Stretch Marks: An In-Depth Look Into How They Develop

Stretch marks, those faint lines on the skin that often evoke curiosity and concern, are a testament to the dynamic nature of the human body. These visible scars, scientifically known as striae, emerge as the skin undergoes rapid stretching, leaving behind a distinctive mark that can be pink, red, or purple initially and gradually fading into a silvery-white hue. These visible lines on the skin often raise questions about their development and how to manage them effectively.

As we scrutinise the causes and risk factors, it becomes evident that these marks are not merely cosmetic concerns; they are narratives written by the skin during periods of profound change, such as adolescence, pregnancy, or significant weight fluctuations. In this article, we will explore the intricate process of stretch mark development, shedding light on their cases and risk factors, as well as the strategies to address and prevent stretch marks. Understanding the science behind stretch marks is the first step towards effectively managing this cosmetic concern.

The biology of stretch marks

Dermal and epidermal changes

Stretch marks occur when the skin is stretched beyond its normal limits, causing the dermis (the middle layer of the skin) to tear. This tearing results in the appearance of fine scars on the skin’s surface. The initial colour of stretch marks is often purple, red, or pink¹ due to blood vessels showing through the tears. Over time, they may fade to a more silvery-white hue.

Elastin and collagen impact

The tearing of the dermis is closely linked to the structural proteins collagen and elastin¹. Collagen provides the skin with its strength, while elastin allows it to stretch and snap back into place. When the skin is stretched rapidly, as seen during pregnancy or periods of rapid growth, the production of collagen cannot keep up with the skin’s expansion. This imbalance leads to the formation of stretch marks.

Causes and risk factors of stretch marks

Adolescent growth spurts

During puberty, adolescents commonly experience rapid growth spurts, which can result in the sudden stretching of the skin. This period of accelerated growth puts adolescents at a higher risk of developing stretch marks² on areas like the thighs, hips, and buttocks.

Weight fluctuations

Significant weight gain or loss can contribute to the formation of stretch marks. The skin stretches as a result of increased fat deposits or contracts³ due to weight loss, creating a scenario where stretch marks are more likely to appear.

Pregnancy

One of the most common causes of stretch marks is pregnancy. The rapid growth of the abdomen during pregnancy puts immense strain on the skin, often leading to the development of stretch marks. Research has shown⁴ that approximately 50 to 90% of pregnant women experience stretch marks during their pregnancy, particularly in the third trimester.

Addressing and preventing stretch marks

1. Maintain a healthy lifestyle

Adopting a healthy lifestyle that includes a balanced diet and regular exercise can contribute to overall skin health. Additionally, maintaining a stable weight and staying hydrated can reduce the likelihood of developing stretch marks.

2. Topical treatments

Various topical treatments are available to address stretch marks. Products containing ingredients like vitamin C, hyaluronic acid, and retinoids⁵ have shown promise in improving the appearance of stretch marks by promoting collagen production and enhancing skin elasticity.

3. Laser therapy

Laser therapy, specifically fractional laser treatment, has been effective in reducing the appearance of stretch marks. This treatment stimulates collagen production and promotes skin remodelling, leading to improved skin texture.

PicoWay Resolve™ stands out as an effective aesthetic laser procedure designed to reduce the severity of these marks. In contrast to traditional nanosecond lasers that emit light energy in one billionth of a second, PicoWay Resolve™ technology delivers high peak power through precise picosecond pulses. This unique approach results in a non-thermal, photoacoustic effect, effectively rejuvenating the skin from its core. PicoWay Resolve™ proves to be a great non-ablative solution for striae albae and striae rubrae, showing its efficacy in addressing different types of stretch marks.

The PicoSure Focus™, another aesthetic laser treatment renowned for its efficacy in addressing stretch marks, utilises the innovative Focused Lens Array (FOCUS™) in conjunction with Picosecond technology. This procedure employs a handpiece with a diffractive lens array that delivers laser energy in the apexes of high-fluence regions surrounding low-fluence regions to specifically target skin irregularities, including stretch marks.

Remarkably effective, these PicoWay and PicoSure lasers in Singapore boast a non-invasive nature, resulting in minimal downtime for rejuvenation. Patients can swiftly return to their regular activities once the procedure concludes, emphasising the convenience and efficiency of this approach.

Pulsed dye lasers such as the 595 nm VBeam™ is particularly useful not only for the treatment of vascular malformations, cherry angiomas and fresh red surgical scars, but is especially useful in the early treatment of fresh red striae rubrae.

4. Microneedling and microneedle radiofrequency

Both microneedling and microneedle radiofrequency treatments create focal areas of microtrauma which stimulate collagen remodelling. This helps to improve the skin texture and reduces the appearance of striae. Microneedle radiofrequency treatments such as the Morpheus 8™ have the ability to go deeper, and can also create a tightening effect due to the concurrent delivery of radiofrequency energy. Sometimes these treatments can also be combined with bio-remodelling filler injections such as Radiesse™ which contains calcium hydroxyapatite particles that can help to stimulate fibroblast activity and improve the skin’s bio-remodelling capacity to lift and smoothen the striae.

Conclusion

Stretch marks are a common and natural consequence of the skin’s response to rapid stretching. Understanding the biological processes that lead to their development is crucial for effective management. As science continues to advance, new and innovative approaches to managing stretch marks may emerge, offering hope to those seeking effective solutions. That said, embracing one’s body, with or without stretch marks, is a powerful step toward self-acceptance and confidence.

If the presence of stretch marks or any other skin condition, like café au lait birthmarks, is affecting your confidence – fret not! Begin your journey to enhance your self-confidence by scheduling a consultation with Dr Yong at Angeline Yong Dermatology, and let us guide you towards a smoother, more confident version of yourself. Your path to radiant skin and boosted self-esteem begins at our dermatology clinic – contact us to book your consultation today.

References

Nichols, H. (2018, January 5). Stretch Marks: Causes and treatments. Medical News Today. https://www.medicalnewstoday.com/articles/283651

Atwal, G. S., Manku, L. K., Griffiths, C. E., & Polson, D. W. (2006). Striae gravidarum in primiparae. The British journal of dermatology, 155(5), 965–969. https://doi.org/10.1111/j.1365-2133.2006.07427.x

Ghasemi, A., Gorouhi, F., Rashighi-Firoozabadi, M., Jafarian, S., & Firooz, A. (2007). Striae gravidarum: associated factors. Journal of the European Academy of Dermatology and Venereology : JEADV, 21(6), 743–746. https://doi.org/10.1111/j.1468-3083.2007.02149.x

Brennan, M., Young, G., & Devane, D. (2012). Topical preparations for preventing stretch marks in pregnancy. The Cochrane database of systematic reviews, 11(11), CD000066. https://doi.org/10.1002/14651858.CD000066.pub2

Ud-Din, S., McGeorge, D., & Bayat, A. (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 : JEADV, 30(2), 211–222. https://doi.org/10.1111/jdv.13223

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Stretch Marks: An In-Depth Look Into How They Develop