Are stretch marks permanent?

Why do they fade but not disappear?

Stretch marks are scars. Rapid stretching or shrinking can break collagen and elastin, the proteins that support skin and help it stretch. They commonly develop during pregnancy, growth spurts or rapid weight changes. Hormones and genetics also play a part, so stretching alone does not explain who gets them.13

New marks can look pink, red, purple or brown, depending on skin colour. As they age, they become paler, sometimes whitish or silver. Older marks can also become smaller, slightly sunken and more wrinkled at the surface. Losing colour is not the same as losing the scar.24

Pregnancy stretch marks usually become much less noticeable after birth. Creams and oils can feel soothing, but have little effect on their appearance. Moisturizing and removing a scar are different jobs, despite the ambitions of the cream aisle.45

What can treatment actually do?

If you want treatment, see a dermatologist while the marks are still new and pinkish or purplish. New marks are easier to treat than older, pale ones. For older marks, several sessions and a combination of treatments are often needed. The goal is less visible marks, not the complete disappearance that a treatment menu would prefer to imply.2

• Prescription tretinoin can help early stretch marks. It is not safe during pregnancy. If you are pregnant or breastfeeding, check with your doctor before starting any stretch mark treatment.
• Lasers can reduce redness in newer marks or improve older marks. They are often expensive and not covered by insurance. Darker skin needs particular care because laser treatment can cause burns or changes in skin colour.
• Radiofrequency treatments, which use energy to heat tissue, are another option. Radiofrequency combined with tretinoin has shown promising results compared with tretinoin alone, but the best choice remains uncertain.
• Professional microneedling uses tiny needles to stimulate collagen production and can diminish stretch marks. It is suitable for all skin tones when appropriately performed.

Will cocoa butter or oils remove them?

Cocoa butter has not been shown to prevent stretch marks or reduce their appearance. Coconut oil, olive oil and shea butter do not remove them either. Use a moisturizer for hydration rather than scar removal. Glycolic acid creams and chemical peels are also used, but peels generally offer too little improvement to make a substantial difference.3

What should you avoid?

Do not tan to hide stretch marks. Scars do not tan, so tanning surrounding skin can make the marks stand out more. Protect exposed skin from the sun. Sunless self tanner can provide temporary camouflage without the harmful sun exposure.3

Avoid trying to puncture stretch marks with a home microneedling device. Home treatment can cause infection, scarring or colour changes. Before professional treatment, mention poor healing, raised scars called keloids, a weakened immune system and isotretinoin use. These can change whether treatment is suitable or when it can happen.6

Microneedling results develop gradually: improvement can appear within weeks, with full results usually taking several months. Temporary burning, swelling or colour changes generally settle within a few days to a week. Follow your dermatologist's aftercare plan and wait 24 hours before applying makeup.6

If marks appear during prolonged mometasone use, discuss them with your doctor: this steroid can thin skin and cause permanent stretch marks. After long use, your doctor may need to reduce treatment gradually rather than have you stop abruptly.7