OVERVIEW

What is stretch mark?

Stretch marks, also known as striae atrophicae or white lines, are a type of skin condition. When they occur during pregnancy, they are referred to as pregnancy stripes.

Are stretch marks common? Who is most affected?

Stretch marks are very common.

• They frequently appear in adolescents aged 13–17 during rapid growth, as well as in pregnant women aged 20–40. Some overweight adults may also develop them.
• Teenagers who drink a lot of tea, stay up late, or don't drink enough water may develop stretch marks on their legs, buttocks, or other areas.
• Excessive hormonal secretion due to intense physical activity, such as in soldiers or athletes, can also lead to stretch marks.
• Patients with endocrine disorders causing excessive glucocorticoid secretion.
• Patients taking certain glucocorticoid medications.
• Patients using topical steroid medications for prolonged periods.
• Individuals who were once obese but later lost a significant amount of fat.

What are the types of stretch marks?

Stretch marks can be categorized into striae atrophicae, pregnancy stripes, and growth stripes.

Are stretch marks hereditary?

This is a skin condition primarily caused by excessive stretching or trauma to the skin and is unrelated to genetics. Therefore, it is not hereditary.

SYMPTOMS

Where do stretch marks commonly appear?

They occur in different areas depending on the situation.

• Pregnancy stretch marks appear on the abdomen, around the breasts, and thighs;

• Adolescent stretch marks are commonly found on the inner thighs, buttocks, and lower back;

• Those caused by corticosteroid use often appear in folds like the inner thighs.

CAUSES

Why do stretch marks appear?

Elastic fibers that maintain skin elasticity degenerate, making the skin fragile. Excessive stretching then causes these elastic fibers to break. Alternatively, when skin or muscle grows too quickly, exceeding its original stretching capacity, stretch marks form in both scenarios.

Simply put, the rupture of elastic fibers leads to stretch marks.

Why do elastic fibers break during the formation of stretch marks?

Causes of elastic fiber rupture include:

• Rapid growth during adolescence, where elastic fiber production lags behind body development;

• Excessive obesity;

• Certain endocrine disorders, such as excessive glucocorticoid secretion, which promotes protein fiber breakdown, leading to elastic fiber rupture;

• Oral intake of glucocorticoid medications;

• Long-term topical use of hormonal drugs, causing elastic fiber degradation and rupture.

What causes striae atrophicae in stretch marks?

Striae atrophicae can result from weight loss. When obese, the skin stretches; after losing weight, the overstretched skin shrinks, forming patterned marks. These are often pale red or purple.

Within six months to two years, most fade to light-colored traces matching the skin tone, which may persist or gradually diminish over time.

What causes striae gravidarum (pregnancy stretch marks)?

Striae gravidarum primarily form due to hormonal changes during pregnancy, combined with abdominal expansion that damages or ruptures elastic and collagen fibers, creating uneven pink or purple wavy streaks.

After childbirth, these streaks fade, leaving white or silvery shiny scar-like lines.

What causes growth stretch marks?

Growth stretch marks occur when rapid adolescent development outpaces elastic fiber production, causing the fibers to tear and form fine white streaks.

DIAGNOSIS

How to identify stretch marks?

When the skin exhibits linear atrophy resembling watermelon patterns—appearing light red initially and fading to pale white over time—without pain, itching, or other discomfort, only visible surface markings, these are stretch marks.

TREATMENT

Can stretch marks heal on their own?

Stretch marks are permanent lesions. Once the elastic fibers are broken, they cannot reconnect. Therefore, stretch marks cannot heal on their own. Some may fade but will not completely disappear. Medical aesthetic methods are needed for removal.

How to treat stretch marks?

• Stretch marks are neither painful nor itchy and do not hinder physical activity, so treatment is generally unnecessary.

• If treatment is desired for cosmetic reasons, topical medications such as tretinoin, heparin, hyaluronic acid, or vitamin E can be applied. Massaging the area helps the medication penetrate the dermis, promoting metabolism and enhancing the skin's self-repair ability.

• Additionally, fractional erbium-glass laser is the most commonly used laser treatment for stretch marks. Most studies indicate its safety, but it is only effective for mature stretch marks and less effective for newly formed or developing ones.

What are the common risks of surgical treatment for stretch marks?

The risks of stretch mark surgery are low. Typically, the treated area may experience needle-like pain and a burning sensation, along with swelling, but these effects are short-lived.

The laser treatment does not cause skin peeling, scabbing, or disruption to daily life. It also does not lead to side effects such as hyperpigmentation, hypopigmentation, or capillary dilation.

How long is the recovery period after stretch mark surgery?

If pain or a burning sensation occurs post-surgery, compound lidocaine cream can be applied to alleviate discomfort, or ice packs can be used for relief, which usually takes 1–2 hours.

Swelling in the treated area may last about 1–2 days but typically subsides naturally after the procedure.

DIET & LIFESTYLE

What should patients with stretch marks pay attention to in daily life?

• Stretch marks are difficult to eliminate. It is recommended to maintain a balanced diet and avoid rapid weight gain in a short period.

• Eat more foods rich in vitamin E.

• When using topical medications, persist with massaging the affected areas. Pregnant women can regularly apply moisturizing lotion to areas prone to stretch marks to maintain skin hydration.

• Additionally, skin cell growth requires adequate hydration, so drinking plenty of water is also important.

Do stretch marks affect fertility?

Stretch marks are caused by skin stretching and damage due to abdominal expansion during pregnancy. They pose no health risks, do not affect fertility, and there is no need for concern.

PREVENTION

Can stretch marks be prevented? How to prevent them?

• You can apply olive oil, almond oil, or other products high in vitamin E with moisturizing properties. Using moisturizing body lotion after daily showers is also recommended.

• Teenagers should drink plenty of water, increase vitamin E intake, avoid staying up late, and reduce tea consumption.

• Pregnant women can start using specialized stretch mark prevention creams early in pregnancy and engage in regular massage.