiggly lines that have been left behind on your abdomen, thighs and hips.
What are Stretch Marks?
According to MedLine Plus, stretch marks (striae is the medical term) are stripe-like marks that appear on the skin when it is stretched due to rapid weight gain or loss. They are a form of scarring caused by the tearing of the middle layer of skin (known as the dermis), which regulates the skin’s elasticity. When the dermis is stretched too taut, it breaks, developing tiny rips in the fibers and causing the blood vessels located under the skin to show through.
This is why stretch marks appear red, purple, or even pink or brown at first. Eventually, the blood vessels contract, leaving only the underlying fat visible, and the stretch marks fade to streaks of glossy silver or white over time and may become slightly indented. Both men and women can get stretch marks on various locations of their bodies, typically areas where there are larger growths of skin or fat stores, such as the abdominal area, thighs, hips, breasts, upper arms and lower back.
Stretch marks commonly occur during the rapid growth spurts that accompany pregnancy and adolescence. A large number of pregnant women, 70% of teenage women, and 40% of adolescent men develop stretch marks. They are more frequent in women and occur equally in all races, although women with light skin are more susceptible.
However, not everyone gets stretch marks, even those people who gain or lose large amounts of weight. According to Britain’s National Health Service, people who have larger amounts of cortisol (a stress hormone produced by the adrenal glands) may be more prone to developing stretch marks. This is because cortisol decreases the skin’s levels of collagen, a protein that helps keep skin stretchy. It is converted into cortisone, which weakens elastic fibers in the skin.
Stretch Marks and Weight Loss
This is what often happens during rapid or extreme weight loss, worsening the appearance of stretch marks. A loss of more than two pounds per week can cause the body to produce cortisol, disrupting the skin’s collagen production. Less collagen combined with overstretched skin from the former weight increases the chances of getting stretch marks. As the skin begins to recover from the overstretching after weight loss, the loose skin becomes less taut, making stretch marks appear more noticeable and numerous. Yo-yo dieting can particularly cause stretch marks to form as weight quickly goes up and down. It is best to lose weight in a slow and steady manner so skin is not put under stress.
Stretch Marks Treatment
According to the American Society for Dermatologic Surgery, treating stretch marks as early as possible is key. Research has shown that stretch marks best respond to treatment in the beginning stages when they are still purple or red. Once they become white or silver, they are more difficult to treat. Treatment methods for stretch marks are varied and fall into two main categories: topical and surgical. However, there is little medical evidence to support the effectiveness of such treatments.
Topical Prescription Products
Retin-A (tretinoin) or Tazorac gels or creams. These are designed to stimulate collagen in order to improve the appearance of stretch marks over time. However, only pink/purple-tinted marks will fade; grey/white striations are mature and do not respond to treatment. In one study cited in Medical News Today, after six months of treatment, tretinoin reduced the length of stretch marks by 14% and the width by 8%. In another study, a 12-week course decreased the length of stretch marks by 20%. However, it is very important NOT to use these treatments while pregnant or breastfeeding, as they are teratogenic, and can cause congenital defects.
Topical Products Available in Both Over the Counter and Prescription Strength
Cosmetic creams, with ingredients such as alpha hydroxy (acids) are used to lessen the appearance of their stretch marks. They are sold both via prescription and over the counter. These creams may be able to temporarily plump up the skin’s surface, but have not been scientifically proven to permanently remove stretch marks. Glycolic acid is a sugar cane derivative and a member of the alpha hydroxy acid (AHA) family. It most likely works on stretch marks by increasing collagen production, says Leslie Baumann, MD, director of the University of Miami Cosmetic Group and author of The Skin Type Solution. Glycolic acid can also be administered in higher doses by a dermatologist.
Using a combination of glycolic acid and retinoids may provide better results. According to Mohamed L. Elsaie, MD, MBA, a trial comparing glycolic acid and tretinoin with glycolic acid and vitamin C both showed equal improvement and increased elastic in stretch marks after 12 weeks of daily application. Prescription-strength retinoids are often applied prior to a glycolic acid peel in order to prepare the skin.
Silicone gel. In a study of 20 volunteers who applied silicone and placebo gels into separate sides of the abdomen daily for 6 weeks, the application of silicone gel was shown to increase collagen levels and reduce pigmentation compared with a placebo. These findings could provide preliminary evidence of the use of topical gels in the clinical management of stretch marks. Products include Stratamark gel, produced by Stratpharma AG, a Swiss-based company, Kelo-cote and Dermatix, made by Obagi Medical Products, Inc., a division of Valeant Pharmaceuticals. They are available in over-the-counter and prescription strengths.
