Stretch marks are linear, smooth bands on the skin that, depending on skin color, can appear as red or purple and which fade over time to leave silvery pale marks.
Stretch marks are not medically dangerous, but can be a cause of aesthetic concern and anxiety. For some people, stretch marks are such a significant cosmetic concern that they affect quality of life. They can be disfiguring, causing emotional and psychological distress, especially during puberty, the latter stages of pregnancy (when they are most prominent), in the postnatal period where they appear pale, or after significant weight loss.
The skin consists of three key layer: epidermis (the outer layer), dermis (the middle layer) and subcutaneous or hypodermis (the deepest layer). Stretch marks form in the dermis when the connective tissue is "stretched" beyond the limits of its elasticity due to rapid expansion or contraction of the skin from sudden growth or weight gain.
The abrupt stretching causes the dermis to tear which allows deeper skin layers to show through, forming the stretch marks.
Usually, as the body grows, the strong connecting fibers in the dermis slowly stretch. However, with rapid growth, the fibers overstretch and break. Stretch marks are red or purple initially due to blood vessels showing through the tears in the dermis.
Stretch marks eventually fade to a silvery, white or glossy appearance due to the blood vessels contracting and the pale fat underneath the skin becoming visible instead.
Stretch marks are more likely to develop and to appear more extreme where there are high levels of circulating cortisone, or where cortisone is used topically. Cortisol, the stress hormone produced by the adrenal glands is converted into cortisone, which weakens elastic fibers in the skin.
Microdermabrasion is a popular technique used in the treatment of several skin problems, including acne, acne scarring, stretch marks, and photo aging. The procedure appears to result in an improvement in skin contour irregularities with significant improvement in early stretch marks.
This treatment involves a device that blows crystals onto the skin, "polishing" the skin's surface while a vacuum tube removes both the crystals and skin cells. The top layer of the skin is gently removed, stimulating growth of new elastic skin.
Side effects are less frequent with microdermabrasion and patients are more likely to stick with (adhere to) the treatment compared with topical tretinoin.
The use of lasers to diminish the appearance of stretch marks or in combination with other treatments can provide safe and effective reduction in the appearance of both red (early-onset) and white (late-stage) stretch marks. Many laser therapies require special measures for darker skin types as altered pigmentation can be more challenging in dark skin.Laser therapies work by using wavelengths of light to stimulate growth of collagen, elastin or melanin production in the skin.