Stretch Marks

Stretch marks, clinically known as striae distensae, are linear scars that form in the dermis when the skin is stretched faster than its elastic fibres can adapt. They typically appear on the abdomen, breasts, hips, thighs, upper arms and lower back, and follow a recognisable two-phase course. In the early active phase (striae rubra), marks are pink, red or purple because the damaged dermis has thinned enough for underlying blood vessels to show through. Over months to years the marks fade to a silvery white (striae alba) as vascularity diminishes and the dermis settles into a permanently thinner, less elastic state. The most common triggers are rapid physical change. Pregnancy produces stretch marks in roughly half to three-quarters of women, typically on the lower abdomen and breasts. Adolescent growth spurts cause marks on the outer thighs, lower back and breasts. Rapid muscle gain in gym-focused younger men produces marks across the shoulders, upper arms and inner thighs. Rapid weight gain or loss, and conditions or medications that raise circulating corticosteroid levels (prolonged oral or topical steroid use, Cushing's syndrome), also damage collagen and predispose to striae. Genetics play a substantial role: a family history of stretch marks is one of the strongest predictors. Non-surgical treatment outcomes are better for early red marks than for mature white ones, so timing matters. Microneedling, either with a medical dermaroller or a motorised device, creates controlled micro-injuries that trigger collagen and elastin remodelling, and works well across both phases. Laser resurfacing with a fractional non-ablative or ablative laser produces more dramatic remodelling by vaporising micro-columns of tissue and stimulating deeper repair. PRP therapy (platelet-rich plasma) involves drawing a small blood sample, concentrating the platelet fraction, and injecting or topically applying it alongside microneedling; the growth factors released are thought to enhance the repair response, though evidence quality varies. Red, vascular stretch marks sometimes respond to pulsed dye laser or IPL to address the colour component first. No non-surgical treatment removes stretch marks completely. Honest consultations discuss realistic improvements, usually in the range of visible texture and colour rather than full erasure, and factor in that maintenance sessions are often needed over twelve to twenty-four months.