Stretch marks are areas of the skin where the deep dermis, located between the epidermis and hypodermis, has torn up spontaneously. When they appear, they have the form of lines that resemble long scars, are purple-red in color and are inflammatory. They lighten over time to become white and pearly, almost the same color as the skin. Stretch marks are mainly found in the stomach, breasts, arms, buttocks and thighs. They can appear during pregnancy, during a significant and sudden increase or loss of weight, as well as during adolescence.
There are two types of stretch marks:
Stretch marks that reveal a health problem
Cushing’s syndrome, caused by an excess of corticosteroids in the body, causes larger striations. They are typically wide, red, and vertical and are found in the abdomen, the root of the thighs and arms and in the breast. Other signs associated with Cushing’s syndrome may also appear such as skin that is very thin, very brittle and prone to bruising, as well as muscle wasting and weakness or weight gain in the stomach and face. Cushing’s syndrome is due to an excess of hormones such as cortisol, the stress hormone normally produced in adequate quantities by the adrenal glands. This Cushing’s syndrome is most often associated with the misuse of corticosteroid drugs. It can also occur if the adrenal glands that produce too much cortisol do not function normally.
Classic stretch marks
These stretch marks are thinner and more discreet and are not accompanied by specific health problems. Although they have no impact on health, they are often considered unsightly and cause significant discomfort. No treatment can make them disappear completely.
These stretch marks also have, at least in part, a hormonal origin, and can therefore appear at the time of puberty or pregnancy, moments of intense hormonal changes.
During pregnancy, from the second trimester onwards, the amount of cortisol, a hormone produced by the adrenal glands, increases and varies the flexibility and elasticity of the skin. The higher the level of cortisol, the lower the production of collagen. Since collagen, together with elastin fibers, is responsible for the elasticity of the skin, the skin becomes less elastic. Therefore, if the skin is tightened (weight gain, pregnancy, puberty), stretch marks may form.
The sudden and significant increase or loss of weight can also be responsible for the appearance of stretch marks. Weight gain may have stretched the skin while weight loss may have loosened it.
The best athletes are often prone to stretch marks because their cortisol level is high.
Prevalence of stretch marks
Stretch marks are very common: almost 80% of women have this type of small scar on some areas of the body.
During the first pregnancy, 50-70% of women notice the appearance of stretch marks, often at the end of the pregnancy.
At puberty, 25% of girls and only 10% of boys notice the formation of stretch marks.
Diagnosis is made by simply looking at the skin. When stretch marks are severe and associated with other symptoms, the doctor will check for Cushing’s syndrome.
Causes of stretch marks
- Stretch marks are believed to be of hormonal origin. More precisely, it would be linked to excessive production of cortisol.
- Skin stretching associated with increased cortisol production. Rapid weight gain, puberty where the body’s morphology changes rapidly or pregnancy, can thus combine hormonal factors and skin stretching.
- The application of creams containing corticosteroids or prolonged use of oral corticosteroids.
- The use of anabolic steroids in athletes to increase muscle mass, especially bodybuilders.
- Very thin skin.
Signs of stretch marks
Striae on the skin, dark red or purple.
Stretch marks on the skin, pale pink or pearly white – The color of the marks depends on the color of the skin. Dark skin can therefore be black.
Stretch marks are mainly found in the stomach, breasts, buttocks, thighs and arms.
Persons at risk
There’s a genetic predisposition to stretch marks. Having a mother with stretch marks increases the risk of having stretch marks in turn.
Women would be more affected than men, although men can also have stretch marks.
The main risk factors for stretch marks are:
- Pregnancy: Risk factors for stretch marks during pregnancy are: under 20 years of age, obesity, having a large baby, multiple pregnancy and very light (I) or very dark (IV) skin.
- Being overweight or obese
- Rapid weight loss or gain
- Taking corticosteroids, orally or dermally.
The prevention of stretch marks requires the reduction of risk factors. Therefore, to limit the risk, it is preferable not to be overweight, not to follow a too restrictive diet or not to get too fat.
Women can be vigilant and regularly moisturize their skin, especially in periods when stretch marks appear frequently, characterized by hormonal changes (adolescence, pregnancy, and menopause). However, a daily massage would have a moderate preventive effect.
During pregnancy, a period that also promotes stretch marks, it is advisable to monitor weight to gain reasonable weight and moisturize areas at risk such as hips, thighs, breasts and, of course, the stomach, where the skin is subject to severe stretching.
However, the effectiveness of these preventive actions is not proven and cannot prevent all stretch marks.
Medical treatments for stretch marks
No treatment can completely eliminate stretch marks.
In the case of stretch marks caused by a medication or a Cushing’s disease, treatment of the cause is essential to prevent aggravation.
When it comes to common stretch marks, they do not require any medical treatment as they are not bad for your health. However, they can cause cosmetic problems.
Existing treatments can relatively reduce the appearance of stretch marks.
There are creams and lotions against stretch marks such as Skinception Intensive Stretch Mark Therapy that have shown some potential in treating stretch marks safely.
There are also procedures such as microneedling, peeling and microdermabrasion that can stimulate the production of collagen and the elasticity of the skin.
Finally, the laser may make stretch marks less visible, stimulating the activity of the fibroblasts, the cells that ensure the flexibility of the dermis. However, this technique does not make them disappear.
Cosmetic surgery can restrict the areas affected by various stretch marks, especially in the stomach. But it also does not make stretch marks disappear.
A study in 1991 suggested that a cream containing Gotu Kola, vitamin E and collagen could help prevent stretch marks caused by pregnancy. In this study 80 pregnant women were followed: 34% of the women who applied the cream developed stretch marks compared to 56% of the placebo group. The effectiveness of the cream was more pronounced in pregnant women who had already suffered from stretch marks during adolescence.