Stretch marks are caused by tears in the outer layer of skin due to rapid stretching that can occur during pregnancy or periods of rapid growth. Can they be prevented? How can they be treated once you have them? Like so many others (up to 90% of women after pregnancy), I have a few of these so, when I stumbled across information on them, I thought I’d do some reading…
What are stretch marks? Why are some red and others white?
Skin contains tiny fibers called collagen and elastin that give it firmness and stretch. Stretch marks occur when skin is stretched so rapidly that these fibers break, exposing under-layers of the skin. The marks look red or purple initially as blood vessels show through the tear in the surface layer of skin. Eventually, as healing occurs, the blood vessels shrink, making the stretch mark scar look white.
Prevention of stretch marks
While an increased tendency to form stretch marks in the skin is partly inherited—if you developed stretch marks during pregnancy, your daughter may be more likely to do so also—any strategies that reduce rapid stretching of the skin, keep the skin healthy or help it to expand when necessary can help prevent them from forming.
Skin is stretched more than usual during pregnancy, in rapid growth periods (like puberty, starting body building or sudden weight gain), or with breast implants. These are times to pay extra attention to skin health and hydration.
Here are some suggestions to prevent stretch marks:
1. Keep body weight consistent and prevent rapid weight gain when possible.
2. Eat a healthy diet: like all parts of the body, skin requires nutrients to stay healthy and to stretch and repair itself when necessary. Vitamin C is needed to form the collagen fibers that keep skin firm, but there are many other nutrients needed for healthy skin, including vitamins A, D and E, omega-3 oils, and zinc. Fruits and vegetables contain plenty of these and other vitamins and minerals.
3. Stay hydrated and keep skin moisturized. Dehydrated cells shrink, and dry, thin skin can tend to tear more easily.
4. Massage can help by improving blood circulation in the skin.
5. Avoid steroids, both creams and anabolic steroids (used to build muscle in body building). Both weaken collagen in the skin and increase the risk for stretch marks. If steroid creams are necessary for a skin condition, ask your doctor about using the lowest strength possible and use only as long as necessary. Ask about non-steroid options and preventive strategies for these skin conditions.
6. Regular exercise helps control weight and increases blood flow to the skin, keeping it healthy.
7. Avoid excess sun exposure. While a little sun enables us to create the vitamin D we need, excess UV rays damage the skin’s collagen and elastin, increasing risk of stretch marks (and premature aging of the skin!).
8. Don’t smoke! Smoking reduces blood flow to the skin, depriving it of oxygen it needs for repairs, and depletes other nutrients skin needs to stay healthy. In addition to aging the skin more quickly, smoking also increases the risk of stretch marks.
Treatment
Stretch marks are most treatable in the early stage (while still red), but both home remedies and prescription treatments can improve the look of these scars, even older ones that have turned white. While some treatments require a doctor’s prescription or are performed by a professional, others can be done at home.
Professional treatments:
Laser removal therapy uses powerful light to trigger skin regeneration. While it may not completely remove stretch marks, it can make them smoother and less visible. However, treatment requires repeated sessions over several weeks, and it can be expensive. Since it is considered cosmetic, it is often not covered by medical insurances.
Microdermabrasion is a painless procedure that uses fine crystals to remove the top layer of skin. Several sessions are required to see results and outcomes are typically better with newer and less severe scars. Short-term swelling and redness, similar to sunburn, are common after-effects of the treatment.
Microneedling uses tiny needles to puncture the skin, prompting it to produce new collagen. It is also used for other minor scars, sun damage and skin wrinkles. Several treatments are needed to achieve results.
Surgery can be used to remove areas of excess abdominal skin that contain stretch marks. It can only be used in areas where there is loose, sagging skin. This procedure is called abdominoplasty or a “tummy tuck”.
Tretinoin cream, a “Retinoid” or vitamin A derivative, exfoliates the skin and stimulates production of collagen. These creams are also used for acne treatment and require a prescription. Retinoids generally are teratogenic (can cause birth defects) and are not to be used in pregnancy or when breastfeeding. They can also cause skin irritation.
Things you can do at home:
There are some things you can do at home to help improve the look of stretch marks. However, home remedies and non-prescription treatments are less tested than the prescription versions.
Exfoliation, a much milder version of the microdermabrasion described above, can help remove dead skin cells when done regularly. This can be done mechanically, by washing with a rough sponge or cloth, or by using a mild exfoliant, such as salicylic acid or glycolic acid in a cream or wash. These ingredients loosen the “glue” between dead skin cells, allowing them to shed more easily, leaving the skin surface smoother.
Non-prescription creams and oils aim to hydrate the skin, increase its elasticity, smooth its surface and stimulate the growth of collagen. The action of massaging these products into the skin also stimulates blood circulation.
Sunscreen, makeup and self-tanner can be used to even the colour of the skin temporarily. Stretch mark scars do not tan, so applying sunscreen to prevent tanning of healthy skin lessens the contrast of the white scar areas. Conversely, carefully applying makeup or self-tanner only to the white stretch mark lines can camouflage the lighter areas, decreasing contrast.
DIY (Do it yourself)
This is where my long history of compounding pharmacy surfaces. Years ago, I had read a book about cosmetic ingredients and even attended a conference on compounding cosmetics! Some of these preparations are quite easy to make (a little like baking!) but extra precautions are necessary for any product you intend to keep more than a couple of days. Cosmetic products grow bacteria, just like food does, and could potentially cause a skin or eye infection.
Bacterial contamination can be prevented in several ways:
Start with clean equipment and ingredients. Pour boiling water over your equipment and soak for at least 5 minutes or wipe with 70% isopropyl alcohol (ordinary rubbing alcohol from the pharmacy) and let air dry.
Add preservatives, like vitamin E or citric acid, both readily available in pharmacies or grocery stores. Usually 1% [or 1ml(gram) in 100ml(grams) of final product] is a good amount
Avoid putting fingers into the jar—scoop out the amount you want to use with a clean spoon
Consider storing the product in the fridge, especially if it contains water (organisms grow more readily in water and water-based creams/lotions).
Only make enough for 2 to 4 weeks
Throw out any cosmetic product (homemade or commercial) that has changed colour or odour.
One simple homemade preparation that (based on theory) could help stretch marks, is a salt scrub. This is made by mixing an oil (like olive oil) with table salt. This can easily be made when needed, so no worries about preservatives. Just stir salt to oil until you reach the desired consistency, and massage the mixture into the area. Since salt doesn’t dissolve quickly in oil, the crystals will provide exfoliating friction while the oil moisturizes the skin and the massage stimulates blood circulation. Adding water toward the end of the massage, will dissolve the salt crystals and dilute the thickness of the oil, making cleanup easier.
Some recipes call for sugar instead of salt in skin scrubs. However, putting sugar on the skin seems likely to increase glycation of collagen (the technical term for attachment of sugar molecules to collagen). Glycation causes stiffening of collagen fibers that we want to stay flexible and strong for healthy skin. In this type of preparation, it’s the crystal that is doing the exfoliating action, so salt would work as well as sugar without the risk of extra sugar being absorbed into the skin.
Final thoughts...
Remember that stretch marks are harmless and often fade over time. And, although treatments usually cannot completely eliminate the marks, they can improve their appearance. So, as they say in my part of Canada, "worry pas"... don't worry too much about them!
References:
White stretch marks: Everything you need to know—Medical News Today
Ten tip to prevent stretch marks—Medical News Today
Stretch marks—Mayo Clinic
