What procedure is best for permanent results on white stretch marks?

Question

What procedure would produce long lasting results for making old white stretch marks less noticeable on darker skin? Would the results last without annual maintenance treatments?

Jason Emer, MD · Answer

white stretch marks are typically unresponsive to lasers, peels, microneedling or microneedling RF but halo and Fraxel sometimes help.  See an expert.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Stretch marks (aka striae distensae) can arise from rapid weight changes, as part of adolsescent growth, body building, the use of muscle-building steroids, and in many women, on the abdomen, following pregnancy. When fully matured, stretch marks have a crinkly, cigarette-paper consistency and are ivory white in color, as you describe here. Early stretch marks, on the other hand, are purple or purple-pink. Most OTC  topical creams that are touted for stretch marks are pretty much useless. The intensive application of high strength ammonium lactate lotion combined with a prescription topical retinoid may prove helpful in improving the appearance of stretch marks, after several months of continuous, daily use, especially when combined with the in-office use of a series of medical microneedling coupled with the application of topical tyrosine and bimatoprost  treatments to help stimulate, new, native collagen production and promote repigmenation, respectively. I have also had some additional success, in selected cases, with the concomitant or subsequent use of bioremodeling agents, such as Profhilo and the use of skin boosters, such as Viscoderm Hydroboosters, injected superficially within the appropriate levesl of each stretch mark in order to help  to stretch the crinkly, crepe paper-like surface appearance. These are believed to work by virtue of their ability to promote skin hydration and their biostimulaory ability to promote new, native collagen and elastic fiber synthesis (neocollagenesis, neoelastogenesis). Make sure to consult with a board certified aesthetic physician. Best of luck and Happy New Year.

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