Pregnancy stretch marks (also called striae gravidarum) are linear marks that are usually seen on the growing belly bump. They may also occur on the breasts, thighs, hips, and other parts of the body.
Pregnancy stretch marks are often seen during the 6th-7th month of pregnancy, which is around 26-28 weeks or the end of the second or start of the third trimester.
There is no effective way to completely avoid or prevent stretch marks in pregnancy, but there are a few treatments that may help in making them less noticeable.
What are pregnancy stretch marks?
Stretch marks that develop during pregnancy are referred to as pregnancy stretch marks or striae gravidarum.
Stretch marks, in general, are also known as striae or striae distensae. Pregnancy stretch marks are a type of striae distensae.
They appear as indented streaks on the skin and can vary in type or color depending on when they occurred and an individual’s skin tone.
When do they appear?
Pregnancy stretch marks usually appear in the late second or early third trimester, specifically around the 6th or 7th month of pregnancy, or between 26-28 weeks of pregnancy. In some cases, they may appear sooner.
Pregnancy stretch marks usually first appear on the growing belly bump due to the stretching effect on the skin.
Causes
The main factors behind pregnancy stretch marks are alterations in the structure of skin components, hormones, and the physical stretching of the skin due to rapid weight gain during pregnancy.
Stretching the skin too quickly in a short duration can result in tears in the collagen and elastic fibers, which are present in the dermis, or the layer just beneath the epidermis.
Additionally, pregnancy hormones like estrogen, relaxin, and adrenocortical hormones can affect elastic and collagen fibers, making one more prone to stretch marks.
Risk factors
Some women are more prone to developing pregnancy stretch marks. The following are commonly associated risk factors:
- Younger age at pregnancy
- Family history of striae gravidarum (genetics)
- Higher weight gain during pregnancy
- Higher birth weight
- Multiple pregnancies (carrying more than one baby)
Appearance and symptoms
Stretch marks of pregnancy can be divided into two types:
- Early pregnancy stretch marks, which are new and usually red in color (also called striae rubra).
- Mature or old pregnancy stretch marks (striae albicans).
1. Early pregnancy stretch marks
Early pregnancy stretch marks, also referred to as new stretch marks, are pink, red, or purple in color. In darker skin tones, the colors can be deeper, such as blue (striae caerulea) or gray/black (striae nigra). These marks appear as indented, thickened, and elevated streaks or lines on different parts of the body.
The initial red appearance is due to inflammation in the skin, secondary to damage to the dermis. This is accompanied by increased blood flow. These are termed red stretch marks or striae rubra. New stretch marks may also be accompanied by a burning or itching sensation.
However, if you experience pain or extreme itchiness on the stretch marks or the surrounding area, it’s best to consult a doctor, as it may be due to another reason or skin condition.
2. Old pregnancy stretch marks
Over time, the inflammation settles, and the stretch marks fade, becoming white, which are mature or old stretch marks referred to as striae albicans. These may be slightly depressed and have wrinkled surfaces.
Other colors of stretch marks like purple, blue, or gray also fade and become white or silver in color.
Location
Though pregnancy stretch marks are most common on the belly or growing bump, they can appear anywhere on the body.
The common locations for pregnancy stretch marks are:
- Stomach area or abdomen (where they are called abdominal striae)
- Thighs
- Breasts
- Hips or buttocks
- Upper arms
Do they go away?
If you are wondering is it possible to completely get rid of pregnancy stretch marks? Or after birth, is there anything you can use to fade post-partum stretch marks? Well, there is no proven method to completely get rid of stretch marks.
Pregnancy stretch marks are a type of scar in the deeper layers of the skin, so they don’t go away entirely. However, over time, the stretch marks may lighten or fade. If your pregnancy stretch marks were severe, certain in-office procedures may make them less noticeable.
Treatment
There are a few treatments that may help lighten pregnancy stretch marks, making them less noticeable. The market offers various products designed to prevent or improve the appearance of stretch marks.
