Stretch marks
This article includes a list of general references, but it lacks sufficient corresponding inline citations. (August 2022) |
Stretch marks | |
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Other names | stria, striae distensae |
multiple recent (reddish) and a few older (white) stretch marks | |
Specialty | Dermatology |
Stretch marks, also known as striae (/ˈstraɪiː/[1]) or striae distensae,[2] are a form of scarring on the skin with an off-color hue. Over time they may diminish, but will not disappear completely. Striae are caused by tearing of the dermis during periods of rapid growth of the body, such as during puberty or pregnancy, in which they usually form during the last trimester. Usually on the belly, these striae also commonly occur on the breasts, thighs, hips, lower back, and buttocks. Pregnancy-related striae are known as striae gravidarum.[3] Striae may also be influenced by the hormonal changes associated with puberty, pregnancy, bodybuilding, or hormone replacement therapy. There is no evidence that creams used during pregnancy prevent stretch marks.[4] Once they have formed there is no clearly effective treatment, though various methods have been attempted and studied.[5]
Signs and symptoms
Striae, or "stretch marks", begin as reddish or purple
Stretch marks occur in the dermis, the resilient middle tissue layer that helps the skin retain its shape. No stretch marks will form as long as there is support within the dermis; stretching plays a role in where the marks occur and in what direction they run, however, there are a number of contributing factors (see: "Causes", below) to their formation.[citation needed]
They can (but do not always) cause a burning and itching sensation, as well as emotional distress. They pose no health risk in and of themselves, and do not compromise the body's ability to function normally and repair itself, however, they are often considered a cosmetic nuisance.[7] Young women are generally affected the most and often seek treatment for them from a dermatologist[8] and following pregnancy.[9]
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Striae gravidarum in a pregnant woman at 38 weeks
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Stretch marks from pregnancy >1 year postpartum
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Normal stretch marks in a teenage male[clarification needed]
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Stretch marks in a female breast
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Striae distensae on an obese male
Causes
Stretch marks appear to be caused by stretching of the skin. This is especially true when there is an increase in cortisone[10] – an increase in cortisone levels can increase the probability or severity of stretch marks by reducing the skin's pliability. More specifically, it affects the dermis by preventing the fibroblasts from forming collagen and elastin fibers necessary to keep rapidly growing skin taut; this can create a lack of supportive material as the skin is stretched, and lead to dermal and epidermal tearing, which in turn can produce scarring in the form of stretch marks. This is particularly the case when there is new tissue growth (which can interfere with the underlying physical support of the dermis or epidermis, by displacing the supportive tissue).[citation needed]
Examples of cases where stretch marks are common, also given by the Mayo Clinic, include weight gain (in the form of
Pregnancy
Pregnancy stretch marks, also known as striae gravidarum, are a specific form of
A number of additional factors appear to promote the appearance of stretchmarks: one study of 324 women, done just after they had given birth, demonstrated that low maternal age, high body mass index, weight gain over 15 kg (33 pounds) and higher neonatal birth weight were independently correlated with the occurrence of striae. Teenagers were found to be at the highest risk of developing severe striae.[15]
These skin marks are
Mechanical distension and rapidly developing areas of the body during pregnancy (such as the abdomen, breasts, and thighs) are most commonly associated with striae formation. Some have suggested that relaxin and estrogen combined with higher levels of cortisol during pregnancy can cause an accumulation of mucopolysaccharides, which increases water absorption of connective tissue, making it prime for tearing under mechanical stress.[8][15] There also seems to be an association between higher body mass indices and in women with bigger babies and the incidence and severity of striae. Also, younger women seem to be at higher risk of developing striae during pregnancy.[8][17]
