Stretch marks are a common phenomenon, affecting millions of people, including children and adults, women and men. The medical term used by physicians to refer to stretch marks is “striae”. The term “striae distensae” refers to stretch marks that result from a rapid change in size, such as stretch marks that occur with rapid weight loss or gain. “Striae gravidarum” is the term used to refer to the stretch marks that develop during pregnancy.
What causes stretch marks?
Stretch marks result from stretching of the skin. The skin is composed of three layers of skin: the epidermis, or outermost layer of skin, is the visible layer that acts as a protective barrier for all of the internal organs. The dermis lies under the epidermis and provides strength and structure to the skin, giving it its firmness and flexibility. The hypodermis (subcutis) is the innermost layer composed of connective tissue and fat. Stretch marks occur when the skin is rapidly stretched, resulting in damage to the dermis, or middle layer. When the dermis is damaged by stretching, the innermost layer of skin, the hypodermis, shows through, resulting in the characteristic appearance of stretch marks.
Who gets stretch marks?
Anyone can develop stretch marks. Children sometimes develop stretch marks during puberty, when they experience rapid growth. Anyone who experiences rapid weight gain or loss may develop stretch marks. Women are more likely to develop stretch marks than men, largely due to the rapid stretching over the skin of the abdomen during pregnancy. Body builders sometimes get stretch marks as their muscles grow.
Where do stretch marks occur?
As might be expected, stretch marks can appear almost anywhere, generally to areas where there is fat storage. They may be seen on the abdomen, buttocks, thighs, breasts, lower back and arms.
What do stretch marks look like?
Initially, stretch marks appear as reddish or purplish lines on the skin that are slightly elevated above the surface of the skin. They may fade in color as they slowly flatten out. Eventually, stretch marks fade to a whitish or silvery color and may resemble scars. They may be a little lighter than your natural skin tone.
Are stretch marks harmful?
Stretch marks do not pose a concern to health. They are common and are experienced by many people. Occassionally, stretch marks may be associated with a health problem that may be more serious, but this is rare. Generally, most stretch marks do not require a visit to the doctor, but stretch marks that do not appear to be related to a rapid change in size, such as that which occurs during puberty or pregnancy, may be cause for concern. There are a few conditions associated with the development of stretch marks:
- Cushing’s syndrome- occurs when the body produces too much cortisol, a hormone that may decrease the amount of collagen in the skin. People with Cushing’s syndrome may gain weight quickly, have excess facial and body hair, and experience back pain. Anyone who has these symptoms in conjunction with stretch marks should consult their physician.
- Connective tissue disorders- rare disorders affecting collagen (connective tissue) in the body may predispose to stretch marks. Marfan syndrome and Ehlers Danlos syndrome are examples of hereditary connective tissue disorders that may cause stretch marks. These syndromes can cause ocular, skeletal and cardiac problems, so the presence of these along with stretch marks should raise concern and prompt a visit to the doctor.
How are stretch marks diagnosed?
Stretch marks are diagnosed based on their characteristic appearance. There are no diagnostic tests for stretch marks.
How are stretch marks treated?
Stretch marks do not pose a concern to health, but may be of concern cosmetically. Stretch marks can be disfiguring and some people, especially women, will be concerned about them for this reason. Treatment for stretch marks aims at reducing their appearance. Many treatments are only partially effective, and although there are many treatments commercially available that claim to be able to remove them completely, short of cosmetic surgery, few of these treatments are successful. Stretch marks fade over time, but generally do not go completely away.
- Creams and oils- there are many products available on the market for the treatment of stretch marks. Tretinoin cream (Retinova) may be helpful if used in the first weeks after stretch marks appear. It works by helping to rebuild collagen, and may diminish the appearance of stretch marks. It cannot be used during pregnancy. Other creams and oils are available; these often contain emollients and vitamin preparations.
- Laser therapy- used on newer stretch marks, pulsed dye laser therapy helps to stimulate elastin and collagen growth. It can be used on older stretch marks but may not be as effective.
- Microdermabrasion- in this procedure, a hand-held wand blows crystals onto the surface of the skin, abrading the skin’s surface. The dead cells are then removed, leaving behind new skin that may have an improved appearance. Microdermabrasion is one option for older stretch marks.
- Excimer laser- this procedure can be used on older stretch marks and works by stimulating melanin production, remodeling stretch marks so that they resemble normal skin tone, making them less visible.
When considering treatment for stretch marks, convenience, cost and expectations should be factored in. Some treatments are expensive and require a time commitment; as well, many treatments will not be covered by insurance.
Stretch marks are a common occurrence, resulting from rapid weight gain or loss. More common in women, stretch marks may appear almost anywhere on the body, including the hips, waist, back, breasts, and arms. Caused by damage to the dermis of the skin, they may be reddish or purplish in color, fading to a white or silvery color. There are several treatments available for stretch marks, ranging from creams and oils to cosmetic procedures, but none are guaranteed to be 100% effective at removing stretch marks.
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