Stretch marks are caused by tears in the deeper layers of the skin, known as the dermis.
This can be caused by things like hormone fluctuations, puberty, weight gain, pregnancy and topical steroid treatment.
There is some research indicating that skin prone to stretch marks are more sensitive to estrogen, androgens and glucocorticoids.
There is a strong genetic component to getting stretch marks, so if your parents have them, it’s likely that you will too at some point of your life – unfortunately.
Not to fret though. New stretch marks may look angry, painful and red…but understand that over time they do become less red and turn grey or white. For most people once they’ve reached the grey or white stage they are no longer bothered by them.
It is important to keep uncovered stretch marks protected with a high and broad spectrum SPF. Clothing provides an SPF of around 15, depending on the tightness of the cloth weave.
There are treatments that have been researched and have been proven to be effective for dealing with stretch marks.
As a TL;DR (Too long, didn’t read): The most effective topical, from my research, is a combination of 0.05% tretinoin and 10% vitamin C applied daily. Slightly less effective is 20% glycolic acid and 10% vitamin C applied daily.
The combination of tretinoin and vitamin C works to fade the appearance of stretch marks as well as remodel the underlying skin, but tretinoin does require a prescription (Though it does seem to be available at Amazon). Glycolic acid and vitamin C provides similar benefits in terms of appearance of the stretch marks, but does not remodel the underlying skin.
Glycolic acid and vitamin C are widely available, though not usually in the same product. Two products you may be interested in trying are Glycolix Elite Treatment Pads ($21.00 for 60 pads on Amazon) and NuFountain 20% Vitamin C Serum ($19.99 for 1 oz on Amazon). The NuFountain product is 20% vitamin C, so you can actually dilute it with distilled water, making 2 oz of 10% vitamin C serum. Store the product in a cool place (preferably a fridge for long term storage) and away from light.
Laser treatment is also very effective, though expensive.
It’s important to remember that with any treatment involving exfoliation or Vitamin A derivatives that your skin becomes more sensitive to the Sun, so it is important to use a broad spectrum sunscreen daily when treating the skin.
Preventing Stretch Marks
Cocoa Butter, Other Butters and Oils
Firstly know that products commonly sold for preventing stretch marks containing things like cocoa butter and shea butter – just don’t work. Two studies that examined the effect of applying cocoa butter lotion to the skin before and during pregnancy showed no difference between those who had and those who hadn’t (First study, second study).
As well there is little research showing that cocoa butter or other butters applied topically will increase the amount of collagen and other elastic fibres in the skin. This is necessary for repairing and reducing the size of stretch marks. There is experimental (non-human) evidence that cocoa polyphenols may increase collagen, but cocoa polyphenols are not present in cocoa butter.
A study examining the use of olive oil during pregnancy to prevent stretch marks also had lack luster results. So it’s unlikely that other vegetable oils such as coconut or grape seed oils will have a preventative effect.
Anecdotally, many people do seem to have good results with applying cocoa butter, but as I mentioned previously stretch marks do improve in appearance considerably on their own, as well research indicates that the positive effects may be from massaging the product in.
Massage
A German study found that massaging the skin with a water and oil based massage lotion helped prevent stretch marks formed during pregnancy.
Centella asiatica
A study found that a cream containing Centella asiatica, Trofolastin ($39.95 for 8.5 oz on Amazon), reduced the incidence of stretch marks forming in pregnant women.
Of the 22 women in the placebo group, half of them developed stretch marks. In the group receiving treatment, only a third developed them.
The cream was most effective at preventing stretch marks in women who had formed stretch marks during puberty. 89% of the women receiving treatment who had formed stretch marks during puberty, did not form stretch marks during their pregnancy.
Do keep in mind that the study had involvement with the makers of Trofolastin.
Fading Stretch Marks
Exfoliation
One study examining the use of 70% glycolic acid (applied for 1 minute, monthly) found minor improvements in the texture of the stretch marks in some (15%) patients. Unfortunately stretch marks weren’t completely or greatly improved.
However good results were achieved in a study examining the consistent use of 20% glycolic acid and 10% vitamin C (L-ascorbic acid). A panel of 4 plastic surgeons graded a 43% improvement in the appearance of stretch marks after a 12 month period. Here is an example photo of the results on a black woman’s 6 year old stretch mark.
Do note that about 70% of the patients using glycolic and vitamin C treatment had mild irritation of the skin.
Glycolic acid and vitamin C are widely available, though not often together so you will need 2 seperate products. Try Glycolix Elite Treatment Pads ($21.00 for 60 pads on Amazon) and NuFountain 20% Vitamin C Serum ($19.99 for 1 oz on Amazon). The NuFountain product is 20% vitamin C, so you can actually dilute it with distilled water, making 2 oz of 10% vitamin C serum. Store the product in a cool place (preferably a fridge for long term storage) and away from light.
