75% of all women have some sort of stretch mark problem in their lifetime—all hate it! Oddly enough, men seldom notice stretch marks on their lady friends—perhaps a throwback to the ‘Earth Mother” syndrome—viewed by the male as a natural part of the female during pregnancy. Yet the paparazzi here in Hollywood seem to take great delight in publishing photos of divas and pop princesses and their stretch marks, as if celebrities were supposed to be exempt!

Very simply, stretch marks or Striae as they are called medically are simply scars that appear in the Dermis rather than on the epidermis as conventional scarring from outside injury… Most people are led to believe that stretch marks are caused by stretching the skin beyond its tensile strength—either from weight gain, pregnancy or extreme muscle building.

While all these things DO play a role, there are hormonal aspects during puberty that can leave stretch marks on a very young girl’s breasts, even if she has no rapid weight gain or loss. I know of a grown man 36 yrs of age who has odd striae on his buttocks—he was never fat as a boy nor did he have rapid physical changes!

I believe there is an enzymatic power at play here, principally the enzyme collagenase that determines how much collagen fibers are in place to support tissue. If this enzyme is compromised by hormonal flux, it can destroy the very collagen fibers it is supposed to regulate. The skin then becomes ‘ruptured” or broken down and weakened at that point and appears on the surface as a silvery or reddened “scar”. The stretching of skin plays more of a role in where the marks occur and what direction they run in.

IS THERE A CURE?

I have always treated stretch marks like any other scar revision. Based upon a ‘remove” and “rebuild” concept, a great amount of stretch marks, whether they be new or older marks, can be alleviated nearly 80%.

The removal systems can be combination of Alpha Hydroxy Acids blended with retinoids and applied to the area professionally. Home use of retinoids will advance the results and an occasional ‘Alkaline Wash” treatment can further plane down the stretch marks that have raised and reddened edges with deeper furrows in the centre.

A Body Enzyme series of treatments will help tighten the epidermis on older stretch marks. Skin that loses its elasticity over time creates a deeper stretch mark appearance as well. Firming the skin makes the marks appear less deep and rippled.

The ‘rebuild” portion of the treatments is vital. New collagen formation via the fibroblast cells will increase with retinoids, but amino acid creams with a full complement of ascorbic acid will help the fibroblast cell produce more fresh collagen fibers to the site of the stretch mark—so what is actually occurring is the removal of surface corneum and the rebuilding of deficit under-support fibers.

There has been a great deal of speculation about the 585-nm pulsed dye laser, radiofrequency and the newest modality, Fraxel (fractional laser resurface). I am a little skeptical over this one, it does not somehow make sense that scattered pulses of light zapping the skin and creating microscopic wounds to produce new collagen would actually be beneficial. It is like creating another scar to replace a scar.
Collagen fibers will ALWAYS rush to the surface during any form of injury or trauma.

The old fashioned CO2 laser, which virtually vaporized away the epidermis, was nothing more than a controlled scar machine. No wrinkles, but weird and plastic skin for life! Of course this is an extreme case and this laser is not popular much now, but the entire premise of actually removing Striae is based upon gently hydrolyzing the surface scar tissue whilst rebuilding the underlying dermis and epidermis for a stronger and more supportive skin.

Also, hyperpigmentation often accompanies stretch marks—this has to be dealt with professionally and at home using melanin inhibitors and nutritive, transepidermal crèmes.

IS PREVENTION POSSIBLE?

During pregnancy the glucocorticoid hormones prevent the fibroblast from forming collagen and elastin fibers (the two main products this ‘factory” makes). This creates a lack of supportive tissue and leaves the skin wide open for stretch marks. Body enzymes treatments performed professionally at least twice a month until just before delivery (will not harm fetus) is advised.

The application of a good, transepidermally formulated protein crème rich in ascorbic acid, Asiatic Acid, Vitamin E and panthenol three times daily, stroking the crème from below the belly upwards to under the breast bone will reduce stretch mark potential. I dubbed this type of formulation “Mums Crème” many years ago and am still surprised when a happy Mother informs me it actually works!