Striae (Stretch Marks)

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active.

I am often asked "What can I do to get rid of my stretch marks?" The short (honest) answer is nothing. Stretch marks are scars. The longer answer is addressed here---causes and ways to improve their appearance. 

Striae distensae (stretch mark) is a common skin condition. It rarely causes any significant medical problem. However, striae can be of significant emotional distress to those affected. They represent linear dermal scars accompanied by epidermal atrophy. (photo credit) 

Stretch marks affect skin that is subjected to continuous and progressive stretching. Common predisposing circumstances for the development of stretch marks include: those which involve a physical stretching of the skin, such as rapid weight gain or adolescent growth spurts, and others that involve hormonal changes, such as chronic steroid medication use or Cushing syndrome (increased adrenal cortical activity). Genetic factors could certainly play a role, although this is not fully understood.[I have never seen stretch marks occur from augmentation mammoplasty or soft tissue expanders, nor are they ever listed as a possible complication of those surgeries.] 

Regardless of their causes, all stretch marks follow a natural course of progression. An early sign of stretch marks developing is when an area of skin becomes flattened and thin with a pink color. The area may occasionally be itchy. Soon reddish or purplish lines develop (striae rubra). Over time these lighten to become whitish or flesh-colored and much less conspicuous. Stretch marks are usually several centimeters long and 1-10 mm wide. Those caused by corticosteroid use or Cushing's syndrome are often larger and wider and may involve other regions, including the face. 

How are they treated?

There are many treatments available, ranging from therapy applied to the skin, laser therapy, and even more invasive surgical methods. Unfortunately, stretch marks remain a tricky problem to target, in which no established treatment exists. Recent studies have evaluated laser treatment on stretch marks of various ages, topical 0.1% tretinoin cream applied to early clinically active stretch marks, and treatment of mature stretch marks with two different topical regimens (including glycolic acid, L-ascorbic acid, zinc sulfate, and tyrosine vs glycolic acid, and tretinoin emollient cream). Treatment with laser and treatment with glycolic acid in combination with 0.05% tretinoin emollient cream appeared to increase the elastic content in the treated lesions, improving the appearance of the striae. (Please, note none of these treatments remove the stretch mark. They only improve the appearance of the stretch mark.) In particular, clinical improvement in the laser treated group continued for 6 months or more after treatment.

The left photo is prior to treatment with tretinoin 0.1% cream, the right is after 8 weeks of treatment (same person). I don't really appreciate the improvement, do you? photo credit

The only way to truly remove (or get rid of) a stretch mark is to surgically excise it. If your stretch marks happen to "sit" in the area of your central lower abdomen, then you may be able to have yours removed by an abdominoplasty. Most of us aren't that fortunate. Many of us have them on our hips or outer thighs from puberty. If you are a teenager, the stretch marks you have now that are in that bright pink or purple stage will fade. That alone will make them less visible. 

Be careful if someone promises to completely get rid of or erase your stretch marks. There is no proven way to do so at this time.

References
Striae Distensae by Samer Alaiti, MD--eMedicine article
Stretch marks (striae)--DermNet NZ
Stretch Marks by Patrice Hyde, MD--Kid's Health article
Stretch Marks--Virtual Medical Centre
Photo Gallery of Stretch Marks
Derm Atlas--Stretch Marks