Stretch marks usually appear around the butt, chest, stomach, and inner thighs. They can appear in both men and women, and have many causes.
The good thing is that although stretch marks are seen as an aesthetic flaw, they pose no health risks to you and are merely scars. So, do not worry!
This article will help you understand what stretch marks are, what causes them, and what you can do about their appearance.
What are stretch marks?
Stretch marks are long scars with underlying thinning of the skin, known as epidermal atrophy, which occurs when the skin is continuously stretched.
When your skin expands or shrinks rapidly, such as during pregnancy or muscular hypertrophy, the abrupt changes trigger a breaking up of the collagen and elastin that sustain our skin.
Like other types of scars, stretch marks may appear as the skin heals. When stretch marks first emerge, they tend to be red, purple, yellow, reddish-brown or dark brown, depending on your skin colour.
Stretch marks can fade with time; however, there are treatments to make them less noticeable more quickly.
Like any scar, stretch marks are permanent, but their treatment may make them less noticeable and can also help relieve the itch .
What do stretch marks look and feel like?
Early stretch marks may feel very raised, accompanied by some itchiness.
In time, the colour fades and the narrow bands sink under your skin. They may then appear colourless or silvery.
If you run your finger over a mature stretch mark, you often feel a slight depression.
Common causes of stretch marks
As stretch marks are scars that form when your skin cannot stretch or shrink fast enough and/or sufficiently, some common causes include:
- growth spurts that happen during puberty
- rapid weight loss or gain
- rapid muscle growth (e.g. from weight training)
- a decreasing of the skin’s ability to stretch due to corticosteroid creams, lotions and pills
If you are unsure of what is causing your stretch marks, visit a doctor, who will be able to further assess your condition.
Treatments for stretch marks
Topical management is usually a recommended treatment. Its purpose is to reduce redness, swelling and irritation in the stretch marks, increase the production of collagen and elastic fibre, improve hydration and reduce inflammation .
Most emollients and drugstore cosmeceuticals are marketed to and used by pregnant women to prevent or reduce stretch marks. However, non-prescription creams demonstrate very little effect in improving stretch marks.
Massage is a form of topical therapy and is also used in scar management. Do be aware that this will take a lot of commitment to be consistent, as the results are usually very gradual and take months to show.
So keep massaging and do not give up!
One simple way to treat white stretch marks is through regular exfoliation to remove excess dead skin from the skin’s surface and expose new skin from your stretch marks.
Chemical peels were used to treat stretch marks using various acids. The results of weak peeling acids are not as useful, however, and strong acids increase the risk of burns but may yield good results.
Exfoliating scrubs are safe to use during pregnancy, and thus much recommended.
Silicone gels are indicated for atrophic wounds, and can be used in reducing stretch marks.
Also, there is no evidence to suggest that there is an issue when silicone gel is used during pregnancy.
Tretinoin (Retin-A, Renova, Avita) is a Vitamin A retinoid. Applying retinoids can make stretch marks less visible and look more like your normal skin by encouraging collagen production.
Tretinoin cream has been reported to be effective in treating stretch marks when compared with a placebo over a six-month period. However, using tretinoin creams can lead to pain, redness and peeling.
Tretinoin (Retin-A, Renova, Avita) has also not been proven safe to use during pregnancy, however it has not been proven unsafe either. So be sure to consult your doctor first.
Microdermabrasion is a professional exfoliation procedure in which the outer layer of the skin, i.e. the epidermis, is excoriated lightly with a concentrated crystal spray to remove the dead skin cells and rejuvenate the appearance of the skin. It is non-invasive and non-chemical.
However, stretch marks form in the dermis, the layer of skin beneath the epidermis. As such, the scar itself is not affected by the procedure.
So why undergo microdermabrasion?
By making the outer layer of the skin look better overall, microdermabrasion may make stretch marks look less noticeable. Note that the effects are temporary and you will need maintenance sessions.
Sadly, microdermabrasion isn't safe during pregnancy because the treatment is likely to scar the extra-sensitive skin of a pregnant woman. Besides scarring, undergoing microdermabrasion while pregnant may cause breakouts and uneven results.
Before I explain what microneedling is, there is one important pointer you must note: Microneedling can be done at both salons and clinics.
However, in salons, the depth of penetration is less than what is allowed in a medical aesthetic clinic, therefore it is less effective.
Here, I will refer to a clinical setting.
Microneedling, also referred to as collagen induction or skin needling therapy, involves the doctor using a derma roller with many tiny needles to prick the skin. By causing controlled damage to the skin, it induces your body to produce more collagen and elastin for skin healing.
When done over stretch marks, microneedling can induce new skin growth over the scars. You may need multiple treatments with intervals of between 4 and 6 weeks to get the best results .
Microneedling is not recommended for pregnant women because the microneedles produce microinjuries on the skin, which naturally cause the repair process to begin.
In aesthetic clinics, more refined technology like fractional radiofrequency (RF) offers more mechanisms for collagen stimulation.
