A Fine Line: Stretch Marks – Today's Parent October 2006
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Stretch Marks

What to do when stretch marks leave a lasting impression.

By Sara Marett-Carter 

For nine months, you diligently rubbed cocoa butter on your growing belly. Now a new mom, you think you made it through unscathed, then suddenly (gasp) squiggly red lines appear. How did they get there? Can you cure them? (You wish.) Conceal them? (You hope.) Read on for everything you need to know about stretch marks. 

Stretch mark specifics 

Called striae distensae in medical terms, stretch marks occur when the skin’s elastin and collagen fibres (which weave through the dermis, the middle layer of your skin, giving it flexibility and firmness) split after being expanded beyond their limits. This is usually a result of rapid weight gain, explains Lisa Kellett, a dermatologist in Toronto. Fresh stretch marks are red, purple, reddish brown to dark brown in colour due to inflammation; more mature marks have loss of blood flow and usually appear lighter, like scar tissue. 

Although they can make an appearance at any time during or after pregnancy, you may not notice stretch marks until your pre-baby size reappears, as weight loss can make them more obvious. They are typically found on areas with higher skin tension, explains Kellett, including hips, abdomen, butt, breasts and thighs. 

The bottom line: Sorry, girls, once a stretch mark appears, it isn’t possible to remove it. There are ways, however, to diminish its appearance. These treatments vary in price, effort and, of course, effectiveness.

Cure-all creams? 
Don’t count on it. Applying creams to your burgeoning belly, such as the popular cocoa-butter concoctions, may soothe the itchiness that occurs as the skin stretches in pregnancy, but will not prevent stretch marks from appearing, says Kellett.

Topical creams, such as StriVectin and glycolic acid, are supposed to minimize the appearance of stretch marks, but there is no evidence to support these claims. The one exception may be vitamin A, a cream that helps fill the stretch mark by stimulating collagen production (cream available by prescription). Kellett has seen adequate results when it is used once a day. But note: Any vitamin A cream (including Retin-A) is not safe to use when you’re pregnant — it can affect fetal development. And it ain’t cheap. Cost: Vitamin A cream, $50 per tube (the amount you need will depend on the severity and number of stretch marks). Topical creams, $50–270. 

Laser therapy 
If you’re serious about reducing the appearance of your stretch marks, laser treatment is really the only way to go. And though treatments are pricey, and health plans typically don’t cover them, those hoping to get rid of unwanted lines don’t seem to mind. “We are seeing a huge increase in the number of women (and even men!) using lasers to treat stretch marks,” says Kellett. The treatments use non-ablative lasers that don’t burn or scar the skin. But timing is crucial for optimal results — it’s best to seek treatment when your stretch marks are red or purple, usually within one year of their appearance. Older, whiter stretch marks are more difficult to treat. One option that Kellett uses is an Nd:YAG laser that minimizes the stretch marks’ colour, texture and depth. The effectiveness varies with individuals and according to the marks’ age and thickness, but it can reduce their appearance by up to 90 percent. The treatment is fairly painless — akin to snapping a rubber band on your skin — and there is minimal redness and swelling afterward. 

Perhaps the most exciting, if expensive, news on the stretch mark therapy front is a laser called Fraxel. Unlike other laser therapies, Fraxel’s microscopic, closely spaced lights don’t affect any of the surrounding tissue when they target cells located deep below the epidermal layer of the skin, small portions at a time. This not only reduces recovery time, but also promotes the skin’s natural process of creating new tissue to replace damaged cells. “It regenerates both the epidermis and dermis layers of the skin,” says Sheetal Sapra, a dermatologist at the Institute of Cosmetic and Laser Surgery in Oakville, Ont. Some redness and swelling occur, but scarring risk is low, adds Sapra. Typically, at least four visits are necessary with any type of laser treatment. Cost: Nd:YAG, $400/treatment; Fraxel, $1,000/treatment. 

Can a stretch mark be a sign of something more serious? 
Possibly. A new study, published in the Journal of Investigative Dermatology, suggests that women with stretch marks may face triple the risk of pelvic prolapse. This disorder is a weakening in the web of pelvic-floor muscles that holds the uterus and bladder in place. The condition can result in pain and loss of bladder control; in some cases, the organs can actually slide down from where they should be held. The link seems to be a compromised ability to produce connective tissue, as researchers found decreased levels of structural collagen in women who experienced both disorders. The bottom line? If you have stretch marks, don’t just consider them a cosmetic problem, particularly if you experience pelvic pain. Talk to your doctor about the possible link. 

Stretch Mark Myths 

Stretch marks aren’t an inevitable part of pregnancy — there are a lucky few who get through unscathed. However, between 75 to 90 percent of mothers aren’t so fortunate. But despite the old wives’ tale to the contrary, scratching your belly during pregnancy will not give you stretch marks. Stretch marks are not hereditary and women of all ethnic backgrounds and skin types get them, says Lisa Kellett, a dermatologist in Toronto. Consider them the equal opportunity blemish. 

Planning Baby Number Two? 

Start warding off stretch marks before you get pregnant. The most effective prevention seems to be exercise — before and during pregnancy. If you are a consistent exerciser, you will likely have less subcutaneous fat compared to someone who does not exercise, explains Stacy Irvine, a fitness expert, chiropractor and co-owner of Toronto’s Totum Life Science. (Subcutaneous fat lies just beneath your skin and is responsible for giving us lucky ladies cellulite.) 

Exercising can decrease the stress put on the skin as it stretches to accommodate a growing baby, she explains. It also improves your circulation, which in turn can help your skin accommodate the demands of pregnancy. However, don’t start a strenuous exercise regime while you’re pregnant, and be sure to consult your doctor before working out during your pregnancy.

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