Motherhood can bring unparalleled joy and love to your life. It may also bring some unwanted changes to your appearance such as stretch marks. Stretch marks, while harmless, can cause considerable distress.

What are stretch marks and what can you do about them?

Stretch marks, technically known as striae, are tears in the dermis, which is the layer of skin just deep to the surface. They form when the skin is stretched. Stretch marks typically appear during periods of rapid growth, such as in puberty and in pregnancy. Certain medications such as steroids, both topical and systemic, can also increase the likelihood of developing stretch marks.

Stretch marks are essentially scars. They may appear purple or blue at first, then fade into colorless streaks over time. Like other scars, stretch marks look less noticeable over time, but they never completely disappear.

Why pregnancy?

Up to 90% of women will develop striae during pregnancy. Stretch marks that appear on the abdomen during pregnancy are known as striae gravidarum. Like other stretch marks, striae gravidarum form when the abdominal skin stretches rapidly causing the underlying dermis to tear.

Studies have shown that younger women, particularly teenagers, who have large babies and gain over 33 pounds during pregnancy are at the highest risk for developing striae gravidarum.

What can be done to prevent these unwanted blemishes?

Unfortunately, no topical cream or oil is effective in preventing striae. In fact, women who apply creams during pregnancy in an effort to prevent stretch marks should be particularly careful that the ingredients are safe for the fetus. Creams and lotions may sooth itchy, tight skin during pregnancy, but will not prevent stretch marks from forming.

What are the treatment options?

Similarly, once striae are present, removing them completely is challenging. Time fades the pigment within the stretch marks and helps them look less conspicuous. Topical retinoids may improve their appearance and improve the quality of the skin, but will not completely erase them. Other treatments such as lasers, glycolic acid and microdermabrasion also have been attempted as methods of removing stretch marks, all with limited success.

As with other scars, the only definitive way of completely eliminating stretch marks is to excise them. One way of removing striae gravidarum is through abdominoplasty, or tummy tuck surgery. With this procedure, the excess skin from pregnancy, along with the accompanying stretch marks, are removed, leaving the abdomen smooth and tight. While it leaves a scar of its own behind, many women find the surgical scar easier to conceal than their stretch marks, and happily trade the tummy tuck scar for the overall improved appearance.

Stretch marks are not dangerous, but they do cause many women to feel less confident about their appearance. In these cases, it’s worth seeking out the advice of a physician to see if removing them is possible. If not, we can learn to accept these scars as part of our life story.

References & Further Reading

1. WebMD: http://www.webmd.com/baby/features/stretch-marks#1
2. Brennan M, Young G, Devane D. Topical preparations for preventing stretch marks in pregnancy. Cochrane Database Syst Rev. 2012;11:CD000066.
3. Atwal GSS, Manku LK; Griffiths CEM, Polson DW. Striae gravidarum in primiparae. British J Derm. 2006;155(5): 965–9.
4. Al-Himdani S, Ud-Din S, Gilmore S, Bayat A. Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. British J Derm. 2014;170 (3): 527–47.

By Drs. Jennifer Weintraub and Angeline Lim - Expert Plastic Surgeons
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