It must be frustrating when you slather your skin with wonderful ointments to make it soft and supple, while someone else declares they use nothing at all during their pregnancy. Then lo and behold, you get stretchmarks while they defiantly declare they have not a single mark!
Being in the beauty industry, I hear this all the time. Or I hear that women swear by a certain oil or celebrity endorsed product. The cruel truth is that some people get stretchmarks and some don’t.
It’s down to how much cortisone your body produces. Cortisone is a steroid hormone, produced by the adrenal glands when we are under stress. We also get it during hormonal changes to the body such as puberty. You may have heard of cortisone injections which are used by the medical community to reduce inflammation and suppress the immune system in areas of pain and injury. Another effect of cortisone is it reduces the amount of collagen and therefore elasticity in our skin and this is where their connection with stretch marks comes in.
At times of a growth spurt such as during puberty or pregnancy, our skin will stretch. The elastin fibres in the skin allow it to stretch and expand, like when you’re blowing up a balloon. But if you have excess cortisone in your body, your elasticity is greatly reduced and the elastin fibres weakened. Your skin will stretch and stretch until it reaches a point where the middle layer of skin called the dermis tears and the underlying blood vessels show through. This is why stretch marks initially appear red or purple. The redness fades over time and they eventually turn white.
Some medications can supposedly make your skin more susceptible to stretch marks. These are cortiscosteroids, or topical hydrocortisone which, taken long term can thin the skin and are like having excess cortisone in your body.
An industry has developed over treating stretchmarks, either treatments in clinics or topically applied creams you buy from your local shop. Some of them offer a good degree of improvement especially done on fresh marks. This is because before they turn white, the marks are still in the healing process. Some treatments have a chance of changing the way the scars harden and form and can even reduce their diameter or length. The fibres of collagen and elastin are permanently torn. You cannot fix them but you can induce more collagen and elastin production to help improve the appearance of the scar tissue and this is what most treatments aim to do. Seeing as fresh stretchmarks might take anything from 3 months to a 1 year to (anecdotal evidence, not statistics) to go from red to white, look at the minimum time as your open window within which to start treatment.
All treatments work best while marks are still fresh, red or purple. You can still change the scar as it is healing, but once it’s turned white, the tissue underneath hardens and you have a harder job on your hands.
If you have very fair skin, the white scars will not be as apparent as on dark skins, although in daylight, they have a habit of glistening as they catch the light. I’m sorry, but I have a good eye for spotting stretchmarks. Don’t think that sunbathing will disguise them. Your skin will tan but the marks themselves will remain white. Self-tanning lotions or body make-up offer a better camouflage.
One of the most popular treatments for stretchmarks is LASER, such Nd:YAG, fractional laser and pulsed dye. Some will burn the skin to remove thin layers around the scars. Some use UV light to break down the skin tissue to remove the scarred skin. After wounding, the layer of skin underneath will heal and emerge as new, healthier skin. Several sessions are needed. There are some downsides, such as blistering, burns and taking a long time to heal. Fractional and pulsed dye lasers are not as effective on dark skins and can cause pigmented marks.
Microdermabrasion abrades the skin scar tissue. By removing the top layer of skin, the marks appear more flat against the surrounding skin so they appear less noticeable. MDB will not erase the scars as they are down at the deeper layer of skin, in the dermis. Any smoothing out is not permanent.
There are some creams that claim to reduce stretchmarks such as Retin-A, but as these are best used on fresh marks that are still red, they are not helpful if you’re pregnant. Retin-A or lotions that contain retinoic acid are thought to help collagen production but you can get a retinoid reaction which is a reaction to the high concentration of vitamin A suddenly on the skin. This can be dry, irritated or reddened skin. If your fresh marks are itchy, you need to be aware of this.
Acid peels are said to have some effectiveness. They help to renew the skin by encouraging the skin to shed its top layer, and promoting an increase collagen production. They give similar results to fractional laser.
Combining glycolic acid and vitamin C is said to be more effective than acid alone, probably because C helps to lighten the skin and contributes towards collagen production. As vitamin C degrades on exposure to light and air, the product should be in an airless container or pump, or a kit of vitamin C which is mixed up only when about to be used, e.g. a powder and activator set. Any treatment involving acid peel can cause irritation and you need to keep out of the sun.
Carboxytherapy is carbon dioxide being injected into the individual marks. This process indicates to the body that this area needs oxygen and over days, new blood vessels, oxygen and nutrients are brought to the scar tissue. It can help to shrink the scar, especially if it is still red.
Mesotherapy is a means of injecting a cocktail of vitamins and minerals including silica into the skin to help repair skin tissue.
Radio frequency tightens the skin and can help in collagen production. Scars and marks appear less visible. It doesn’t product heat like a laser will.
If you’ve heard that vitamin E will reduce stretchmarks, this is a myth. Vitamin E impedes the healing of scars. If you marks are already white and hard, then it won’t do anything.
Needling or dermal rolling is recognised as a treatment to help stretchmarks, even old ones. Needles penetrate the skin to mechanically break down the old scar tissue and promote new collagen formation. Needling will not remove stretchmarks as breakdown of scar tissue is partial. Although it will fade them, improvement in appearance depends on how many sessions are performed, the depth of scars and how well the skin can heal. However, there are no side effects, no risk of pigmentation, burns or bruising.
Light Emitting Diodes or LED (red and near infra red) in combination with needling will produce better results as the lights act as an anti-inflammatory and induce wound healing.
Conclusion
Unfortunately we cannot quote the line of ‘prevention is better than cure’ with stretchmarks because if you’re going to get them, you’re going to get them, especially if you’re undergoing puberty or going to get pregnant. However, do apply creams or oils to your skin. Anything that will help keep skin supple will help reduce how much damage can be done.