Anecdotal evidence from a French dermatologist suggested improvements in stretch marks with aggressive microdermabrasion. 10-20 sessions, not more than a month apart produced the best results (as relayed by the dermatologist). The microdermabrasion was aggressive, to the point that areas of the skin were bleeding.
It’s important to remember that with any treatment involving exfoliation or Vitamin A derivatives that your skin becomes more sensitive to the Sun, so it is important to use a broad spectrum sunscreen daily when treating the skin.
Vitamin A Acids
There are a few studies examining the effect of tretinoin with positive results.
One study found that 0.1% tretinoin cream was effective in improving the appearance of newer, red stretch marks after 6 months.
One study using 0.1% tretinoin cream applied daily for 3 months produced significant results, this study specifically examined stretch marks due to pregnancy in women.
Another study found great results with a 0.05% tretinoin cream in combination with 20% glycolic acid. The combination produced results similar to the ones found in patients using 20% glycolic acid and 10% vitamin C. However, results with tretinoin were slightly better, and also induced deeper structural improvements, which the glycolic acid and vitamin C combination did not.
Finally, one study found that low-dose tretinoin (0.025%) did not produce results, so it is important to ask your dermatologist for a minimum of 0.05% tretinoin.
Tretinoin is prescription-only, but it does seem to available on Amazon: Tretinoin Gel 0.05% ($20.77 for 20 g on Amazon) and Tretinoin Micro-sphere Gel 0.1% ($29.80 for 2.1 oz on Amazon)
Irritation of the skin is common when using retinoids (Vitamin A acids) on the skin, generally the irritation will reduce after 1 month of consistent use.
There are no studies examining the effects of other vitamin A acids, such as tazarotene, but it is likely they will provide benefits as well as they activate the same receptors in the skin.
It’s important to remember that with any treatment involving exfoliation or Vitamin A derivatives that your skin becomes more sensitive to the Sun, so it is important to use a broad spectrum sunscreen daily when treating the skin.
Bio-Oil
A South African study looked at the effect the product Bio-Oil ($8.99 for 2 oz on Amazon) had on stretch marks. While there was a statistically significant result, the visual improvements were minor when assessed by a third party.
I don’t recommend Bio-Oil because it contains lavender essential oil, which is cytotoxic to human fibroblasts, in a clinical setting it killed the skin cells responsible for creating new collagen and other skin fibres, which is exactly the opposite of what we want when treating stretch marks.
Mederma
A study funded by Mederma found that applying their stretch mark product ($29.99 for 5.29 oz on Amazon) containing onion extract, Centella asiatica extract, and Hyaluronic acid cream improved the appearance of stretch marks over 12 weeks. Here is an example image of the results.
Lasers and Radio Frequency
Though effective, lasers and radio frequency treatment are less commonly thought of as a viable treatment for stretch marks due to the cost.
The literature indicates that there are effective treatment types for both red and white stretch marks, and that these treatments are safe and effective for various skin tones.
There is always a risk of scarring or worsening of the condition if the wrong laser or energy level is used – this increases as a person’s skin tone becomes darker. Extensive consultation should be undertaken before choosing a doctor or clinic to perform treatment, I’ve summarized a few different studies to help provide some information for those interested in laser treatment.
31 subject study using 308-nm excimer laser in the treatment of white stretch marks. Improvement was rated at 60-70% after 9 treatments bi-weekly. The researchers suggest a maintenance treatment afterwards every 1-4 months. Another study using the same 308-nm excimer laser and 75 patients showed significant improvement after an average of 8.4 treatments.
22 female subject study using two sessions over 4 weeks of fractional photothermolysis at 30 mJ, density level 6, and 8 passes. 6 of the 22 patients showed “excellent” results. The treatment was most effective for older, white stretch marks as opposed to newer red stretch marks.
1 Korean patient study using the Ultrapulse Encore laser (10 600-nm CO2 fractional laser). The patient was 27 years old and had Fitpatrick type IV skin. The treatment took 2 session spaced 4 weeks apart. An image of the results.
22 patient study using the 1064-nm long-pulsed nD:YAG laser found good results in treating newer and red stretch marks. Half of the patients rated the improvement after 3-4 treatments spaced 3-6 weeks apart as “Excellent”.
20 patient study with the 585-nm pulsed-dyed laser examined the effect on both red stretch marks and white stretch marks. No noticeable improvement was gained in patients with white stretch marks after 2 treatments, however there was a moderate reduction in redness in those with red stretch marks.
2 patient study with the 1550-nm erbium-doped fiber fractionated laser found significant improvement in red stretch marks after 3-5 treatments spaced 4 weeks apart. An image of the results.
15 patient follow up study with patients originally treated with 577-511-nm copper bromide laser. The results were satisfactory and maintained after 2 years.