For example, in the case of Infini RF, the depth of needle penetration is controlled and different depths can be used to treat the same area to provide an even distribution of the radiofrequency energy delivered. Once radiofrequency energy is delivered, the fibroblast is stimulated to migrate over to the area to produce collagen and elastin.
Laser treatment is a procedure in which a dermatologist or cosmetic surgeon uses a concentrated laser to destroy the skin to induce new skin growth over stretch marks. Such therapies can be costly but, in the good hands of an experienced doctor, they can be highly effective.
Laser treatment like fractional CO2 can fade or remove stretch marks and requires less recovery time than deep chemical peeling.
Laser treatment is a highly effective method for removing those stretch marks you get from pregnancy.
Energy-based treatment like HIFU and radiofrequency, such as Exilis, aims to improve skin elasticity and remove fat.
By tightening the skin and reducing fat, you may notice an improvement in stretch marks. This treatment is ideal for people who cannot afford downtime, e.g. cannot take leave from work, or are expecting to attend an important function by the beach.
Treatment like HIFU and radiofrequency are not recommended during pregnancy. This is due to the lack of information regarding their effects on the foetus.
A commonly used skin surgery for the removal of stretch marks is abdominoplasty, also known as a tummy tuck. This is the most effective treatment, with just one session.
However, it will require you to go under the knife, and a scar may result.
Laser treatments for stretch mark removal
For stretch marks that are white, or if the texture is more of an issue, I may recommend fractional laser therapy such as Fraxel laser. Fraxel is a non-invasive, microscopic laser that penetrates your skin to stimulate the growth of new collagen and elastin.
Laser treatment with fractional CO2 is a new treatment that can smooth out old white stretch marks. One study showed that women's stretch marks diminished after five sessions, relative to others who used glycolic acid and tretinoin topical creams.
The Fractional Erbium: Glass laser (ResurFX) is a new and popular laser for the treatment of stretch marks. This laser is a non-ablative laser for light and dark skin.
Last but not the least, the Excimer laser procedure uses high-energy ultraviolet light to remove thin layers of skin around the marks.
Cost of stretch mark removal treatments
$500 to $1,400
$400 to $700
Fractional Erbium: Glass laser / ResurFX
$200 to $1,070
Seeing a doctor for stretch mark treatment
You should consult a dermatologist or an aesthetic doctor who can assess your condition and advise on an appropriate treatment for you. Your doctor should assess your condition based on your overall health, age, skin tone, the stage and how long you have had the stretch marks for.
Alert your doctor if you are pregnant or breast-feeding — some products contain ingredients that may harm your child, such as retinol.
Risks of stretch mark treatment
As with any form of treatment, you should be well aware of the risks involved. Everyone is different — you may respond to treatments differently from another person.
Fraxel®: pigment changes, burns, scars (rare), and tanning issues.
Fractional CO2: Severe marks may not respond to the treatment, can leave permanent pigmentation on dark brown or black skin.
The Fractional Erbium: Glass laser / ResurFX: crust formation is minimised
The Excimer laser: redness (in light skin) or purpleness (in dark skin), blisters, temporary pain, and pigmentation changes
Microdermabrasion: minor skin infections
Microneedling: swelling, discomfort at the site, redness, bruising, dryness, and flaking of the skin.
Abdominoplasty: pain, swelling and redness
My advice to you on choosing an aesthetic doctor you can trust is to ask these questions:
- Do you feel comfortable and confident in the doctor and his/her clinic?
- Is your doctor knowledgeable on stretch marks and their treatment?
- Did your doctor take time and effort to explain his/her recommended treatments?
- Are you properly briefed on the cost involved and its breakdown?
- How successful are his/her previous cases and how many past cases did he/she treat?
Making sure your doctor helps you understand the process and manages your expectations is important for your post-procedure satisfaction.
Preventing stretch marks
Methods to prevent stretch marks have not been very effective. By hydrating and moisturising and massaging your skin, you can improve your skin’s condition, and potentially help minimise the appearance of stretch marks.
Stretch marks are mostly an aesthetic concern, so you should not be too worried about them. While there are no treatments to completely undo these scars, there are many options to reduce their appearance. A trustworthy doctor will be well placed to assess your condition and recommend treatment options.
Most cosmeceuticals for stretch marks have been proven to be ineffective. Before you splurge on an entire suite of creams and lotions lauded by marketing departments instead of doctors, it is best you speak with a real doctor about them.
Dr Sau Po Yi is an aesthetic doctor with Sozo Aesthetic Clinic. She joined the field of aesthetic medicine because she believes she can be a real patient advocate. In addition, the Singapore Medical Council has awarded her certificates of competence in multiple aesthetic programmes.
1. Stretch marks: Why they appear and how to get rid of them. Published 2017. Accessed January 20, 2020.
2. Oakley AM, Patel BC. Stretch Marks (Striae). Accessed January 20, 2020.