Stretch Marks: Is there a way to avoid them?

CHENNAI: What are stretch marks?

Stretch marks are a very common concern for many women, and men too. A simple mechanical process, stretch marks occur due to excessive stretching of the skin's connective tissue support, which simply gives way. Just like a sheet of plastic stretched too much, gives way to rents, the skin also undergoes tears which then simply do not close again!

How and why do they occur?

Now, the severity of stretch marks is a function of 2 factors - the intensity of the stretching force and the duration. Meaning, someone growing tall gradually may end up with lesser stretch marks as compared to someone with a sudden growth spurt during puberty. Also, someone with a bigger growth spurt reaching a bigger height, may have more stretch marks than someone who did experience a growth spurt but did not reach the same height. Despite being such a normal physical phenomenon, stretch marks are distressing to some, because - in most cases, they are not reversible - well atleast, not completely. Pregnancy, sudden weight gain, sudden growth spurts, obesity - are all associated with stretch marks. Interestingly, there is a genetic variation in the tendency to develop stretch marks - the skin of some people may be highly accomodating of the stretch as compared to some others. In other words, given everything else is the same, the tendency to develop these marks would be different between two individuals, depending on their genetics!

Can we do anything about stretch marks?

Stretch marks can be early, where they are still red to pink, and late, where they are almost skin coloured to white. In the early phases, prescription strength retinoid creams help to reduce the intensity of the stretch marks, but they cannot completely be made to disappear. At a later stage, when the stretch marks become white, what we call as stria alba, the width and therefore, the visibility can be brought down to a fair extent, with treatments like radiofrequency microneedling and fractional laser devices. Again, not made to disappear, but just made to be less visible.

Can anything prevent stretch marks in pregnancy?

Not really. Here it is a combination of the weight gain during pregnancy, size of the baby, number of babies (twins vs singleton) and a very important component of genetics, that determines whether someone will have stretch marks or not. However as the skin tends to be very dry, and areas subject to stretching may be associated with itching, moisturisers may help to a very large extent in calming the skin and adding some subjective relief. Other than this, a well balanced diet, and overall staying fit and agile during pregnancy may be the maximum that one can do!

Should you treat stretch marks?

Striae are purely a cosmetic concern. Starting a treatment should begin with the understanding that stretch marks can only be made to be less visible but not vanish! If weight gain is the main reason for stretch marks, then a good weight management program may be the right place to start, before signing up for lasers and devices to treat the striae. And very important, don’t get started on treating pregnancy related stretch marks on the abdomen, if you are planning to have your next baby in the very near future! Laser and radiofrequency devices do a very good job of reducing striae visibility but can do nothing to prevent the abdomen stretching again, and the stretch marks would simply return then. The only thing that would have vanished is the treatment results!

— Dr Renita Rajan, Chief Consultant Dermatologist, RENDER Skin and Hair