Stretch marks, or striae distensae, are a common problem that I see as a Miami dermatologist, affecting a quarter of people during their lifetime, and are twice as prevalent in women than men. They can occur after any rapid or dramatic change in body habitus, such as after pregnancy, extreme weight loss (i.e. gastric bypass surgery) or gain, or during a teenage growth spurt.
Stretch marks are rarely symptomatic, but they can cause considerable social distress. Early stretch marks, also known as striae rubra, are red and elevated. Over time these areas on the skin become white and depressed, so-called striae alba. Common areas for stretch marks to appear include the breasts, buttocks, thighs, abdomen, and lower back.
Stretch marks require a clinical diagnosis, meaning dermatologists (and almost everyone!) can tell what they are based on their appearance. However, if we were to take a sample of the skin with a punch biopsy and look at it under the microscope, it would show thinned collagen bundles (the cushioning and youthfulness of the skin) and ragged and diminished elastin fibers.
So why would I bore you with this information? Well, any treatment to get rid of these unwanted skin lesions would try to reverse this by increasing dermal collagen and elastin. Probably the best at-home treatment is tretinoin cream or gel, also known by the brand names Retin-A, Atralin®, and ZIANA®, among others. This prescription-strength topical retinoid applied nightly for many moons will result in new collagen formation and a diminished appearance of the stretch marks.
There are also laser and light options to treat stretch marks, available at our Miami and New York dermatology offices. For the early striae rubra, we recommend vascular lasers including the Cutera Excel V™ KTP laser and the Candela VBeam® Perfecta pulsed-dye laser. Once stretch marks have evolved and become atrophic and white, our preferred lasers are so-called non-ablative fractional resurfacing lasers, either the Cynosure Palomar Icon™ 1540nm XD/XF or the Fraxel® Dual 1550 nm erbium glass.
Each of these devices uses invisible laser light to apply thousands of small points of safe, heat-based injuries to the skin. This in turn safely triggers a wound-healing response that activates the cells that make new collagen, called fibroblasts, thereby healing the stretch marks from the inside out. Although we would love to be able to erase stretch marks completely, a more realistic goal after a series of treatments is a 25% to 50% reduction in their severity.
If you’d like to learn more, please visit our dermatology practice in Miami or New York by scheduling a consultation. It would be our pleasure to discuss the best options for you.
