Stretch Marks

Patient Expert

I have stretch marks on my thighs and stomach. How do I get rid of them? I've read about creams that can make them go away but they're very expensive. Is it worth it?

Stretch marks are medically known as striae distensae. They occur more often in women-although men can develop them as well-and they appear on many areas of the body including the abdomen, the hips, breasts, arms, and thighs.

Although we use the term "stretch" marks, it's not the action of stretching our muscles that causes them. Stretch marks are actually created when the level of glucocorticoids, a type of steroid hormone secreted by the adrenal glands, rise in the bloodstream during periods of intense hormonal change. Puberty, pregnancy, obesity, and rapid muscle gain can all cause glucocorticoid levels to elevate.

When these hormones rise in the bloodstream, they prevent the dermis from forming collagen and elastin fibers, leading to a decrease in elasticity and a thinner support structure for skin. During any of the stages listed above, your skin "stretches" according to the way your body develops. Without sufficient collagen and elastin, dermal tears occur and flatten the epidermis, leaving surface marks that are dark and red in appearance. As the tears heal, the collagen fibers do not align properly. In the end, your skin is left with an uneven appearance and white striated marks.

So how do you prevent them? Despite the claim that applying cocoa butter will keep skin smooth throughout pregnancy, there have been no scientific studies proving that cocoa butter is the ingredient that does the trick. A few studies claim that massaging any cream into the skin on a daily basis leads to fewer stretch marks during pregnancy as opposed to no treatment at all. However, no cream can prevent stretch marks completely.

Once you notice stretch marks, take action as soon as possible. It's easiest to fade stretch marks when they're red and haven't healed. Research suggests that topical applications of tretinoin (commonly found in prescription anti-acne and anti-aging medications such as Retin-A) can help improve the appearance of stretch marks. Tretinoin has shown some success in stimulating fibroblasts to produce collagen and elastin, resulting in more skin support. Unfortunately, tretinoin is not recommended for pregnant women or women who are breastfeeding. A safer option is to try Mederma, an over-the-counter scar fading ointment.

Another option is a chemical peel such as a trichloroacetic acid (TCA) peel. TCA is similar to AHAs, but a TCA peel will get deeper into the skin and deliver a more intense skin-tightening effect. This kind of peel should only be performed by a dermatologist or cosmetic surgeon.

If you're still not getting the kind of results you want or your stretch marks have already faded to white, consult with your dermatologist about non-ablative lasers. These lasers can also help increase the production of collagen and elastin and demonstrate some success in reducing the appearance of stretch marks. The downside? Laser therapy is not recommended for those with darker skin since it may lead to hyperpigmentation. In addition, it's costly. You need at least three sessions in order to see improvement and the price tag may be upwards of $2,500.

On a final note, don't buy into the hype surrounding stretch mark creams. As I mentioned earlier, no cream can truly prevent or treat stretch marks. If an over-the-counter product claims that it can, it's making promises it can't deliver. Speak with your dermatologist and discuss the options you have that will actually make a positive difference.