Key takeaways:
Stretch marks —or striae distensae — are the red, purple, or brown lines that some people get on their thighs, butts, arms, and abdomen.
Stretch marks are common in pregnancy, after puberty, and in other times of rapid growth or weight gain.
Some creams and other skin treatments claim to prevent or treat stretch marks. But genetics decide whether you get stretch marks or not.
Stretch marks are linear scars in the skin. And there’s a lot of historical documentation that proves they’ve been around for a long time. As far back as 16 B.C. there are reports of people taking steps to improve the appearance of stretch marks, including making natural remedies with olive oil, salt, and frankincense.
Pregnancy is one of the most common reasons for stretch marks. Up to 90% of pregnant people get stretch marks. But it’s not just pregnancy that causes stretch marks. People of all genders —at any stage of life — can get stretch marks. Sudden weight gain and puberty are other common times. It’s not clear why some people get them worse than others, but stretch marks seem to run in families.
Many people find their stretch marks distressing, but they’re not anything to worry about beyond their physical appearance. While there are many ways to treat stretch marks, there’s no cure. Here, we’ll cover what the scientific evidence says about how to prevent and treat stretch marks. We’ll also tell you what doesn’t work, so you can shop smart.
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Types of stretch marks
The medical name for stretch marks is “striae distensae,” which loosely translates as “stretch lines.” There are other names, depending on how recent the stretch marks are or when they developed. Let’s look at what these terms mean.
Striae rubrae
Striae rubrae is the medical name for newly developed stretch marks. It means “red lines,” but the color actually depends on your skin tone. New stretch marks can be red, brown, or purple. Stretch marks may feel raised and itchy at first. You might even feel itching before you notice a change in the appearance of your skin.
Striae alba
Striae alba, loosely translated as “white lines,” are older stretch marks. This is because as stretch marks heal in white skin they fade to a silvery white. In darker skin shades, striae alba may look dark gray, black, or even bluish.
Stretch marks change in color from new to old over months to years. The scars may also shrink, which makes the stretch marks sink and appear wrinkled. Old stretch marks may look like shallow, linear pits in the skin. They can become more noticeable with age as skin loses its elasticity.
Striae gravidarum
Striae gravidarum is the specific term for stretch marks of pregnancy. They typically follow the same patterns as other stretch marks. They start out darker, raised, and/or itchy. And they eventually fade with time. Striae gravidarum typically start in the second and third trimesters. They’re common on the abdomen, breast, and thighs.
Where on the body do stretch marks mostly occur?
Stretch marks can happen anywhere on the body, but they commonly develop on these body parts:
Buttocks
Insides of upper arms
Stomach
Thighs
Breasts
Lower back
Stretch marks are usually symmetrical, meaning that they develop on both sides of the body. They can be thin (a few millimeters wide) or thick (up to 1 centimeter wide).
What causes stretch marks?
The science isn't clear on why stretch marks happen. It's likely due to a combination of factors. Typically, stretch marks happen when skin stretches quickly at a time of hormonal change. It's also likely there are features of certain skin types that make it more or less likely that stretch marks will develop. This explains why not all areas of skin or all people get stretch marks.
At a microscopic level, stretch marks happen because there’s damage to the collagen and elastin proteins that maintain our skin's stretchability.
Stretch marks don’t happen to everyone. Some people have more elastic skin and are less likely to develop stretch marks.
But some situations make stretch marks much more likely:
Puberty growth spurts
Rapid weight gain
Pregnancy
Rapid muscle growth from certain types of exercise, like weight training
Use of steroid cream over a long period of time
Being female
Family history of stretch marks
If you’re pregnant, you’re more likely to get stretch marks related to pregnancy if:
You’re in the second or third trimester of pregnancy
You’re younger than 35
Your close relatives developed stretch marks in pregnancy
You have a high prepregnancy body mass index (BMI)
You had stretch marks in a previous pregnancy
You have more than average weight gain during pregnancy
Are stretch marks bad?
Stretch marks can be uncomfortable and itchy at first, but they’re not physically harmful. They don't cause any other medical conditions, but they might cause cosmetic concerns and distress to people who have them. This emotional stress can lead to a lower quality of life, so it’s important to talk to your healthcare provider if your stretch marks bother you.
In rare cases stretch marks can be a sign of an underlying medical condition, such as Cushing’s syndrome, Ehlers-Danlos syndrome, or chronic liver disease.
How do you treat stretch marks?
Stretch marks may fade with time, but they usually don't go away completely. Still, research shows that many people try to prevent or lessen the appearance of stretch marks. The most common treatments people use are creams, gels, and oils. For the best possible results, it’s important to be patient and apply the products daily for at least several weeks.
Even with prescription treatments and cosmetic procedures, results vary and are hard to predict. And like with any prescription treatment or procedure, there’s also a risk of side effects. Many prescription treatments that help stretch marks fade may not be safe for pregnancy. In this case, you should opt for treatment after pregnancy has ended.
