In our previous blog posts we’ve explored dermatological issues like hirsutism and skin growths. In this blog post we deep dive into the issue of stretch marks.

Stretch marks are dermal scars caused by tearing of the dermis due to rapid distension or stretching of the skin. Stretch marks, or striae distensae, happens due to rapid fluctuations in weight or due to hormonal changes occurring during pregnancy or puberty. Once formed, stretch marks may gradually diminish in size, but they are not known to disappear completely.

Prevalence:

  • Stretch marks are a common concern and can occur in anyone. Although, they have a strong female predilection and are seen in 40-90% of women, owing to hormonal factors.
  • They can occur at any age, when there is distension of skin, due to weight fluctuations, particularly a gain in weight. Sometimes, they can also occur due to rapid and quick weight loss.
  • They are occur most commonly during pregnancy and puberty, which are associated with hormonal changes, thus, occurring in about 40-90% of pregnant women (striae gravidarum) and 70% of girls during puberty.
  • In men, they occur due to rapid weight gain, owing to obesity or as a result of excessive weight lifting regimen in order to increase muscle mass rapidly, like in body-builders.

Appearance, stages and symptoms:

  • They appear as reddish-purple, long, narrow and smooth streaks or bands, occurring particularly in the areas of body with excessive fat storage like, belly, buttocks, thighs, breasts, upper arm, under arms and back.
  • They arise in the dermis layer of the skin.
  • Gradually, the stretch marks begin to atrophy and lose their reddish-purple hue, fading down to whitish, pale or silver-coloured lines, which are soft and empty upon touch.
  • They visibly differ in appearance from the surrounding skin, and are thus an aesthetic concern for most people, causing emotional distress, especially in young women. However, they do not pose any medical threat to the person, and are completely asymptomatic. Though, they can sometimes cause an itching (or burning ) omit sensation, in some people.

Causes:

  1.   Weight gain-
  • The primary reason for stretch marks is tearing of the dermis due to distension of skin, caused due to weight fluctuations and an increase in cortisone levels, which occurs in response to stress.
  • Higher cortisone levels are known to worsen the gravity of stretch marks by reducing the skin’s pliability. This occurs due to inability of fibroblasts to form collagen and elastic fibres, which help in maintaining the skin’s firmness. Thus, lack of supporting structures of skin, leads to dermal and epidermal tearing, which eventually leads to scarring.
  1.   Pregnancy-
  • In pregnancy, 50-90% of women are affected with striae gravidum due to sudden weight gain and hormonal changes. The more the weight gain and increase in BMI during pregnancy, the more is the risk of developing stretch marks. Higher neonatal birth weight also contributes to the same.
  • Striae gravidum develop due to tearing of the dermis, when estrogen and relaxin hormones combine with higher cortisol levels during pregnancy.
  • This softens the pelvic ligaments, making them flexible, which causes atrophy and loss of rete ridges, particularly in rapidly growing areas during pregnancy, like abdomen and breasts.
  • They are more common in first pregnancies and in women with lower maternal age.
  1.   Puberty-

In puberty, the body goes through a lot of hormonal changes and rapid growth spurts, leading to the appearance of striae, which occur on breasts, hips and thighs for females, and shoulders and back in case of males.

  1.   Genetic  factors-

Genetic  factors like genes, race, family history are also determinants in the appearance of striae.

  1.   Medical Conditions-
  • Certain medical and hormonal disorders, like Cushing’s Syndrome or Marfan Syndrome are also known to cause stretch marks.
  • In Cushing’s Syndrome, there is over-production of cortisol, leading to rapid weight gain, especially in abdomen, causing stretch marks to appear in that area. It also causes the skin to become thin and fragile, which makes it more susceptible to scarring.
  • In Marfan Syndrome, there is weakness and decreased elasticity of body tissues, which has the same effects.
  1.   Certain Medications-

Prolonged usage of topical corticosteroid creams and lotions decreases collagen levels of the skin, leading to thinness of skin and a greater risk of developing stretch marks.

Diagnosis:

Stretch marks are easily diagnosed upon the observing the skin of the affected area. A history of weight gain or weight loss, or pregnancy makes the diagnosis clear.

Stretch marks do not cause any medical threat, but they may sometimes be associated with an underlying medical disorder, like, Cushing’s Syndrome or Marfan Syndrome, which must be identified and treated first. It is always best to consult a dermatologist for stretch marks.

Prevention and Treatment:

  • Stretch marks are not hazardous to health in any ways but the disfiguring scar is a cosmetic concern, which may cause emotional distress and depression, especially in women. Stretch marks must be taken care of and treated in such cases.
  • Stretch marks often fade away and diminish with time, though they do not completely disappear.
  • When associated with pregnancy, they diminish 6-12 months postpartum. Chances of developing stretch marks during pregnancy can be reduced by taking proper care of the skin during this period. 8-12 glasses of water must be consumed and anti-stretch marks oils and creams must be massaged into the skin, to keep it healthy and moisturised which prevents the development of stretch marks.
  • Almond oil, Tretinoin topical retinoid creams cream and Silicone gel are known to improve the disfiguring appearance of stretch marks.
  • Generally, consuming enough water and maintaining a healthy weight, along with a balanced diet is effective in preventing the appearance of stretch marks. Keeping the skin healthy and hydrated, and avoiding fad diets is also equally helpful.
  • Ointments, creams and gels are available for stretch marks shrinkage, which can be prescribed by the dermatologist.
  •  Surgical procedural methods, which include microdermabrasion and laser therapy, and radiofrequency for the removal reduction of stretch marks, are also known.

A dermatologist through Remedico will be able to identify the cause for your stretch marks as well as provide you with a personalized treatment plan to reduce your stretch marks. It’s important to note that you should never self-medicate – only take medical treatment for your stretch marks that has been prescribed by a dermatologist.

With Remedico, you can consult with a certified dermatologist for your stretch marks from wherever you are, from your smartphone. We will send you a personalised treatment plan within 24 hours.

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