Stretch marks or striae (singular stria), as they are called in dermatology, are a form of scarring on the skin with an off-color hue. They are caused by tearing of the dermis, and over time can diminish but not disappear completely.

Stretch marks are often the result of the rapid stretching of the skin associated with rapid growth (common in puberty) or weight gain (e.g. pregnancy or muscle building) or in some cases, severe pulling force on skin that overcomes the dermis's elasticity. Stretch marks may also be influenced by hormonal changes associated with puberty, pregnancy, muscle building, hormone replacement therapy for transsexuals, etc. Medical terminology for these kinds of markings includes striae atrophicae, vergetures, stria distensae, striae cutis distensae, striae gravidarum (in cases where it is caused by pregnancy), lineae atrophicae, striae distensae, linea albicante, or simply striae. (Via Wikipedia)

Symptoms and signs

They first appear as reddish or purple lines, but tend to gradually fade to a lighter range. The affected areas appear empty and are soft to the touch.

Stretch marks occur in the dermis, the resilient middle layer that helps the skin retain its shape. No stretch marks will form as long as there is support within the dermis. Stretching plays more of a role in where the marks occur and in what direction they run. Stretching alone is not the cause.

Stretch marks can appear anywhere on the body, but are most likely to appear in places where larger amounts of fat are stored. Most common places are the abdomen (especially near the navel), breasts, upper arms, underarms, thighs (both inner and outer), hips, and buttocks. They pose no health risk in and of themselves, and do not compromise the body's ability to function normally and repair itself.

Causes

The glucocorticoid hormones responsible for the development of stretch marks affect the epidermis by preventing the fibroblasts from forming collagen and elastin fibers, necessary to keep rapidly growing skin taut. This creates a lack of supportive material, as the skin is stretched and leads to dermal and epidermal tearing. If the epidermis and the dermis has been penetrated, laser will not remove the stretch marks.

Skin subjected to more stretching force than it can handle will tear. Hormonal changes and genetics influence the skin's capacity to withstand stretching forces, as do diet and [possibly] exercise.

Prevention and removal

Between 75% and 90% of women develop stretch marks to some degree during pregnancy. The sustained hormonal levels as a result of pregnancy usually means stretch marks may appear during the sixth or seventh month, primarily during the 3rd trimester, as that is when skin tends to be subjected to higher levels of stretching forces.

Only one randomized controlled study has been published which claimed to test whether oils or creams prevent the development of stretch marks. This study found a daily application of a cream containing Gotu Kola extract, vitamin E, and collagen hydrolysates was associated with fewer stretch marks during pregnancy. Another study, though lacking a placebo control, examined a cream (Verum) containing vitamin E, panthenol, hyaluronic acid, elastin and menthol. It was associated with fewer stretch marks during pregnancy versus no treatment.

Though cocoa butter is an effective moisturizer, no research studies have shown its ability to either prevent stretchmarks, or to reduce their appearance once a stretch mark has already formed.

Various treatments are available for the purpose of improving the appearance of existing stretch marks, including laser treatments, dermabrasion, and prescription retinoids. Some cream manufacturers claim the best results are achieved on recent stretch marks; however, few studies exist to support these claims.

A study in the journal Dermatologic Surgery showed that radiofrequency combined with 585-nm pulsed dye laser treatment gave "good and very good" subjective improvement in stretch marks in 33 of 37 patients, although further studies would be required to follow up on these results. In addition, the use of a pulsed dye laser was shown to increase pigmentation in darker skinned individuals with repeated treatments.

A surgical procedure for removing lower abdominal stretch marks is the tummy tuck, which removes the skin below the navel where stretch marks frequently occur.

A new modality, fractional laser resurfacing, offers a novel approach to treating striae. Using scattered pulses of light only a fraction of the scar is zapped by the laser over the course of several treatments. This creates microscopic wounds. The body responds to each treatment by producing new collagen and epithelium. In a 2007 clinical trial, 5-6 treatments resulted in striae improving by as much as 75 percent. A 2007 Brazilian clinical study showed that fractional laser resurfacing improved both texture and appearance of mature, white striae in skin types I-IV.

A recent study of new modality for the treatment of stretch mark published in the Journal of Dermatological Treatment. The study entitled “Treatment of striae distensae with a TriPollar radiofrequency device: A pilot study" by Dr. Manuskiatti et al. - See full article was done on seventeen females with stretch marks that underwent six weekly treatments. Results showed that at one week after the final (sixth) treatment 38.2% and 11.8% of the patients were assessed to have 25-50% and 51-75% improvement in the appearance of their stretch marks, respectively. The long term effect of the treatment was confirmed during the 6 weeks follow up which showed that a higher percentage of the patients were rated to have improvement of their stretch marks, including 26.5% and 5.9% showing 51-75% and >75% improvement, respectively. None of the participants was rated as having no improvement in their clinical appearance of stretch marks. Patient satisfaction was also measured and 65% of patients reported that they were very satisfied with the treatment, 23% were satisfied and 12% were slightly satisfied.

