Stretch marks can occur unfortunately in any of us typically due to wear and tear of the skin. Most commonly seen post puberty due to an abnormal mechanical stretch to the skin they are also seen during puberty or weight change. Stretch marks are not essentially due to “stretched” skin – stretching maybe one of the triggers and its actually scar formation which eventually occurs – which is actually what makes it difficult to treat as well.
Causes of stretch marks?
Stretch marks have been an enigma since time immemorial. Different hypotheses on the development of stretch marks have been mentioned in the literature.
a) Infection leading to the release of “striatoxin” that damages the tissues in a toxic manner.
b) Mechanical effect of stretching- leading to rupture of the connective tissue framework of your skin leading to gaping of the network (e.g., pregnancy, obesity, weight lifting)
c) Normal growth spurts seen in adolescence and the puberty.
d) Increase in the levels of body steroid hormones – Cushing’s syndrome, local or systemic steroid therapy (abused by body builders) – has a breakdown effect on the fibroblasts which are responsible for collagen synthesis, which forms the framework that holds our skin together.
e) Genetic factors
f) Immunosuppression states such as HIV or tuberculosis.
g) Associated with chronic liver disease.
At what stages of your life are you most prone to stretch marks?
People most prone to stretch marks are adolescents (due to their growth spurts) and women going through pregnancy. Almost up to 90% of pregnant women land up with stretch marks.
What are the treatment options?
Regardless of the cause the treatment options for stretch marks are limited, however not impossible. Early treatment of stretch marks will provide you with better overall outcomes. Although topical treatments in the form of silicone gels, Trofolastin (centella asiatica), hyaluronic acid, oils and moisturizers help to some extent and are more preventive, to actually decrease the dimensions of the stretch marks one has the following treatment options available:
a) Fractional lasers – Probably the only US FDA approved non-surgical approach for stretch mark reduction. According to latest guidelines (Journal of Dermatologic Surgery,2017,May) fractional lasers for stretch mark reduction are considered first line treatment. The treatment is well tolerated and has minimal downtime.
b) Fractional Microneedle Radiofrequency – This novel technology has the ability to penetrate deep and remodel the stretch marks.
With either of the above technologies the size and dimensions of the stretch mark improve and so does the texture and overall global appearance of the stretch mark.
Some authors have tried TCA peeling under occlusion for stretch mark reduction, but one should practice caution employing this technique in Indian skin.