What are some ways to minimise really old stretch marks?

Stretch marks can't officially be "cured," and it will take a combination approach and consistent treatment to see great results. However, there are a multitude of treatments currently available that can be utilized.​ I recommend a combination of microneedling/PRP, lasers (Erbium, Fraxel, Excel V, Pulsed Dye Laser, Laser Genesis, Yellow laser) or radiofrequency devices like Intensif, Fractora, Morpheus8, PiXel8, Skinfinitiy, and Venus Viva. I recommend seeing an expert for a formal evaluation. Best, Dr. Emer​

Old stretch marks can improve, but 13-year-old marks are considered mature striae alba, meaning they are usually pale, slightly indented, and more resistant to treatment than newer red or purple marks. Complete removal is not realistic, but meaningful softening of texture, depth, and contrast is possible with the right expectations.

Over-the-counter creams, oils, cocoa butter, and vitamin E can moisturize the skin but will not substantially remodel long-standing stretch marks. Prescription tretinoin may provide modest improvement in texture for some patients, but it is generally more effective for newer marks and should not be used during pregnancy or breastfeeding.

For older stretch marks, procedures that stimulate collagen are typically more worthwhile. Microneedling, radiofrequency microneedling, and fractional laser resurfacing can improve texture and blending over a series of treatments. I commonly recommend three to six sessions, spaced about four to six weeks apart, with continued remodeling for several months afterward. Combination treatments may provide greater improvement than a single approach.

The best option depends on the location, skin tone, depth, and whether the marks are white, red, raised, or depressed. Darker skin tones require careful device selection to reduce the risk of pigment changes. Maintaining a stable weight, moisturizing, and using sunscreen on exposed areas can help minimize contrast, although they will not erase established marks. An in-person consultation allows treatment to be tailored safely to your skin and goals.

The only way to completely eliminate stretch marks is to have them surgically removed. However there are ways to improve their appearance. You can consider treatments such as Morpheus8. This highly requested treatment uses RF technology combined with microneedling to improve overall skin tone and texture. See my website for more information, or visit a provider near you.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon