Stretch marks (striae) are small scarring  or stripes on the skin that result from the rupture of elastic fibers of the epidermis (outer layer of the skin that ensures its protection function) as a result of excessive stretching or hormonal change. The abnormality concerns mainly those who grow rapidly or who have suffered a sudden weight gain, pregnant women for example. In most cases, stretch marks appear on the breasts, belly, hips, inner thighs, buttocks, as well as growth areas, such as the shoulders (mostly the athletes). Although stretch marks affect people of any race, it seems that white skin women are most affected.

Although adolescents may be affected (in about 10% of cases), stretch marks occur most often in pregnant women. Among teens, stretch marks are often the result of obesity and a slightly higher rate of cortisol (also known as hydrocortisone, is a hormone secreted naturally by the body but can be increased by taking certain medications) in the blood. During pregnancy, stretch marks begin to develop from the fourth month until the sixth month in the majority of pregnant women. In some women, stretch marks can appear at first pregnancy; this is caused by the distension of the abdomen skin due to the fetal growth.

Stretch Marks Causes

Stretch marks are the result of distension of the skin in certain areas. This may be normal, as the case of a pregnancy; or accidental, the result of taking certain medications that contain steroids. In general the common causes suspected in the development of stretch marks include the following:

Hormones/Pregnancy: stretch marks are often related to hormonal changes which affects the skin at the time of puberty and/or during pregnancy among women. In fact, nearly 90 % of women have stretch marks after their pregnancy. Women with multiple pregnancies are more at risk. Often, the first stripes appear around the 4th month, when the abdominal is really starting to swell.

Weight Loss: the skin of people who are obese are prone to distension directly related to the amount of fat in reserve. After they lose weight, the skin does not find its usual structure and is stretched; this can lead to development of stretch marks. That is why stretch marks tend to develop in the areas of the body where there is a reserve of fat.

Medication Use: stretch marks may be the consequence of inappropriate use of corticosteroids (cortisone) either in the form of creams, lotions, pills, or injection. In fact, even in the absence of corticosteroid drugs, stretch marks can form; In this case, it is the result of excessive secretion of cortisol (hypercortisolism) in the blood (Cushing’s disease).

Some Sports: weightlifting is a sport consists of lifting heavy weights. During the event, the athlete lifts the weight, arm outstretched above the head in one dynamic movement. It is a sport that requires strength as well as mastering particular techniques: speed, flexibility, coordination and balance. Individual who practice weightlifting are also likely to have stretch marks.

Certain Diseases: certain medical conditions such as Cushing’s syndrome, Marfan syndrome, Ehlers-Danlos syndrome and adrenal gland diseases can lead to formation of stretch marks.

Stretch Marks Risk Factors

Sex and race may increase the risk for stretch marks. Women are more diagnosed with the condition than men are. In addition, it is found a higher stretch marks cases in white women than in Asian and Black women. In general, you are at higher risk to have stretch marks if you are:

• being female
• being pregnant
• rapidly gaining or losing weight
• using corticosteroid medication
• being overweight or obese
• Carrying larger babies – this causes your abdomen to stretch more.

Stretch Marks Symptoms

Stretch marks are parallel and willowy fine lines (scars) that form on the skin. Often, they create tiny scarring on the surface of the skin, initially red and then white and finally become pearly. These scars give the skin a wrinkled appearance. Stretch marks occur mainly on the abdomen, breasts, upper arms, buttocks and thighs.

In general, signs and symptoms of stretch marks include:

• red, pink or purple streaks under the skin;
• reddish brown or very dark brown streaks or lines in the skin;
• Bright streaks that fade to light pink, white or silver color.

Stretch Marks Complications

Stretch marks can be extended and become large. It could affect not only your physical appearance but also your psychological state. In general, stretch marks fade away slowly once they are old. From their genesis, have recourse to a treatment that can eliminate or slow their evolution. In addition to creams and lotions, there are now laser treatments available to treat stretch marks. Talk to your dermatologist for more information.

Stretch Marks Diagnosis

No specific medical exam is necessary to confirm you have stretch marks. With naked eyes, the marks can be seen on your skin, especially in your abdomen, thighs, breasts, flanks, buttocks. Sometimes they are also found in the armpits (underarm) and in the lower back.

If your doctor suspects that your stretch marks are related to any medical condition, he would recommend blood tests and/or imaging tests to detect and confirm the primary cause of the stretch marks. This, however, barely happens. In over 95% cases of stretch marks, they are not complications or signs related to other diseases.