However, many of these may contain retinoids like retinol or its derivatives, which should not be used during pregnancy.
Always check the ingredient list of the product, or consult your doctor before using such products. If you’re not familiar with different types of retinoids, you may refer to this post for more information.
Topicals during pregnancy
1. Hyaluronic acid
Hyaluronic acid is a humectant and can hydrate the skin and stimulate collagen production in the skin. There is some research data suggesting that hyaluronic acid may improve the appearance of stretch marks.
You can incorporate this ingredient into your skincare routine by using a serum or moisturizer that contains hyaluronic acid or its salts, such as sodium hyaluronate.
2. Centella Asiatica
Centella (also known as Gotu kola) is known for its anti-inflammatory and wound-healing properties. It may be a useful ingredient to improve stretch marks.
In one study, a cream containing Centella Asiatica extract, α-tocopherol, and collagen-elastin hydrolysates helped in preventing stretch marks.
3. Ascorbic acid
Ascorbic acid may benefit stretch marks by stimulating collagen production. It may also decrease redness in new stretch marks. However, we don’t have enough studies about its benefits for stretch marks.
In one study, when used in combination with glycolic acid, it improved stretch marks.
Can it give the same results if used as a single ingredient? We don’t know that. Still, one can use it with other ingredients to get the benefit.
4. Moisturizer
A moisturizer may hydrate the skin giving it a smooth appearance and making it more flexible. In addition, it can calm down the itching associated with stretch marks.
Will it improve stretch marks? We don’t have quality data but it won’t hurt to use a moisturizer.
It is recommended to apply it by massaging the skin rather than just patting it. It may boost blood circulation which can aid in repair.
Some ingredients to look for in a moisturizer are almond oil, vitamin E, cocoa butter, etc.
Topicals after pregnancy
Postpartum or after-pregnancy stretch marks treatment will depend on whether you are breastfeeding or not. Most of the time, stretch marks involve a large area of the body so make sure to consult with your doctor before using retinoids while breastfeeding.
In addition to the topicals mentioned above (hyaluronic acid, Centella extract, ascorbic acid, and moisturizer), the following may benefit stretch marks:
1. Retinoids
Retinoids are vitamin-A derivatives that can boost collagen production in the skin.
Tretinoin is a prescription-strength retinoid that has some favorable studies where it improved stretch marks by decreasing their length and width and preventing the worsening of new stretch marks. (Read more about tretinoin and stretch marks in this article)
One can also use over-the-counter retinoids like retinol or retinaldehyde to treat stretch marks. These are less potent and may take longer to give visible results.
2. Glycolic acid
Glycolic acid is an alpha hydroxy acid that helps exfoliate the top layer of the skin, making it smoother. It can also boost collagen production.
In-office procedures
There are various procedures that can be done by a doctor or a trained professional. Most of them are not done during pregnancy. They may be the options to consider in the postpartum period or after pregnancy.
1. Lasers and light therapy
There are different types of lasers. They can stimulate collagen production or decrease redness. The laser treatment will depend on the type of stretch marks and your skin tone.
2. Microdermabrasion
This procedure uses tiny crystals to remove the top damaged layers of skin. It can give a smooth appearance to the skin. In addition, it can stimulate collagen production.
3. Micro-needling
In this, a device with small needles is used to stimulate collagen production in the deeper layers of the skin.
4. Chemical peels
This procedure uses a high concentration of acids to remove the top layers of skin and stimulate collagen production.
5. Radiofrequency
It involves the use of radiofrequency waves to stimulate collagen production.
6. Ultrasound
It involves the use of sound waves to increase collagen production.
The final results may vary from person to person. A combination of different topicals and procedures can give better results than one treatment modality.
Prevention
Another common question is, “Can you prevent or avoid pregnancy stretch marks?” There’s no guarantee that any topical skincare product or ingredient can prevent stretch marks during pregnancy. There are a few measures one can take to promote healthy skin.
