Stretch Marks Getting Under Your Skin?

which she had diligently tried to minimize with topical creams and ointments -- had multiplied.

She'd heard that stretch marks were hard to avoid, but Nugent wasn't particularly concerned. She was looking forward to abdominoplasty surgery.

"I still have some stretch marks, but they're very, very low on my belly," says the 38-year-old. "Most got cut out with my tummy tuck ."

Not everyone is willing to go to such lengths to get rid of stretch marks, however. So it's important to understand first what causes stretch marks, and what steps, if any, you can take to prevent them.

What Causes Stretch Marks?

Known by doctors as "striae" (usually "striae distensae" or, in the case of pregnancy , "striae gravidarum") stretch marks typically appear after rapid weight gain or loss. They are most common during pregnancy and the teen years, when growth spurts and increased levels of steroid hormones cause significant changes throughout the body. Stretch marks can also be brought on by obesity and weight lifting .

Genetic factors -- including inherited defects of connective tissues -- also play a role, Mohamed L. Elsaie, MD, MBA, says in the August 2008 issue of Esthetic Dermatology News. But the basic cause of stretch marks is unknown.

"Basically, if your mother had them, you're probably going to have them," says Leslie Baumann, MD, director of the University of Miami Cosmetic Group and author of The Skin Type Solution.

Stretch marks affect as many as 90% of all women, she says, and they are not easy to get rid of. Once they have passed the initial stage, when they are red or purple, to the later stages, where they become white or silver -- often with deep indentations -- they are much more challenging to treat.

Prevention, therefore, is key.

"Avoiding rapid weight gain or loss is a good start. For those who are pregnant or experiencing the hormone changes of the teen years, it is crucial to moisturize," Baumann says. "Skin becomes more pliant, more plasticized and better able to stretch when it's well hydrated."

She recommends moisturizing three or four times a day with products that contain cocoa butter or shea butter as a prime ingredient. Massage the moisturizer deep into breasts, belly, hips, and buttocks.

How to Get Rid of Stretch Marks

The appearance of stretch marks depends on the color of your skin; they can start out pink, reddish brown, brown, or dark brown, and fade over time to a more silvery color. Once stretch marks have appeared, it's essential to treat them as early as possible. Research has focused exclusively on the early stages of stretch marks, when they are still red or purple and most readily respond to treatment, Baumann explains.

Grocery stores, pharmacies, and web sites boast a multitude of products and cosmetics that claim to "repair" striae. However, only a few work, she says.

Here's a rundown of the products available for stretch mark removal and what they can -- and cannot -- do:

Wheat germ oil: There is not much scientific data on whether home remedies for stretch marks, such as wheat germ oil, can help. One recent study did find it helped improve stretch marks in their early phase.

Glycolic acid: Widely touted for its rejuvenation powers, glycolic acid is a sugar cane derivative and a member of the alpha hydroxy acid (AHA) family. It most likely works on stretch marks by increasing collagen production, says Baumann. Glycolic acid can also be administered in higher doses by a dermatologist. Treatment typically costs around $100 and requires three or four office visits before results will appear.

Vitamin C: Certain formulations of vitamin C, which have become increasingly popular as over-the-counter brands, may also increase collagen production and help early-stage stretch marks, says Baumann. For maximumeffect, combine with glycolic acid. Vitamin C supplements may also be effective. She suggests 500 milligrams three times a day.

Relastin, peptide-containing products: The jury is still out on Relastin, an eye and face cream product marketed for its ability to increase elastic tissue production. But peptide-containing products, which are widely marketed as effective "repair" creams, are a waste of time and money, Baumann says. Despite commercial claims, there is no convincing data that these work.

Retinoids: A family of products that includes vitamin A, retinoids have been shown to be fairly effective in increasing collagen and elastic production during the early stages. Retinoids should be avoided entirely if pregnant or nursing. Retinol, tretinoin, and the prescription medications Retin-A, Renova, Tazorac, and Differin are examples of retinoids.

Glycolic acid and retinoids: Using these together may provide better results. According to Elsaie, while glycolic acid alone for stretch mark treatment has not been fully studied, a trial comparing glycolic acid plus tretinoin with glycolic acid plus vitamin C both showed equal improvement and increased elastic in stretch marks after 12 weeks of daily application. Various prescription-strength retinoids are often applied as a preparation to "rev up" the skin before a glycolic acid peel is applied.

Laser treatment: This popular treatment option is used by many dermatologists, and they are also being tried on white stretch marks, as well.

Linda K. Franks, MD, a clinical assistant professor at New York University School of Medicine and director of Gramercy Park Dermatology Associates, is a big fan of laser procedures, which she frequently uses in her New York City practice to treat both red/purple and white stretch marks.

"Lasers promote synthesis of healthy, new collagen, which has been damaged when stretch marks appear," she explains.

For red and purple marks, Franks uses a vascular laser called a V-Beam, which targets swollen and inflamed blood vessels and helps with skin cell production and increased collagen production. Treatments usually require three to six sessions at an average rate of $450 per session.

"Vascular lasers won't take away the superficial skin but will take away the redness," she says. "The redness is caused by blood flow. V-Beam treats those blood vessels.

One laser that may help minimize older, more entrenched stretch marks is the fractionated laser, which hits tiny "fractions" of the skin, often in a grid-like pattern. Franks describes the process as "smudging" the lines of stretch marks, which makes them less distinct.

Like most Floridians, Franshely Calero, 25, loves to go to the beach near her home in Miami. But after giving birth to her son one year ago, she was plagued with stretch marks and became too embarrassed to take off her shirt.

Pink at first, the stretch marks turned white after three or four months and deepened significantly. So Calero decided to try Fraxel, a, fractionated laser that has been approved by the FDA for use with age spots, acne scars, and "mask of pregnancy" also known as melasma. Like other fractionated lasers, it is also being used to treat stretch marks. She received three laser treatments.

"They're still there but they're a lot less noticeable. I mean, a lot," she says. "I had big, deep wide ones on my stomach. You could run your finger over them and it was like falling into a pit. They were super wrinkly and saggy. Now, the skin is more even and smooth. It doesn't look like my body has been taken over by stretch marks."

Expect to pay up to $1,000 per session for these treatments, and be prepared to pay for at least three sessions.

Even in the best cases, however, Franks warns not to expect perfection. She estimates that patients will see about 30% improvement but is quick to add that almost everone who does the treatments is usually quite pleased.

"People are resigned to the fact that stretch marks are permanent and can't be fixed, but there are ways to treat them," Franks says. "There will always be some left, though, whether you're treating the red ones or the white ones."

By Annabelle Robertson
Reviewed by Louise Chang
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