Stretch Marks the Spot

What causes stretch marks, how to prevent them and what to do about them

By Anna Sachse
CTW Features

Angry red, purple or pink squiggles that typically show up over hip bones, on thighs and underarms, or across bellies, breasts and bottoms, and then fade to a white or silvery hue, often with deep indentations – these are a common skin condition called “striae” – better known as stretch marks.

Stretch marks occur when there is rapid expansion of the skin due to puberty-related growth spurts, pregnancy, rapid weight gain or loss, and bodybuilding, as well as some medical conditions such as Cushings syndrome, says Dr. Mary Sheu, an assistant professor and associate residency director in the Department of Dermatology at Johns Hopkins School of Medicine, Baltimore, Md. “If the expansion occurs more quickly than the skin can accommodate, small tears occur in the dermis, which is the collagen layer of the skin,” Sheu explains. “Additionally, prolonged stretching of the skin may cause release of inflammatory chemicals that cause breakdown of collagen and elastic tissues.”

Natural hormonal shifts and genetic factors (if your parents were prone to them, you probably are too) also play a role in producing these occasionally wrinkled scars. And certain medications, especially steroid creams and oral steroids, if used for long periods of time, can increase the risk of stretch marks, Sheu says.

Although there’s no way to guarantee you won’t get them during the teenage years or pregnancy when you have little to no control over your expanding body and hormones, the best general solution for bypassing stretch marks is to avoid gaining weight too quickly, says Dr. Joel Schlessinger, an Omaha-based dermatologist and cosmetic surgeon, and president of LovelySkin.com. This advice also applies to rapidly packing on pounds of muscle; however, the average exerciser need not worry, and keep in mind that staying active will help you prevent packing on pounds of fat. If you’re planning to have a baby, Schlessinger advises eating a nutritious, balanced diet and exercising before, during and after to promote weight gain (and loss) that’s healthy and gradual.

There is also anecdotal evidence that keeping the skin moisturized can help prevent stretch marks, but it hasn’t been scientifically proven in controlled studies, Sheu says. “Nonetheless, I recommend that my pregnant patients and teenage patients who are genetically prone to them keep their skin moisturized.” No need to spend a fortune on fancy potions – simply look for a product that will help keep the skin hydrated and thus arguably more pliant and able to stretch.

Once stretch marks are in place, there’s no way to get rid of them for good, but you can take steps to minimize their appearance. Topical retinoids (Retin A and the generic equivalent, tretinoin, along with tazarotene and adapalene) can help to reduce the appearance of red stretch marks, Sheu says, but note that they are not as helpful once the stretch marks have turned silvery white. (Pregnant women should consult their doctor before using topical retinoids, as the oral variety has been shown to cause birth defects.) For the initial phase, Schlessinger also frequently works with Intense Pulsed Light to improve the redness of stretch marks, and Sheu recommends Pulsed Dye Laser treatments. Fractionated ablative and fractionated non-ablative lasers can help to reduce the appearance of red and silvery white stretch marks, Sheu adds. “The best results are seen with multiple sessions.”

For a quicker and less expensive fix, try “covering” your stretch marks with an over-the-counter sunless tanning lotion or spray, or a professional faux tanning session at a salon. But skip the actual sunbathing, as stretch marks themselves are less likely to tan and can end up looking more prominent, and the ultraviolet rays can further damage your skin. If you’re not interested in a golden glow, you can also purchase a concealer that matches your skin tone to make the marks all but invisible.

And, of course, you can choose to see your stretch marks as a badge of honor, battle scar or a probable fact of life, and simply let them fade.

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