Stretch marks, also known as striae distensae, occur when there is an increase in circulating glucocorticoid hormones in the bloodstream. These hormones produced by the adrenal glands, are increased in Pregnancy, Obesity, Adolescence (growth spurt), Cushing’s Disease, Body Building (as a result of strenuous repetitive exercise) and Rapid Weight Gain and Loss. They may also be caused by the ingestion of oral steroids and the application of steroid creams and ointments. 90 percent of pregnant women develop stretch marks during this period due to the increase in circulating glucocorticoids and other hormones such as Relaxin and Estrogen. The sustained stretching of the abdomen due to weight gain and the expanding uterus cause marks to develop at about the sixth to seventh months. The breasts, buttocks and thighs are also commonly affected.
The skin is comprised of three layers, the Epidermis (protective outer layer), the Dermis (elastic, resilient middle layer) and the Subcutis (subcutaneous layer of fat beneath the dermis that supplies nutrients to the other two layers and that cushions and insulates the body).
Stretch marks occur in the Dermis when circulating glucocorticoids prevent cells known as fibroblasts from producing supportive collagen and elastin fibres required to keep the skin taught. In periods of rapid growth, as the skin is stretched, this lack of support leads to dermal tearing. As a result, the Epidermis becomes thin making the defects in the dermis readily visible. It is now known that Zinc deficiency greatly contributes to the development of stretch marks. Zinc is found in shellfish, lean meat, lentils and spinach.
Depending on your skin colour, stretch marks begin as raised, reddish-brown, dark brown or pink striations that turn purple. Over time, these turn into flattened white bands that appear a few shades lighter than your natural skin tone. If your skin is dark, these colours may not be seen but are present. Stretch marks can appear anywhere on the body where the skin has been stretched and are most likely to appear in skin overlying deposits of fat like the thighs, buttocks, abdomen, breasts and upper arms. They usually become less noticeable over time, pose absolutely no health risk and are purely a cosmetic issue.
The best time to treat is early when the marks are red and raised (striae rubra) to limit the potentially damaging effects. When the marks age, they flatten and become white (striae distensae alba).
The prescription cream Tretinoin 0.1% (Retin-A) works by rebuilding collagen which plumps out the squiggly looking lines, smoothing their appearance. This has to be applied every night for about nine to twelve months to see good results. For best results, this should be used in conjunction with the daily application of a prescription strength alpha-hydroxy acid moisturizer such as Lac-Hydrin.
Tretinoin should not be used in pregnancy or by nursing mothers as the risks far outweigh the benefits.
Non-prescription treatments include Vitamin C preparations such as Cellex-C High Potency Serum that stimulate fibroblasts to produce collagen, Mederma which contains onion juice extract and Regenetrol which has sunflower oil, jojoba oil, horsetail extract and other ingredients that stimulate collagen production. These are safe to use during pregnancy and should be applied for six to twelve months.
These may help reduce the appearance of stretch marks. As the skin tightens, the marks become less noticeable.
Compression Bandages such as the Belly Bandit (available at DermaCare Medical Ltd.) used by pregnant women immediately after delivery helps to reduce the appearance of Abdominal stretch marks while it shrinks and flattens the belly over a period of 8 weeks
The skin is “Sand-blasted” with tiny salt particles that gradually remove scarred and discoloured epidermal tissue. The high pressure of salt particles delivered to the skin also stimulates collagen production. Creams containing glycolic acid and Vitamins C and A are then applied with an ultrasonic device to enhance penetration. A series of seven treatments over several months are recommended.
Treatment with a pulsed dye laser helps to fade stretch marks. Laser responds to dark colours so treatment is best in the early stages when the stretch marks are dark red or brown. This treatment option is NOT recommended for individuals with dark skin tones as there is a high risk of permanent discolouration. It is also not recommended in pregnancy.
Preventing Stretch Marks
There are ways to help prevent stretch marks. Massage your skin with a massage brush or gloves to help improve circulation, apply moisturizing cream daily to keep skin supple, eat foods that improve the overall health of your skin such as those rich in Vitamins C and E, silica and zinc as these promote collagen production.
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