Over-the-counter products like Lac-Hydrin lotion hydrate the skin to help to reduce the appearance of stretch marks, according to WebMD. Charles E. Crutchfield III, M.D., clinical adjunct associate professor of dermatology at the University of Minnesota Medical School recommends AmLactin, produced by Upsher-Smith Laboratories, Inc. and Merz Pharma’s Mederma (a gel based on an onion extract).
Certain preparations of vitamin C, which have become increasingly popular as over-the-counter products, may increase collagen production and help early-stage stretch marks, says Dr. Baumann. She recommends combining them with glycolic acid for optimum effect. She also says vitamin C supplements may be effective, suggesting 500 milligrams three times a day.
For years, women have often sworn by cocoa butter to help prevent stretch marks during pregnancy. However, in two different studies of 300 and 175 women, application of a cocoa butter containing lotion did not appear to reduce the likelihood of developing stretch marks during pregnancy.
Surgical procedures seem to have the most success in treating stretch marks. Dermatologist and health and beauty expert Dr. Susan Evans, M.D. recommends dermabrasion, laser treatments and fractional laser resurfacing, all which utilize the body’s natural healing process of generating new skin to heal over the removed scar tissue.
Microdermabrasion uses a device that blows crystals onto the skin, “polishing” the skin’s surface. A vacuum tube then sucks up both the crystals and skin cells, gently removing the skin’s top layer, thus stimulating growth of new skin. It has been shown to improve skin contour irregularities, such as early stretch marks. Side effects are less common than topical tretinoin and patients are more likely to adhere to the treatment schedule.
Laser therapies can provide safe and effective reduction in the appearance of both red (early-onset) and white (late-stage) stretch marks. Lasers use wavelengths of light to stimulate growth of collagen, elastin or melanin production in the skin. According to the Cleveland Clinic, the heat from the laser light triggers new elastin production in the deeper layers where the stretch marks are formed, giving skin a tighter and smoother appearance. Pulsed dye lasers have been shown to be effective for early stretch marks, and fractional laser treatment has been found to work best for older stretch marks. Newer stretch marks that are reddish in color may be successfully removed with a single treatment, but those that are older and deeper may require several treatments.
Rapid or excessive weight loss often results in saggy skin; causing people to seek a tummy tuck procedure, which can also be helpful for stretch marks. Tummy tucks cannot correct stretch marks, but they may eliminate or improve their appearance if the marks are located on the area of excess skin to be removed.
Radiofrequency devices use radio waves to heat tissue under the skin, which triggers collagen production, which can fade stretch marks. “As new collagen grows, it plumps up skin so it’s smoother while also increasing elastin, the fibers that keep skin firm,” says M. Christine Lee, M.D., an assistant clinical professor of dermatology at the University of California, San Francisco, and director of the East Bay Laser and Skin Care Center in Walnut Creek, CA. Fotona4D is a procedure that combines several lasers and typically provides the best results, even on older stretch marks. But radiofrequency is not permanent. Once treatments are discontinued, so is the production of collagen. “So you have to redo them every couple of years to maintain the best results,” says Lee.
There is not much scientific data on whether home remedies for stretch marks, such as wheat germ oil, are effective. One recent study did find it helped improve stretch marks in their early phase. A different study testing the application of olive oil in the second trimester of pregnancy did not appear to reduce the likelihood of developing stretch marks.
Another study to see whether applying bitter almond oil would prevent stretch marks during pregnancy found that a 15-minute massage applied with almond oil during pregnancy reduced the development of stretch marks. However, using bitter almond oil without massage did not reduce the development of stretch marks, leading the authors to conclude that pregnant women should be made aware of the positive effects of massaging almond oil early on in pregnancy.
Avoid These Products
Peptide-containing products, widely marketed as effective “repair” creams, are a waste of time and money, Dr. Baumann says. Despite commercial claims, there is no convincing data that these work. The American Society for Dermatologic Surgery agrees, cautioning that there is no convincing evidence that creams and ointments containing peptides work to treat stretch marks.
Losing weight has numerous health benefits, but unfortunately it will not make stretch marks disappear, and may even make them worse. However, it is reassuring to know that stretch marks typically fade, becoming less noticeable over time, and most do not require any specific self-care or home therapy. Any concerns are best addressed with a doctor, who can recommend the best course of action. Catching them while in the early stages is key to the most effective treatment results.
It is helpful to keep in mind that many creams, ointments and other products claim to prevent or treat stretch marks, but their effectiveness is not backed by strong evidence. Products made of cocoa butter, vitamin E and glycolic acid, for example, aren’t harmful, but they probably won’t help much either. If you’re pregnant, check with your doctor before using alternative products that claim to treat or prevent stretch marks.