Stretch marks

Stretch marks are small scars that appear when the skin stretches rapidly and the collagen and elastin fibres of the dermis partially break.

They are a very frequent and completely benign alteration. They can affect both women and men and appear at any stage of life.

Although they do not represent a health problem, many people consult because of the aesthetic impact they produce.

There are currently treatments that make it possible to improve their appearance, although it is not possible to eliminate them completely.

Stretch marks develop when the skin stretches faster than it can adapt. The most frequent factors are:

• Rapid growth during adolescence.
• Pregnancy.
• Significant weight gain.
• Rapid weight loss.
• Intense development of the musculature.
• Prolonged treatments with corticosteroids.
• Some endocrine diseases, such as Cushing's syndrome.
• Genetic predisposition.

Not all people develop stretch marks under the same circumstances, since there is an important hereditary component.

Stretch marks change in appearance over time.

Red stretch marks (striae rubrae). They correspond to the initial phase. They are characterised by a red or purplish colour, slight relief and a better response to treatments.

White stretch marks (striae albae). With the passage of months or years, the stretch marks become white or pearly, thinner and slightly depressed. They represent an already established scar and are more difficult to treat.

The most usual locations are:

• Abdomen.
• Hips.
• Thighs.
• Buttocks.
• Chest.
• Arms.
• Lumbar area.

In men they are also frequent on the shoulders and back after a significant increase in muscle mass.

The risk increases in people with a family history, rapid weight changes, pregnancy, puberty, treatments with corticosteroids or accelerated growth.

The diagnosis is clinical. During the consultation, the age, the colour, the location, the width, the depth, the quality of the skin and the possible triggering causes are assessed.

In some cases additional studies may be requested if a hormonal disease is suspected.

The treatment depends on the type of stretch mark and its age. Recent stretch marks respond better than old ones.

Topical retinoids. In certain people they can favour the production of collagen in recent stretch marks. They must not be used during pregnancy.

Microneedling. The microneedles stimulate the formation of new collagen and progressively improve the texture, the width and the appearance of the stretch marks. It is one of the most used treatments.

Fractional lasers. Fractional lasers, such as CO₂ or some non-ablative lasers, stimulate collagen remodelling and improve the appearance of stretch marks. Several sessions are usually required.

Microneedling radiofrequency. It can stimulate the production of collagen and improve the quality of the skin in selected patients.

Biostimulation. Collagen biostimulators can complement other treatments by favouring tissue regeneration.

PRP (Platelet-Rich Plasma). In some cases it can be used as a complementary treatment to favour skin repair.

The objective of the treatment is to reduce visibility, improve texture, reduce width, match the colour with the surrounding skin and achieve more uniform skin.

The improvement is usually progressive and depends on the type of stretch mark.

Not always. However, some measures can reduce the risk: maintaining a stable weight, avoiding abrupt weight gains and losses, maintaining good skin hydration, following a balanced diet, adequately controlling hormonal diseases and using corticosteroids only under medical supervision.

During pregnancy, preventive measures may be recommended, although none guarantees to completely avoid stretch marks.

It is advisable to consult when the stretch marks appear very rapidly, are very extensive, are accompanied by other hormonal symptoms, you want to improve their appearance or you have doubts about the most appropriate treatment.

• Myth: Creams eliminate stretch marks. Fact: Creams can improve hydration and, in some cases, recent stretch marks, but they do not eliminate established stretch marks.
• Myth: Stretch marks appear only during pregnancy. Fact: They are also frequent during adolescence, rapid growth and significant weight changes.
• Myth: Drinking a lot of water prevents stretch marks. Fact: Maintaining good hydration is healthy, but it does not by itself prevent the appearance of stretch marks.
• Myth: Stretch marks disappear over time. Fact: Over the years they usually become less visible, but they remain as permanent scars.
• Myth: Only women have stretch marks. Fact: Men can also develop them, especially during growth or the increase in muscle mass.

• Stretch marks are small scars produced by the rapid stretching of the skin.
• Red stretch marks respond better to treatment than white ones.
• They cannot be eliminated completely, but they can improve significantly.
• Microneedling and fractional lasers are among the most effective treatments.
• Maintaining a stable weight can help reduce the risk of appearance.
• Early treatment offers better results.