If you can’t prevent stretch marks and cosmetic treatment isn’t for you, you could try to camouflage stretch marks with self tanner. A product like this can darken stretch marks and camouflage them in the way that makeup can on your face. But it won’t cause the stretch marks to go away.
Although it’s difficult to accept the stretch marks of pregnancy and the changes to your body, be kind to yourself and try to acknowledge what your body has accomplished.
Home remedies and over-the-counter treatments for stretch marks
There aren’t well-designed studies on most of the available over-the-counter (OTC) products for stretch marks. But there has been some research showing benefits with the following topical medications:
Centella asiatica (a plant extract in products like Trofolastin)
Hyaluronic acid (like Alphastria cream)
Cocoa butter
Olive oil
Silicone gel
Almond oil
Vitamin E
Bio-oil (an oil with vitamins and plant extracts)
But the studies on these products show varied results. So although OTC treatments are generally safe to use in pregnancy, there’s no definitive scientific evidence to show that they make much difference.
For instance, moisturizing creams, such as those with cocoa butter or shea butter, have been used for decades. But there’s no strong evidence to prove that these help. In fact, it might just be the extra moisture and the act of massaging the product into the skin that actually helps. Extra moisture can help the skin remain more elastic instead of stretching too thin. This might help decrease the chance of getting stretch marks— or lessen the appearance of them.
Whatever you decide to use, it’s probably best to start using safe products on early stretch marks (striae rubrae), rather than later stretch marks (striae albae). You have more of a chance of lessening the appearance of striae rubrae than if you wait to treat stretch marks that have been there for a while.
Tretinoin (Retin-A)
Tretinoin is a prescription retinoid cream that helps increase collagen production in the skin. A few small studies have shown that tretinoin may improve stretch marks by making them smaller and less noticeable. This improvement happened with early treatment of stronger doses of tretinoin. But tretinoin and other retinoids aren’t safe to use in pregnancy. You have to wait until after your pregnancy ends to use them safely.
Cosmetic procedures that treat stretch marks
Cosmetic treatment isn’t necessary, but if you want treatment there are some procedures that can help. To get the best results, your provider may combine different treatments. For example, they may use radiofrequency with tretinoin or a laser. Cosmetic procedures may include:
Several small studies show that laser therapy is one of the best cosmetic treatment options for striae rubrae. Laser therapy targets the blood vessels to increase collagen production and skin elasticity. A typical treatment to reduce the appearance of stretch marks is up to 6 sessions, 4 weeks apart.
Another study showed that microdermabrasion can help reduce the appearance of striae rubrae. A few different studies showed that microneedling could be helpful in reducing both striae rubrae and striae alba. One study showed that radiofrequency and ultrasound helped improve the appearance of striae alba.
Preventing stretch marks
Despite many treatments available and marketed especially at pregnant women, there’s no strong evidence that any of the following creams work to prevent or reduce stretch marks in pregnancy:
Alphastria
Trofolastin
Verum
Olive oil
Cocoa butter
There’s also no evidence that "belly bands" prevent or improve stretch marks in pregnancy. The truth is, some people get mild stretch marks, some get severe stretch marks, and some get none at all.
The bottom line
Stretch marks are common in pregnancy, but they can affect people with other skin and hormonal conditions as well. The most common treatments for stretch marks include massaging moisturizing creams and lotions into the skin. Your healthcare provider might recommend prescription products or cosmetic procedures for stretch marks. Stretch marks may fade, but it’s unlikely that they will ever truly disappear. So try to remember that stretch marks aren’t harmful, and focus on things you can try to improve — like your mental health, a well-balanced diet, and a healthy pregnancy if you’re pregnant.
References
American Academy of Dermatology Association (n.d). Stretch marks: Why they appear and how to get rid of them.
American Osteopathic College of Dermatology. (n.d). Striae.
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Farahnik, B., et al. (2017). Striae gravidarum: Risk factors, prevention, and management. International Journal of Women’s Dermatology.
Genetic and Rare Diseases Information Center. (2017). Ehlers-danlos syndromes. National Center for Advancing Translational Sciences.
Hague, A., et al. (2017). Therapeutic targets in the management of striae distensae: A systematic review. Journal of the American Academy of Dermatology.
Icahn School of Medicine at Mount Sinai. (2021). Stretch marks.
National Health Service. (2019). Stretch marks in pregnancy.
Oakley, A. M., et al. (2021). Stretch marks. StatPearls.
Osman, H., et al. (2007). Risk factors for the development of striae gravidarum. American Journal of Obstetrics and Gynecology.
Ud-Din, S., et al. (2016). Topical management of striae distensae (stretch marks): Prevention and therapy of striae rubrae and albae. Journal of the European Academy of Dermatology and Venereology.
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Wollina, U., et al. (2017). Management of stretch marks (with a focus on striae rubrae). Journal of Cutaneous and Aesthetic Surgery.
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