1. Hyaluronic acid and centella extract
You can use skincare products that contain hyaluronic acid and Centella extract. There is some evidence to suggest that these ingredients may help prevent stretch marks.
2. Keep your skin moisturized
Moisturizers can make your skin supple and more pliable or flexible. This may make your skin less likely to get damaged by physical stretching of the skin. Look for nourishing oils like almond oil, cocoa butter, vitamin E oil, etc. in your moisturizers.
3. Massage your skin care products
Apply your skincare products by massaging them instead of patting them. The action of massaging may increase blood flow and help strengthen your skin against wear and tear.
4. Eat a healthy diet
Eating a healthy diet rich in omega fatty acids, vitamins A, D, E, and C, as well as elements like zinc and proteins, provides essential nutrients to our skin. A well-balanced diet can not only promote healthy skin but also protect it from damage.
5. Exercise regularly
Always discuss your exercise schedule with your doctor when you are pregnant. It may be unsafe in certain conditions like if you have a heart or lung condition.
Regular exercise can promote healthy weight gain during pregnancy. This can lower the risk of getting stretch marks. In addition, it can improve circulation which may be beneficial for our skin.
It also decreases the risk of gestational diabetes, preeclampsia, and C-sections.
Key points
Pregnancy stretch marks, also known as striae gravidarum, often appear on the belly during the 6th or 7th month of pregnancy. The main factors causing these marks are skin stretching, hormonal changes, and alterations in skin components like collagen and elastic fibers.
There’s no guaranteed way to prevent pregnancy stretch marks, but they usually fade with time, although they don’t disappear entirely. Various skincare ingredients and treatments may help improve their appearance.
If you’re considering using a stretch mark cream during pregnancy, make sure it’s free from retinoids, high concentrations of glycolic acid, or any other ingredients that should be avoided during this time.
References
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- Ersoy E, Ersoy AO, Yasar Celik E, Tokmak A, Ozler S, Tasci Y. Is it possible to prevent striae gravidarum? J Chin Med Assoc. 2016 May;79(5):272-5. doi: 10.1016/j.jcma.2015.12.007. Epub 2016 Apr 4. PMID: 27056109.
- Buchanan K, Fletcher HM, Reid M. Prevention of striae gravidarum with cocoa butter cream. Int J Gynaecol Obstet. 2010 Jan;108(1):65-8. doi: 10.1016/j.ijgo.2009.08.008. PMID: 19793585.
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- Osman H, Rubeiz N, Tamim H, Nassar AH. Risk factors for the development of striae gravidarum. Am J Obstet Gynecol. 2007 Jan;196(1):62.e1-5. doi: 10.1016/j.ajog.2006.08.044. PMID: 17240237; PMCID: PMC1913631.
- Mallol J, Belda MA, Costa D, Noval A, Sola M. Prophylaxis of Striae gravidarum with a topical formulation. A double blind trial. Int J Cosmet Sci. 1991 Feb;13(1):51-7. doi: 10.1111/j.1467-2494.1991.tb00547.x. PMID: 19291041.
- Lokhande AJ, Mysore V. Striae Distensae Treatment Review and Update. Indian Dermatol Online J. 2019 Jul-Aug;10(4):380-395. doi: 10.4103/idoj.IDOJ_336_18. PMID: 31334056; PMCID: PMC6615396.
- Ash K, Lord J, Zukowski M, McDaniel DH. Comparison of topical therapy for striae alba (20% glycolic acid/0.05% tretinoin versus 20% glycolic acid/10% L-ascorbic acid). Dermatol Surg. 1998 Aug;24(8):849-56. doi: 10.1111/j.1524-4725.1998.tb04262.x. PMID: 9723049.
- Park KY, Kim HK, Kim SE, Kim BJ, Kim MN. Treatment of striae distensae using needling therapy: a pilot study. Dermatol Surg. 2012 Nov;38(11):1823-8. doi: 10.1111/j.1524-4725.2012.02552.x. Epub 2012 Aug 22. PMID: 22913429.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.