Stretch Marks Treatment

Stretch marks must be treated as soon as possible to facilitate the chance of a successful treatment. The treatments have less impact when the striae are installed largely and become white. In the other hand, there is sometimes a gradual decrease when stretch marks are taken into account from the beginning. Whatever the type of treatment used, it is important that you be patient and combative. A treatment that works for Maria may not work for Anna; therefore, it is good to try all the chances to reduce the scars or eliminate them completely if possible.

There is no definitive treatment for stretch marks; but there are therapeutic methods to reduce their appearance: laser therapy, massage therapy, microdermabrasion, Placental extract, collagen creams, collagen and elastin creams, silicone derivatives, etc. Without proper treatment, stretch marks lead to formation of large scars of one or two centimeters and sometimes up to 10 centimeters long.

Creams: certain anti stretch mark creams can be useful if they are used continuously and from the genesis of the stretch marks. They are most effective when they penetrate the skin deeply and their concentration of active ingredients is high. Tretinoin cream may provide a satisfying result if the stretch marks are recent; that is, those that are still pink or red in color. However, pregnant women should not use tretinoin. In addition, tretinoin can irritate the skin of some patients.

Microdermabrasion: microdermabrasion is a technique used to beautify the skin with few or no side effects. It is performed using aluminum micro-crystals (or aluminum oxide crystals) projected on the skin, specially the area to be treated. The therapy causes microdamages that encourage the skin to produce new, younger and firmer skin tissue. The therapist then cleans debris of dead skin and crystals by suction or with a soft brush. The skin becomes clean, soft and radiant.

This procedure can provide good results in the treatment of older stretch marks. In addition, in stretch marks treatment, microdermabrasion is also recommended in cases of acne scars, fine lines and wrinkles, dark spots, microcysts, enlarged pores, and age spots. They therapy is also used to improve the luster and texture of the skin.

Microdermabrasion is not painful, however; it can cause redness and increased sensitivity for nearly a day after treatment. If you are diabetic, you should not opt for microdermabrasion if your blood sugar is not stable or if your condition is not safely under control.

Fractional Photothermolysis: Like pulsed dye laser therapy, this nonablative laser treatment uses wavelengths of light to stimulate new growth of collagen and elastin. The difference is that it causes partial (fractional) damage to small dot-like areas within a targeted zone. Because most of the treated area remains undamaged, the skin heals quickly.

Fractional Photothermolysis: this is a new concept of using laser to stimulate new growth of collagen and elastin. This is a gentle non-invasive treatment which does not remove the epidermis. It causes a progressive elimination of the damage cells. In average, four sessions allow an almost complete epidermal and dermal renewal comparable to which would have been obtained with mechanical dermabrasion.

Fractional photothermolysis is FDA approved for all skin types regardless of the region of the body. There is no risk of discoloration, and the skin heals quickly after the therapy; however, in some patients, there may be a transient hyperpigmentation (darkening of an area of skin or nails caused by increased melanin) after the treatment.

Pulsed Dye Laser Therapy: this technique consists of heating intensely, by high-energy laser light (or radiation), the dermal blood vessels. The energy produced will be absorbed by the hemoglobin causing the destruction of diseased cells of the skin without affecting healthy tissue. During the therapy, the radiation is produced by stimulation of liquid dye and “Pulse “; the length of the radiation is controlled in a way that the heat does not damage tissue.

This therapy is among of the nonablative laser treatments used to treat various skin problems anywhere on the body: warts, rosacea, erythema (redness of the skin), spider veins, new lesions of psoriasis, stretch marks, sebaceous hyperplasia and other dermatological problems.

Stretch Marks Prevention

Unfortunately, there is no effective method to prevent stretch marks; cosmetic creams used as prevention have rarely proven to be effective. However, constantly feeding your skin with massage and applications of stretch mark creams can help your skin to soften and relax, which reduces your chances of having stretch marks. Nevertheless, even when following all beauty and health tips, there is never guaranteed at 100% to prevent the appearance of stretch marks.

The following tips may reduce your risk of stretch marks:

• avoid taking and/or losing weight quickly by following strict diets;
• avoid using cortisone creams or lotions without your doctor’s advice;
• do not use creams to lighten your skin that contain cortisone which makes the skin very fragile and very prone to stretch marks;
• during pregnancy, practice these tips: 1 ) take regular massage that help to stimulate production of collagen fibers; 2 ) avoid any diet that increases your weight
• Eat a healthy and balanced diet; drink plenty of water and carrot juice to keep your skin hydrated.