ALTERNATIVE APPROACHES TO STRETCH MARKS
The medical term for stretch marks is striae distensae. These occur when the skin is abnormally stretched in a rapid amount of time (ie, pregnancy, significant weight gain, rapid growth during puberty). As a result, the skin’s support structure of collagen and elastin breaks down and ruptures. Stretch marks are actually a scar that has formed from the inside out, rather than a scar that happens when the skin is externally wounded. Discoloration from these marks tends to fade over time, but the tread-mark appearance of the skin rarely returns to its original smooth state.
Not everyone gets striae though. There appears to be a genetic tendency toward them, but the exact link is not clear. There does not seem to be an ethnic tendency toward stretch marks, as all races can be affected. The type of discoloration may vary, however, in different skin tones, as those with fair to light skin typically have pink-tinged stretch marks while darker skin tones tend to be more heavily pigmented.
Conventional Treatments
Currently, there are a variety of treatments including topical tretinoin, chemical peels, microdermabrasion and non-ablative laser treatments. Brief descriptions of these conventional treatments follow.
Tretinoin: Tretinoin (Retin-A, Renova, or in generic form) can have a modest positive effect. The best results are seen when it is used at the first signs of stretch marks (red) but not when the stretch marks are mature (white).Typical improvement in these trials is a 8% to 20% reduction in length and width. The dilemma for expectant mothers is that tretinoin cannot be used during pregnancy, and is also contraindicated if the mother-to-be intends to breastfeed her baby.
Lasers/Light/Radiofrequency Devices: Intense pulsed light (IPL), pulsed dye lasers (PDL) emitting 585 nanometers (nm) of light, and the xenon-chloride laser (Excimer) emitting 308 nm treatments result in varying degrees of clinical improvement. Neodymium-doped YAG (Nd:YAG), diode and fractional lasers are the newer applications of laser technology to venture into treatment of stretch marks, all showing encouraging preliminary results.
Acid Peels: Trichloroacetic acid (TCA) peels may be of some help for improving the appearance of stretch marks when used at the proper concentration.
Microdermabrasion: There is insufficient literature about the efficacy of microdermabrasion for stretch mark improvement.
Alternative Approaches
Is there something you can do to improve or eliminate the appearance of stretch marks that is natural? The simple answer is not really. There are a lot of creams, ointments, vitamin preparations and plant oils available that largely rely on anecdotal evidence only. Below are some common preparations that you may be seeing in health food or department stores or on the internet.
The preparations below provide hydration to the skin but are unproven regarding stretch mark improvement:
• Hydrating creams: cocoa butter, shea butter
• Vitamin capsules: vitamins E, A and C
• Plant oils: rose hip, emu, jojoba, castor, sweet almond, avocado, wheat germ, eucalyptus
There are also some preparations, tested in Germany and Spain — that are combination topicals that have shown some improvement:
Combination Topicals: Trofolastin, Verum, Alphastria
• Trofolastin cream contains Centella asiatica extract, vitamin E and collagen-elastin hydrolysates.
• Verum ointment contains vitamin E, panthenol, hyaluronic acid, elastin and menthol.
• Alphastria cream contains hyaluronic acid, allantoin, vitamin A, vitamin E and dexpanthenol.
All of the studies for these topicals were tested in too few people and the active compound(s) in these preparations have not been identified so these studies are really not that helpful.
Other Topical Products: StriVectin-SD, Mederma, ScarSof Scar Softening Cream, Vita-K Solution, Magia Bella Ultra-Intensive Anti-Stretch Mark Concentrate, Maternity Solutions Stretch Mark Cream, Phytomer SeaTonic Stretch Mark Reducing Cream, Decleor Stretch Mark Restructuring Cream and Mustela Stretch Marks Double Action
These products are all heavily marketed and available in department stores, drug stores and on the Internet, and in general contain moisturizing agents, emollients and various plant oils. None of them have substantiated evidence they can make a positive impact on the formation or prevention of stretch marks. And they are ridiculously expensive: a 6-oz tube of StriVectin-SD is >RM400!
So far, no single treatment has been proven more effective than the other, although laser technology applications seem the most promising. Lastly, don't waste your money on creams, lotions or plant oils with the exception of tretinoin cream.