The prevalence and severity of striae gravidarum varies among populations. The current literature suggest that in the general population of the
Prevention
Collagen and elastin are proteins in the skin that contribute to the skin's strength, resilience, flexibility, and help skin that has been stretched to recover its original state. Boosting the production of collagen and elastin helps prevent stretch marks from occurring.[20] Stretch marks can also derive from nutritional deficiencies. Consuming foods that contribute to the skin's health, such as zinc-rich foods, foods high in vitamin A, C, D, and protein rich foods, can help suppress stretch marks.[21] A systematic review has not found evidence that creams and oils are useful for preventing or reducing stretch marks in pregnancy.[4] The safety in pregnancy of one ingredient, Centella asiatica, has been questioned.[18] Evidence on treatments for reducing the appearance of the scars after pregnancy is limited.[18]
Treatment
There are no clearly useful treatments for stretch marks, although there are many different suggestions on how to remove them or lessen their appearance.[5]
Various efforts that have been tried including
Carboxytherapy is a known procedure; however, there is a lack of evidence to support how effective it is.[26]
Research into a new skin grafting technique called "microcolumn grafting / micrografting", which uses needles to take autologous full-thickness skin biopsies, is also being investigated as a potential treatment for stretch marks.[27][28]
History
Since ancient times, pregnant women have sought remedies to prevent stretch marks during pregnancy. Both ancient
Striae were first recognized by Roederer in 1773, and were later histologically described by Troisier and Ménétrier in 1889.[30] In 1936, Nardelli made the first morphologically correct descriptions.[31]
Terminology
Medical terminology for these kinds of markings includes striae atrophicae, vergetures, stria distensae, striae cutis distensae, lineae atrophicae, linea albicante, or simply striae.[citation needed]
References
- ^ "striae - Wiktionary". en.wiktionary.org. 17 April 2021. Archived from the original on 28 July 2021. Retrieved 28 July 2021.
- ISBN 978-3-11-085727-6.
- ^ "Are Pregnancy Stretch Marks Different?". American Pregnancy Association. 19 January 2013. Archived from the original on 19 January 2013.
- ^ PMID 23152199.
- ^ PMID 25184641.
- ^ "Stretch Mark". Encyclopædia Britannica. Archived from the original on 25 June 2010. Retrieved 1 November 2009.
- ^ a b c "Stretch Mark". Retrieved 10 November 2011.
- ^ PMID 15583577.
- ISBN 978-0-7216-2921-6.
- ^ "Stretch marks - Symptoms and causes". mayoclinic.org. Archived from the original on 9 December 2015. Retrieved 4 April 2018.
- ^ Burrows N. "Skin". Ehlers-Danlos Support UK. Archived from the original on 14 June 2023. Retrieved 14 June 2023.
- ^ "Cushing Disease". Medline Plus. Archived from the original on 14 June 2023. Retrieved 14 June 2023.
- ^ "Symptoms - Marfan syndrome". National Health Service. 3 October 2018. Archived from the original on 14 June 2023. Retrieved 14 June 2023.
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- ^ S2CID 42623629.
- PMID 12712115.
- ^ S2CID 36643446.
- ^ PMID 17263216.
- PMID 17263216.
- ^ "Skin: Layers, Structure and Function". Cleveland Clinic. Archived from the original on 4 March 2022. Retrieved 17 February 2022.
- ^ "Stretch Marks". Cleveland Clinic. Archived from the original on 17 February 2022. Retrieved 17 February 2022.
- S2CID 13416547.
- PMID 31334056.
- ^ "Stretch marks: Why they appear and how to get rid of them". American Academy of Dermatology. 11 November 2019. Archived from the original on 10 March 2021. Retrieved 16 June 2020.
- ^ "Renova (tretinoin) cream". DailyMed. FDA and National Library of Medicine. Archived from the original on 29 October 2013. Retrieved 14 July 2013.
- ^ "Carboxytherapy And Mesotherapy Unproven" (Press release). 2009. Archived from the original on 13 May 2019. Retrieved 21 May 2016.
- S2CID 209671919.
- PMID 27296503.
- ^ "Botany". Archived from the original on 21 April 2021. Retrieved 10 November 2009.
- ISSN 2511-820X.
- S2CID 7887237.