Unsightly stretchmarks (medically termed striae distensae) are a very common problem for many men and women. Stretchmarks are generally considered unsightly, disfiguring and unacceptable by many people.
What do stretchmarks look like?
Recent or immature stretchmarks are flattened areas of skin which appear pink or red in colour (striae rubra) and may be itchy and slightly raised.
As stretchmarks mature they tend to increase in length and develop a dark purple colour. Over time stretchmarks eventually attain a white colour (striae alba) and become depressed.
Under a microscope stretchmarks resemble the appearance of scars.
What causes stretchmarks?
While the exact cause of stretchmarks is unknown, it is thought that stretchmarks are the result of a breakdown in the structures that provide the skin with its strength and elasticity.
Who gets stretchmarks?
Stretchmarks are two and a half times as frequent in women than men and affect up to 90% of pregnant women. Stretchmarks are also commonly seen in body builders and any others who have experienced rapid weight gain.
In some individuals normal growth itself may be a cause with stretchmarks commonly developing during adolescence and associated with a rapid increase in the size of particular body regions.
In certain people stretchmarks can be linked to higher levels of steroid hormones as a result of such things as treatment with steroid medications or illnesses such as Cushings disease
Where do stretchmarks occur?
The commonest sites are the thighs, upper arms, buttocks and breasts in women and outer aspects of the thighs and lower back in men.
Successfully treating stretchmarks has proven to be a challenge with no one therapeutic option offering complete treatment. The optimal treatment modality for an individual needs evaluation of the stage of the stretchmarks (rubra or alba) and skin type. Expectations need to be realistic and several treatment strategies are often necessary. No matter which treatment approach used the earlier the treatment the more effective the results.
Creams containing Centella Asiatica extract have been shown to be effective in preventing stretch mark development in pregnant women. The mechanism of action was through stimulation of fibroblast cells in the skin inhibiting the effects of glucocorticoids.
Diet and Exercise
There is a lack of data showing any beneficial effects of diets and weight loss on stretchmarks. Weight loss programs using diet alone or a combination of diet and exercise have not been shown to change the degree of stretchmarks Microdermabrasion
Microdermabrasion is effective in may skin conditions such as acne scars, pigmentation and fine wrinkles. Microdermabrasion appears to induce a reaction in the skin causing dermal remodelling and repair. Microdermabrasion can be effective in improving stretchmarks in some patients especially red stretchmarks. A series of 10 to 20 sessions are usually necessary.
Laser treatment of stretchmarks?
Several laser techniques are available to try and improve stretchmarks. The light energy from the laser is thought to stimulate the fibroblasts in the skin to begin to divide again and possibly also stimulate the production of collagen and elastin. This thickens the skin under the stretchmark until it closely resembles the surrounding normal skin.
Which stretchmarks respond best to laser?
Results may vary from patient to patient and may not be immediate. Importantly some patients do not get any significant improvement. Results from laser stretchmarks treatment are generally progressive and may require multiple treatments. About 70% of patients receiving laser treatments for their stretchmarks notice an improvement. Newer and shallower stretchmarks respond better than older deeper ones. The best results tend to be found with red stretchmarks (striae rubra) in lighter skinned individuals.
What type of laser is used?
Vascular lasers such as the pulse dye V Beam laser are the most commonly used laser to target red stretchmarks. In darker skin tones (types 4 and 5) pulse dye lasers are usually avoided as they can result in pigmentation changes. Hence in dark skinned individuals with immature stretchmarks a YAG laser is usually preferred.
Fractional lasers such as the FRAXEL which are the treatment of choice for acne scarring have been found to be very effective in improving both immature (red) and mature (white) stretchmarks with a good safety profile including in patients with pigmented skin.
How many treatments are needed?
This will vary depending on the level of improvement required, the type of stretchmark and the response of an individuals skin. Typically 4-6 treatments are needed spaced about 6 weeks apart.
What are the costs?
Treatment costs for stretchmark treatment will vary depending on the type of treatment used, the extent of the stretchmarks and the level of improvement required. The government provides no medicare rebate for stretchmarks and in addition will charge 10% GST.