Stretch marks are visible scars occurring in the skin. Stretch marks are caused by a tearing of the dermis and are the result of rapid stretching of the skin seen during periods of rapid growth. The normal expansion of the skin cannot keep pace with the volume growth and a rent or tear occurs within the dermis. This most commonly occurs during puberty, pregnancy or weight gain. The scars are heighted by a color change with pink or red hues occurring when the stretch marks are young and newly formed up to 9-12 months. During this early phase lasers and IPL may be effective in lessening the appearance of the stretch marks. Mature stretch marks are those that are older than a year. Depending upon one’s skin type, these may appear either as hyper- or hypopigmented scars. At this time, surgical excision is the only effective modality-either by targeting individual stretch marks alone or by removing a segment of skin that is populated by numerous stretch marks, as seen in tummy tucks and body lifts, etc. A prospective patient who is considering surgical excision must realize that it is a tradeoff in visible improvement… exchanging surgical scars for the stretch mark(s).
There are hormonal receptors in skin. Hormones certainly influence the characteristics of the skin. Men are noted to have a thicker dermis probably influenced by Testosterone. Because stretch marks occur during pregnancy and puberty, hormonal changes influence the degree and capability of dermal “stretching”.
What advise may we give patients our patients to prevent or lessen stretch marks? Currently, there is no preventive treatment strictly to avoid stretch marks. We advise our patients to keep the skin as healthy as possible, such as taking oral vitamins and topical vitamins directly applied to the skin. The topical applications of vitamin C (l-ascorbic acid) and B complexes (niacin) seem to help. Because of the sudden change in breast volume, stretch marks are often seen affecting the skin of the breasts. To this end, wearing supportive bras is advised. Lastly, it is advised to keep pace with the occurrence of new stretch marks treating the effected zone with IPL. The future does appear promising with drugs that up and down regulate certain gene expressions and by the therapeutic application of various human recombinant transforming growth factors.
I hope this helps.
