Stretch Marks

If you’ve talked to me in the office lately, I may have recommended a new cream by Cetaphil called their Activator Hydrating and Firming Cream.  Wow, that’s a mouthful. I randomly tried this on the back of my hands this winter and noticed they started looking better.  What is this stuff?  What’s in it?  And what else can I use it for?  Stretch marks?

I haven’t written many articles about stretch marks, so I thought this would be a good time to discuss.

Stretch marks are lines most often seen on the abdomen and thighs of women and girls.  They come as the collagen and elastin in the skin give way as the skin rapidly stretches from a growth spurt, pregnancy or weight gain.  

As an interesting aside, horizontal stretch marks most often seen on the backs of thighs of teenage females and lower to mid back of males come from rapid vertical growth, not from weight changes.  Stretch marks from weight gain tend to be vertically or diagonally oriented.  This is my personal observation after examining thousands of patients. 

Unfortunately, genetically some patients are more prone to having stretch marks than others.  Some gain a hundred pounds and don’t have any.  Others gain 20 pounds and have tons.  There are many home regimens to prevent development of stretch marks, but genetics play a bigger role than anything we can do preventatively.  This includes cocoa butter and all other moisturizers. The American Academy of Dermatology summary on stretch marks cites there is limited scientific evidence for using hyaluronic acid and Centella asiatica as preventive measures.

Centella asiatica aka CICA is available in a number of OTC creams for stretch marks as well as my new favorite Cetaphil Firming Cream.  It is a traditional Asian herb that is used in many Korean beauty products. 

In addition to trying to prevent stretch marks, there is some evidence suggesting that tretinoin or RetinA can effectively treat stretch marks.  While this is good in theory, tretinoin is not well tolerated on thin skin areas where stretch marks occur and may likely cause them to be more red and inflamed in the short term.  This is often the exact opposite of what patients want.  

Once stretch marks have appeared, treatments are aimed at decreasing the appearance by fading the red color and rebuilding the collagen and elastin in these areas.  In my experience, nothing erases stretch marks.  Improvement once they are skin colored and shiny are minimal.

Laser treatments can be effective in lightening the red color and can stimulate collagen growth.  In the office, we have used Laser Genesis for years now and have had very good results in fading the red color.  However, this treatment is not covered by insurance and can be time consuming. 

Microneedling is often touted to help with the texture and appearance of stretch marks once they are faded.  While we have great results using microneedling for pore size, fine lines, skin texture and tone, our patients have not been impressed with the results for stretch marks.  So generally, I am hesitant to recommend it. 

How about you?  Did you do anything special that helped prevent or treat stretch marks?  Share your secrets with us on social media.