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Striae distensae(SD), the medical name for stretch marks, affect a substantial proportion of the worldwide population and pose a psychological and cosmetic burden to those affected. A multitude of companies and over the counter agents target pregnant women and others affected by SD, with the aim of preventing or treating these cosmetically undesirable marks.  We are always presented with this issue in our practice, and patients frequently ask, “Does anything work?”

Q:  Do any creams or topical formulations help with improving Stretch Marks?

A:  SD is caused by tearing of the dermis during the rapid growth of skin (ie. pregnancy or puberty). This tearing is at the deepest layer of the skin, and therefore, for any topical treatments to work they would have to penetrate the protective top layers of the skin. No topical known currently can effectively do this.  In fact, there are no high-quality, double-blind controlled studies in the literature that supports the use of creams and lotions in the prevention of pregnancy-related stretch marks. Furthermore, most evidence points to a lack of effect with even the “medical grade” topical preventative agents sold by television or online retailers.  Additionally, most articles that evaluate the use of lasers, and other energy-based devices for treatment of SD are also low-quality studies. Significant side-effects may occur with both topical treatments and laser devices when used in a non-clinical setting or without physician guidance. So be careful and seek the advice of medical professionals when anything sounds “too good to be true.”  I always tell my patients that the best thing you can do is to keep your skin well moisturized, and hydrated. Massaging areas that are most prone to SD during growth and pregnancy is also helpful.

Q: Is there anything I can do for Stretch Marks?

A:  In short, the only real treatment available today to remove stretch marks is actual surgical excision. This is the only procedure that will eliminate the problem and improve body image. The downside of surgical treatment, however, is that we will leave a resulting scar. But today, that is the only acceptable tradeoff.  Nevertheless, as plastic surgeons, we always try to hide scars in the natural skin folds, or underneath regular clothing to make them less noticeable. Tummy tucks, breast lifts, arm lifts, and body lifts are all performed to improve body shape and remove stretch marks. Someday we will likely have some “non-surgical” method of removing stretch marks, and believe me when that day comes, we will be the first to offer it!

By Erez Sternberg, MD

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