Pregnancy Stretch Marks and Treatment Explained
Stretch marks are called stria distensae. When they happen during pregnancy they are called stria gravidarum. Over half of all women will develop stretch marks on either their abdomen, hips, thighs and/or breasts during pregnancy (see Reference 6).
Celebrities aren’t immune either. Super-celeb Chrissy Teigen has won the gratitude of many fans for her recent openness about her own pregnancy stretch marks when she posted pictures of them on SnapChat saying “Lol my thighs have tributaries.”
What Causes Pregnancy Stretch Marks?
Doctors have long believed that stretch marks happen during times of rapid growth such as the growth spurt of adolescence, the tummy during pregnancy and the breasts during breastfeeding.
That doesn’t explain all stretch marks though. We scratch our heads when we also see them in kids whose growth spurt is not that dramatic or in pregnant women on the thighs even when they haven't gained that much weight during pregnancy, like Chrissy. Scientists don’t know exactly why stria happen in these cases, but there are a few possible explanations:
One study conducted in Turkey found that vitamin C blood levels were lower in women who developed stretch marks during pregnancy. Family history also played a role. This same study also found that there was no correlation between getting stretch marks and age, weight gain during pregnancy, abdominal and thigh circumference, or smoking status (see Reference 1).
A second study conducted in France found that younger women were more likely to get stretch marks during pregnancy. Other risk factors were higher pre-pregnancy weight, higher weight gain during pregnancy, lighter skin color, larger babies and twin pregnancies. They also found that the “absence of employment” predisposed a woman to stretch marks when pregnant! One can only wonder what that's about...!?! (see Reference 6). These two studies contradict each other to some extent, which shows that we have more to learn about risk factors for stretch marks.
In my opinion, it is likely the complex biochemistry of a woman’s body during pregnancy that is largely responsible for stretch marks.
An intriguing study found a correlation between low levels of a substance called relaxin (a hormone secreted by the placenta) and the risk of stria. Study investigators posit that lower relaxin levels could contribute to “decreased elasticity” of the skin (see Reference 2). I think they are on to something! Other hormone changes associated with pregnancy may also play a role in a woman’s predisposition to stretch marks (see Reference 3).
Treatment of Pregnancy Stretch Marks
Basically, it's frustrating. There are no proven ways to reliably prevent stretch marks if you are already prone to them (see Reference 4).
There is some evidence to suggest that the herb centella may help. I have no experience with it and would love to hear from readers who have tried it! Another option found to work in some women is massage with bitter almond oil. Hyaluronic acid topical products may help during pregnancy too.
Common home remedies that were not found to be helpful are cocoa butter, olive oil and vitamin E. In fact, applying straight vitamin E oil is terribly taunting to the skin’s immune system. I have seen women get horrible skin rashes and develop life-long internal vitamin E allergies when they topically apply this 'remedy' in a desparate attempt to treat their stretch marks. For these women it means they cannot even take vitamin E supplements for the rest of their life! Don’t do it!
The best proven treatments for stretch marks are topical tretinoin (Retin A) and lasers. These forms of treatment are most succesful on stretch marks that are still red. It is important to know that tretinoin is NOT to be used during pregnancy. Also, any laser treatment would need to be discussed between the woman and her physician. In my own practice, we use tretinoin as soon as possible post-partum. I have also had good results when combining tretinoin with IPL to treat stria. Other lasers used to treat stria include Pulsed-dye laser and fractional lasers (see Reference 5).
Diet Recommendations to Help Prevent Pregnancy Stretch Marks
I think all pregnant women who are worried about stretch marks should discuss the vitamin C study I mentioned above with their obstetricians. Prenatal vitamins are important for many reasons and perhaps stria are one of them. It is also important to learn which foods are high in vitamin C and make a point to eat them during pregnancy. Eating fresh fruits and veggies are good for both mom and baby and may be helpful with stria too when they are rich in vitamin C.
The Best Skin Care Recommendations to Help Prevent and Treat Stretch Marks During Pregnancy
I always recommend that pregnant women use hydrating and hypoallergenic moisturizers during pregnancy such as my All Natural Lotion or All Natural Body Butter. These are applied to stria prone skin every day within 3 minutes after toweling your skin dry following the bath or shower.
If a woman’s obstetrician agrees, the hyaluronic acid rich Instantly Luminous Serum can be applied at the first sign of stretch marks. Professional level products with glycolic acid are also known to increase skin hyaluronic acid production. These are another option if approved for use by a woman’s obstetrician.
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- Int J Vitam Nutr Res. 2011 Jan;81(1):43-8. Striae gravidarum, vitamin C and other related factors. Findik RB1, Hascelik NK, Akin KO, Unluer AN, Karakaya J.
- Arch Gynecol Obstet. 2011 Feb;283(2):219-22. Association of serum relaxin with striae gravidarum in pregnant women. Lurie S1, Matas Z, Fux A, Golan A, Sadan O.
- Br J Dermatol. 2014 Mar;170(3):527-47. Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Al-Himdani S1, Ud-Din S, Gilmore S, Bayat A.
- Br J Dermatol. 2015 Mar;172(3):606-15. Stretch marks during pregnancy: a review of topical prevention. Korgavkar K1, Wang F.
- Andrews Diseases of the Skin, James WilliAM d, Berger Timothy G et. al., Elsevier, 11th edition
- Journal of the American Academy of Dermatology, October 2015Volume 73, Issue 4, Pages 699–700 Incidence and risk factors for striae gravidarum, Damien Picard, MD, PhD,Séverine Sellier, MD,Estelle Houivet, PhD,Loic Marpeau, MD, PhD et. al.