How to help with stretch marks

What are stretch marks?

Stretch marks, also called striae, are scars that form when skin stretches or shrinks quickly and its supporting collagen and elastin break. Common triggers include puberty, pregnancy, rapid weight changes and rapid muscle growth. They often appear on the abdomen, breasts, hips, thighs and buttocks. Family history also affects your chances of developing them.1234

New marks can be pink, red, purple or brown, depending on skin colour. They can feel slightly raised or itchy. Older marks become paler, flatter or slightly sunken, with a different texture from surrounding skin. Stretch marks that develop during adolescence usually become less visible without treatment. Ordinary stretch marks are harmless; treating their appearance is optional.1456

Which treatment is worth considering?

If you want treatment, arrange a dermatologist appointment while the marks are still new and coloured. Older white marks are harder to improve and often need several sessions or a combination of procedures. Creams offer little help for mature marks, however ambitious the name on the jar.37

How to use a topical stretch mark treatment

1. 1Start with early marks. Products intended to fade stretch marks have little effect once the marks are mature.
2. 2Massage the product gently into the marks. Gentle massage during application can improve the product's effect.
3. 3Apply consistently. For a cream, lotion or gel intended to fade marks, daily use for weeks is needed before any visible improvement.
4. 4Follow your prescription directions for tretinoin. One treatment study used nightly application for 24 weeks; that is a timescale for improvement, not a dose to choose yourself.

Tretinoin is a prescription retinoid, a type of medicine related to vitamin A. It can make early marks less noticeable. Retinol is another retinoid that can help early marks, but it is not the same ingredient as tretinoin. Hyaluronic acid is another option for new marks. There is no single treatment that works for everyone.7

Do cocoa butter, oils or stretch mark creams work?

Cocoa butter can moisturize skin, but it has not been shown to prevent stretch marks or reduce their appearance. Coconut oil, olive oil and shea butter are not effective stretch mark treatments either. Cocoa butter can make skin feel luxurious, which is a different job from removing a scar.2

Glycolic acid creams exfoliate, meaning they help skin shed its outermost layer. Glycolic acid and trichloroacetic acid peels can lessen the appearance of marks, but the improvement is often too small to make a meaningful difference. Moisturizing and exfoliating are not equivalent to repairing the deeper scar.2

Can lasers or microneedling help?

Dermatologists can use lasers, radiofrequency devices and microneedling, sometimes in combination. For new breast stretch marks, pulsed dye lasers target red and purple colour. For older breast marks, fractional lasers are among the options, but complete clearance is not possible. Ask which feature the proposed treatment aims to improve: colour, texture or both.3

Laser treatment needs particular care on darker skin because burns and changes in skin colour are possible. Choose a board certified dermatologist experienced with your skin tone. Redness and swelling after procedures commonly settle within hours or days. The choice of procedure depends on your health, age and how long you have had the marks.37

Before paying, ask about the likely improvement, number of sessions and total cost. Older marks can need several sessions, so the first appointment's price is not necessarily the price of the plan. Cosmetic stretch mark treatments are not available on the NHS, which makes the budget part rather less cosmetic.13

How can you make marks less visible right now?

Self tanner can camouflage both new and old marks temporarily. A sun tan does the opposite: stretch marks do not tan, so the contrast can make them stand out more. Protect exposed skin from the sun rather than tanning to hide the marks.27

What if you are pregnant or breastfeeding?

Do not use retinoid creams during pregnancy. If you are pregnant or breastfeeding, check with your doctor before starting any stretch mark treatment. Botanical creams also need checking during pregnancy rather than assuming that a natural ingredient is suitable.123

Pregnancy stretch marks affect around 8 out of 10 pregnant women. They often appear on the tummy, thighs or breasts as pregnancy progresses, and itchiness can be an early sign. After birth, they can gradually fade into paler scars, although they probably will not disappear completely. Do not try to prevent them by eating less to lose weight during pregnancy. Discuss concerns about pregnancy weight gain with your midwife or doctor.5

Can you prevent more stretch marks?

Prevention is not always possible. Maintaining a healthy weight and avoiding sudden weight changes where possible can reduce the chance of developing marks. Moisturizing keeps skin hydrated, but creams and massage are not reliable prevention methods. Products containing centella or hyaluronic acid could help prevent marks; the benefit remains uncertain.137

When should you see a doctor?

Contact a doctor if stretch marks appear without a clear cause, such as pregnancy, puberty or rapid weight change. Mention your medicines, including steroid tablets and cortisone skin creams. Prolonged corticosteroid use can cause stretch marks. A clinician can examine the marks and decide whether tests are needed rather than treating every unexplained line as a cosmetic issue.46

Arrange a medical appointment if large stretch marks occur alongside more fat on your chest and tummy but slim arms and legs, fat around the back of your neck and shoulders, or a red, puffy, rounded face. These can be signs of Cushing's syndrome, a condition involving too much of the hormone cortisol.14