Stretch marks can happen to anyone. The conversation typically centers around pregnancy (since that’s when women are most susceptible to getting them), but the reality of these streaky lines is that they know no gender, age, or body type. The good news is that there are various options to deal with them if you want. We asked board certified dermatologist Dr. Jason Emer, MD, to weigh in on the most effective stretch mark treatments.
What Are Stretch Marks?
Stretch marks are a type of scar that results from the rapid stretching of your skin. These conditions are often the result of teenage growth spurts, pregnancy, or weight gain. Rapid changes in skin size cause the rupture of collagen and elastin components in the skin and thus form scars.
Less commonly, stretch marks result from prolonged repeated application of corticosteroids to your skin. Anyone can develop stretch marks, but they are more common amongst women, and they often appear on areas like the hips and breasts, as well as the stomach, thighs, and upper arms. Stretch marks tend to fade with time but will not disappear completely without treatment. They are not dangerous, but some people don't like the way they look, which is the main reason patients seek treatment for stretch marks.
Treatment costs vary widely due to the different areas that can be treated, but on average each treatment costs $2,000. We spoke to Dr. Emer about treatment options for patients who want to reduce the appearance of stretch marks, how these treatments work, and what to expect from the procedures themselves.
Stretch marks can be treated with either ablative or non-ablative lasers. By destroying the upper layer of the skin, ablative lasers such as CO2 and Erbium YAG make the body generate a new layer of skin which is smoother and more unified in color. Non-ablative lasers including Alexandrite and Fraxel aim at the deeper layers of the skin, to promote the development of collagen. It often takes a number of sessions of either form of laser treatment to see the full effects.
The number of sessions varies from patient to patient, but the process itself is quick and non-invasive. Patients should expect to take some time off on the day of the treatment, each of which can last between an hour and an hour and a half for ablative laser treatments, or half an hour for non-ablative laser treatments. Skin is often sensitive and slightly pink after treatment, but the effects usually pass within a week. Ablative lasers cause slightly more severe side effects that can include raw skin and mild pain. The skin becomes covered with a scab before healing to reveal the new skin underneath.
Patients are generally offered numbing creams during the procedure and once those wear off they can feel like they have a sunburn. People often report that their skin feels a little rough for a couple of days, but that it returns to normal soon after. The number of sessions it takes to treat stretch marks varies depending on a number of factors including how old the scarring is, the area that is being treated, and the patient’s skin tone.
They can also be combined with other treatments. "A new form of medical dermabrasion called the salt facial (combined with) deeper dermal heating with microsecond YAG lasers like Aerolase and Lasergenesis has been used in our practice to give improvements for those who want minimal downtime," says Dr. Emer. "But these require a number of treatments to start to see results.”
Dr. Emer’s go-to treatment for stretch marks is radiofrequency microneedling because “lasers are more expensive, have more downtime, and higher risk of pigmentation and redness," he says. "Radiofrequency microneedling has less risk for discoloration or scarring from energy-based treatments. Peels, creams, and microneedling have minimal risk, but take many more treatments to begin seeing an outcome.”
Microneedling creates tiny punctures in the outer layers of the skin and affects skin below the surface. It works by promoting elastin and collagen production during the wound healing process, the same way this treatment can help fine lines and acne scars on your face. The process is growing in popularity, with some consumers even purchasing at-home derma rollers to improve the appearance of the skin on their own. However, these at-home options can be more painful and have a higher risk of infection than treatments carried out in-office by an American Academy of Dermatology (AAD) registered dermatologist or cosmetic physician.
Microneedling treatments are carried out after a topical anesthetic has been applied to the treatment area to reduce discomfort during the procedure. It generally takes around an hour for the cream to numb the area. After that point, depending on the size of the area being treated, the procedure usually takes around half an hour.
One of the most attractive features of microneedling for stretch marks is that once the treatment is completed, the results will last indefinitely. "Once you get improvement, you will maintain that improvement forever," says Dr. Emer. "However, hormonal changes, weight fluctuations, or use of corticosteroid creams over the improved areas or oral corticosteroids can influence stretch marks to get worse or return.” It is important for patients to consider if they are likely to expose themselves to more stretch mark risk factors. For example, women planning on having additional future pregnancies should wait until afterward to treat stretch marks that could otherwise return.
It usually takes more sessions to treat stretch marks with microneedling than lasers and your practitioner will be able to provide you with an accurate estimate of how many sessions you will require. The downtime is minimal compared to other treatments.
Topical Creams and Ointments
For years there have been vast numbers of topical treatments like ointments, gels, and serums promising to reduce the appearance of stretch marks. The ability of these treatments to offer significant and lasting results has been debated and researched thoroughly. “Researchers have studied many of the creams, lotions, and gels sold to treat stretch marks," says Dr. Emer. "While no one product seems to help all of the time — and some don’t seem to help at all — researchers have discovered some helpful hacks."
As with any other form of skincare, the key to finding the right product is in the ingredient list. Dr. Emer says that vitamin A is the hero ingredient when it comes to treating stretch marks. Vitamin A is a group of organic compounds that include retinol, retinoic acid, and several provitamin A carotenoids such as beta-carotene. "Researchers found that stretch marks did not fade when people massaged almond oil, cocoa butter, olive oil, or vitamin E into their skin," he says. "Topical vitamin A (tretinoin, retinol, etc), however, is popular and often dermarolled into the skin at home for bigger improvements than just daily use.”
There are ingredients to be cautious of if you are looking to prevent stretch marks from developing during pregnancy. "Safety during pregnancy of one ingredient, Centella asiatica, has been questioned," says Dr. Emer. "Evidence of treatments for reducing the appearance of the scars after pregnancy is limited. Most women avoid retinol and tretinoin (vitamin A) during pregnancy so moisturizing creams with shea butter or vitamin E are often used.” Other options that are considered safe to use during pregnancy include glycolic and lactic acids. Both have exfoliating properties and will stimulate collagen production in the treatment area.
If you choose to use at-home treatment options, Dr. Emer has these tips for getting the most out of them. “If you want to try one of these creams, lotions, or gels to fade stretch marks, be sure to use the product early," he says. "These treatments seem to have little effect on mature stretch marks. Gently massage the product into your skin. Apply the product every day for weeks. If you do see results with these treatments, it will take a few weeks."
Realistically the only way to significantly reduce the appearance of stretch marks is to undergo a more extensive treatment plan. While they do tend to fade with time, microneedling and lasers provide the best long lasting-results for patients.
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