Home Remedies to Remove Stretch Marks

* Time – Stretch marks, like all types of scarring fade over time.

* Retin-A (Tretinoin) – 0.1% Tretinoin creams have been shown to significantly reduce the appearance of stretch marks in a study published in the May 1996 Archives of Dermatology. See your doctor for a prescription. These creams work best when used on fresh stretch marks. WARNING: Do not use tretinoin treatments if you are pregnant of breast feeding as the active ingredient may be passed to the unborn child or the breast milk.

 * Exfoliate daily – use a loofah or scrunchy to remove daily.

* Vic’s Vapor Rub – Many people have reported success using Vic’s Vapor rub by applying it to a washcloth or paper towel and rubbing it forcefully into the scarred skin on a nightly basis for a few weeks.

* Increase Circulation – by taking hot baths and massaging the areas regularly.

* Tanning – Go sunbathing! Tanning can diminish and even eliminate minor stretch marks. Be sure to use sun screen.

* Vitamin E Gel – Break open vitamin E capsules and rub the oil into the skin over the stretch marks daily for 2 weeks.

* Unstretch the skin – After the skin returns to its normal, unstretched size, stretch marks often become nearly invisible.

 * Stretch Mark Creams and Lotions – Using stretch mark creams and stretch mark lotions that heal and beautify your skin can reduce the appearance of stretch marks. The following ingredients are widely accepted as beneficial for this purpose:

• Cocoa butter
• Rose hip oil
• Emu oil
• Jojoba oil
• Castor oil
• Shea butter
• Vitamin A
• Vitamin E
• Vitamin C

Medical Procedures for Stretch Marks

Surgery

Surgery is a possible stretch marks treatment. Unlike many other stretch mark treatments, surgery will permanently remove stretch marks.

A tummy tuck is the usual surgical method employed. As a result of pregnancy, many women have stomach muscles that have been over stretched and many have a lot of loose skin in the abdominal area. Along with this loose skin are stretch marks that are usually present below the belly button. A tummy tuck removes the loose skin and underlying fat and tightens the stomach muscles. Since the excess skin is removed, all the stretch marks residing on that skin are also removed. The result is a flat, tight, smooth abdominal area with no stretch marks. However, due to the surgical procedure, scars around the belly button and across the lower abdomen will be present.

A tummy tuck is a full blown surgical procedure with a recovery time of several weeks. The skin in the abdominal area may loose its sensitivity. In addition, minor touch-ups may be required after the initial surgery. As with all surgical procedures there are risks of infections and other complications.

Other less severe surgical stretch mark treatments such as microdermabrasion and chemical peels can be used to reduce the appearance of stretch marks. These methods strip away the surface of the skin and the new skin that grows is softer, smoother, and more flexible.

Laser Surgery

Laser surgery is a possible stretch marks treatment. However, there is disagreement as to the effectiveness of such a treatment.

Generally, it is accepted that the laser will fade the marks, making them less noticeable. This type of stretch mark treatment is really only intended for coloured stretch marks or those in the early stages. The coloured stretch marks absorb the laser light leading to a sealing of the blood vessels responsible for the colour.

Many believe that stretch marks can be removed with laser treatment. However, lasers do not generally repair torn tissues such as those responsible for stretch marks. Many plastic surgeons agree that lasers are ineffective in making stretch marks completely disappear.

On the other hand, some believe that lasers will remove stretch marks because the laser stimulates the production of collagen underneath the marks. As the collagen content increases, the damaged and missing collagen is replaced. Therefore, the skin plumps up from underneath and this fills in the stretch mark. Lasers may also stimulate the production of an individual’s pigment producing cells, which will reduce the visibility of older stretch marks that are lighter in colour than the rest of the skin.

Laser treatments require little or no recovery time.

Endermologie

This stretch marks treatment involves the use of a motorized machine and was developed in France several years ago. The machine uses rollers and gentle suction to deeply massage the areas affected by stretch marks. The purpose of this process is to:

• expel toxins and abnormal water build up to reduce skin stretching
  
• increase blood and lymphatic flow for better elimination of toxins and water
  
• exfoliate the skin thereby making stretch marks less noticeable
  
• stimulate the production of skin collagen to fill in the marks
  
• facilitate the metabolism of fat which leads to a decrease in the stretching of the skin
  

The procedure is non-surgical and non-invasive. The skin gently folds and unfolds under the action of the suction and rollers. This allows the therapy to occur deep in the skin matrix. Several thirty-minute sessions are required in order for any beneficial results to become visible. Endermologie is also primarily used to eliminate cellulite. As with the laser stretch mark treatment, there is some controversy as to whether endermologie does provide acceptable benefits.