Stretch Marks

What are stretch marks?

Medically known by the names of striae distensae, SD, striae, striae atrophicans and striae gravidarum, stretch marks are defined as dermal scars or lesions on the outermost layer of the skin. They present themselves as pink, red or purple lines (indented streaks) often on the hips, abdomen, breasts, upper arms, thighs or buttocks. Over time stretch marks tend to flatten and fade to translucent white or grey pale marks. While both men and women are affected by stretch marks, around 70 percent of adolescent girls develop the condition during puberty compared to 40 percent of boys. Those at higher risk of developing stretch marks include:

• Adolescents during growth spurts or hormonal changes
• Pregnant women
• Body-builders
• Obese or overweight people

What causes stretch marks?

Stretch marks are formed is the areas of the body where the skin is subjected to continuous stretching. The skin is divided into three main layers: the subcutaneous or hypodermis (deepest layer), dermis (middle layer) and the epidermis (the outer layer). Stretch marks are formed within the dermis. The rapid stretching of the connective tissue due to sudden growth or weight gain damages the dermal tissue atrophy and causes thinning of the outer layer. This allows the deeper skin layers to be revealed, forming the unsightly streaks along the surface. When the body grows, the connecting fibres of the dermis naturally stretch slowly. However with rapid growth, these fibres are overstretched and tear. This inflammatory reaction within the skin is the responsible for the stretch mark’s red or purple tone (new stretch marks). When viewed under a microscope, the tissue affected by stretch marks resembles that of a scar due to the changes in the collagen fibre’s appearance.

Treating Stretch Marks

Treating stretch marks has always been a very difficult task. When stretch marks first appear they look pinky-red and slightly raised. They then increase in length and acquire a dark purple colour and over time, become white and flat. Stretch marks are caused by abnormal collagen formation and all the treatments used at Cosmos Clinic are aimed at improving the collagen fibres in your skin.

At Cosmos Clinic we use four modalities to treat stretch marks. These have resulted in significant improvements in the appearance of stretch marks. Most often they are used together, which is referred to as a multimodal approach.

Patients wanting a non-surgical option are able to combine the Dermapen with PRP. For this treatment option you will generally need 2-3 treatments spaced 1-2 months apart to achieve the best possible results.

Patients wanting a more invasive option, with up to 85% improvement, are combining Vaser Skin Tightening, Fractional Laser and PRP. For this surgical option you generally only need one treatment for a marked improvement in your stretch marks.

If you have loose skin and want a complete removal of stretch marks, you will need to cut out the skin with a Tummy Tuck or Arm Lift.

PRP (Platelet Rich Plasma)

Platelet Rich Plasma (PRP) is blood plasma that contains a high concentration of platelets which activate collagen production in the skin. At the start of this treatment we take a small amount of your blood, put it in a test tube and then spin it in a centrifuge. As your red and white cells fall to the bottom the platelets contained in your blood rise to the top in the form of a golden liquid. This substance that is referred to as PRP is your plasma which is made up of platelets that are rich in growth factors. When these growth factors are injected under the skin they stimulate the stem cells which induces collagen formation, thereby tightening the skin.

Dermapen / Dermaroller

Also known as skin needling, this treatment stimulates new tissue formation through the use of micro-fine needles on areas of skin with stretch marks. Microscopic holes are made into the dermis, which stimulates the production of new collagen and new cell growth. The skin remains intact and is not damaged therefore promoting constructive regeneration. This treatment is most often used in combination with PRP.

Fractional Laser

One of the most exciting applications of Fractional Lasers is for striae (also known as stretch marks). A recent pilot study of 20 patients showed significant improvement in the appearance and texture of mature (white) striae after 3 treatments were performed on moderate settings. Redness in the treated areas does seem to persist a little longer on the body than in the face, however this fades in time.

The Fractional Laser works by increasing the number of collagen and elastin fibres. Patients report a greater than 50% improvement in the appearance of their stretch marks.

Vaser Skin Tightening

Another emerging treatment for improving stretch marks is by using Vaser Skin Tightening. Although this technology was originally designed to tighten the skin, recent trials have shown promising results for reducing the appearance of stretch marks. At Cosmos Clinic we use Vaser to improve stretch marks on many of our patients who have poor quality skin with great results!

A Vaser Probe is passed under the skin to heat up collagen fibres inducing the formation of new collagen. The formation of new collagen helps the skin to contract.

Why is it so difficult to treat stretch marks?

The truth is that we don’t know what exactly causes stretch marks. The theories include genetic factors, increased levels of body steroids, and mechanical effects like pregnancy, obesity and weight lifting. When we look under a microscope stretch marks look like a scar. Therefore, the best way is to treat scars is with a multi-modal approach, and so we apply the same treatment plan to stretch marks.

What topical treatments for stretch marks are available?

Several other treatment methods that help mildly improve the appearance of stretch marks:

• Vitamin A helps improve stretch marks when they are red
• Trofolastin cream (centella asiatica extract) has been shown to help prevent stretch marks in pregnant women
• Verum (Vitamin E, panthenol, elastin and methanol) has also been shown to help prevent stretch marks during pregnancy

It is worth noting that once stretch marks have formed, they need to be treated with procedures tailored for stretch marks.

How soon after pregnancy should I wait before treating my stretch marks?

We advise the treatment combination (of PRP with Dermapen) two months after delivery. The use of Laser Skin Tightening with PRP and Fractional Laser is advised after 6 months. It is important to be note that the sooner the stretch marks are treated after pregnancy the more likely they are to respond to the treatment.

When should I consider surgical excision of stretch marks?

If you have loose skin and want a complete removal of stretch marks, you will need to cut out the skin with a Tummy Tuck or Arm Lift.