Stretch marks

Introduction

Symptoms of stretch marks

Not everyone gets stretch marks. It depends on your skin type. People with a high level of collagen in their skin are less likely to get stretch marks.

Not everyone gets stretch marks. It depends on your skin type.

People with a high level of collagen in their skin are less likely to get stretch marks than people with a low level of collagen in their skin.

Collagen is a protein that makes the skin elastic and stretchy.

Characteristics of stretch marks

Before developing stretch marks, the affected skin will become thin, flattened and pink. The area may also feel itchy.

Stretch marks often appear as red or purple streaks or lines (striae rubra) on the surface of your skin. However, depending on your skin colour, they may appear pink, reddish brown or dark brown.

Initially, the lines will be slightly raised and may feel wrinkly, before eventually flattening out. As the lines become flatter, they will start to fade and will usually change to a white or silvery colour (striae alba).

Stretch marks may appear in patches of parallel lines on your body and often appear scar-like.

In many cases, stretch marks will eventually fade and become less noticeable. However, this can often take years.

Where do stretch marks appear?

Stretch marks can appear anywhere on your body where the skin has been stretched. However, they usually develop on areas where fat is stored, such as your:

  • abdomen (tummy)
  • buttocks
  • thighs
  • upper arms
  • breasts
  • shoulders (in bodybuilders)

Stretch marks due to Cushing’s syndrome (where a person has  high levels of a hormone called cortisol in their blood) tend to be wider and larger, and can also appear on the face.

Causes of stretch marks

Stretch marks occur when the skin is stretched extensively over a short time period.

Stretch marks occur when the skin is stretched extensively over a short time period.

The rapid stretching causes the middle layer of skin (dermis) to break in places, allowing the deeper skin layers to show through, forming stretch marks.

The dermis is made-up of strong, inter-connected fibres that enable your skin to stretch as your body grows.

If part of your body, such as your abdomen (tummy), grows rapidly over a short period, the fibres can become thin and over-stretched and some may break.

At the point where the skin fibres break, tiny tears develop which allow the blood vessels below to show through. This is why stretch marks are often red or purple when they first appear.

When the blood vessels eventually contract (shrink), the pale-coloured fat underneath your skin will be visible, and your stretch marks will change to a silvery-white colour.

When stretch marks occur

Stretch marks often occur in the following situations:

  • during pregnancy
  • after rapid weight gain
  • during puberty
  • if you have a family history of stretch marks
  • if you have an underlying health condition, such as Marfan syndrome
  • after the prolonged or inappropriate use of corticosteroid medication  

These are discussed in more detail below.

Pregnancy

Stretch marks are common during the later stages of pregnancy, affecting up to 80% of pregnant women. Whether or not you will get stretch marks depends on your skin type and how elastic it is.

During pregnancy, your body produces hormones that soften the ligaments in your pelvis so that they are more flexible when you give birth. Ligaments are strong bands of tissue that connect joints. However, the hormones also soften the fibres in your skin, making you prone to stretch marks.

As your baby grows, you may develop stretch marks on your abdomen (tummy) as your skin stretches. You may also develop stretch marks on your thighs and breasts as they get bigger.

After childbirth, most stretch marks will fade and become less noticeable, but they do not always disappear completely.

Rapid weight gain

You may get stretch marks if you put on a lot of weight over a short period of time.

In some cases, the stretch marks may remain, even if you lose the weight. However, they should fade over time.

If you diet regularly, stretch marks can develop as your weight goes up and down. If you need to lose weight, lose it slowly and steadily so your skin is not put under strain.

Read more about how to lose weight safely.

Bodybuilders and athletes can sometimes get stretch marks as their muscles increase in size.

Puberty

During puberty, the body often develops very quickly in growth spurts. As a result, males may get stretch marks on their shoulders and back, and females may get them on their hips, thighs and breasts.

Family history

If you have a close relative who has stretch marks, such as your mother, you are more likely to develop them yourself.

Although stretch marks can affect both male and female members of your family, they occur most often in women.

Underlying health conditions

Stretch marks can sometimes be caused by rare, underlying health conditions, such as Cushings syndrome and Marfan syndrome.

Cushings syndrome occurs when the body produces excess amounts of cortisol, the hormone that may make some people more prone to developing stretch marks than others.

If you have Cushings syndrome, you may develop noticeable, dark coloured stretch marks. 

Marfan syndrome is caused by a faulty gene which affects your bodys skin and connective tissues. It weakens your bodys tissues and affects their elasticity (ability to stretch). This results in your skin not being as resistant to stretch marks as it should be.

If you have Marfan syndrome, you may develop stretch marks on your shoulders, hips or lower back.

Corticosteroids

In rare cases, stretch marks can develop after prolonged or inappropriate use of corticosteroid medicines, such as creams or lotions used to treat skin conditions, including eczema.

Corticosteroids work in a similar way to the hormone cortisol, which is naturally produced by your body.

Corticosteroids can help ease inflammatory skin conditions, but like cortisol, they can also decrease the amount of collagen in your skin.

Collagen is a protein that helps keep your skin stretchy. This means that the less collagen there is in your skin, the more likely you are to develop stretch marks.

When using a corticosteroid cream or lotion, make sure you follow the manufacturers instructions regarding how and where to apply it. The face, groin and armpits are particularly sensitive areas. Ask your GP or pharmacist for advice if you are unsure.

Treating stretch marks

Stretch marks are not often noticeable and usually fade over time. Treatments are available for unsightly stretch marks or those that affect a large area of your body.

Stretch marks are not often noticeable and usually fade over time.

If you have stretch marks that affect a large area of your body, or are worried they look unsightly, there are a few treatment options available.

However, there is little medical evidence to show that these treatments work.

Creams, gels and lotions

Many creams, gels and lotions claim they can remove stretch marks. These products are essentially skin moisturisers and are available from pharmacies, supermarkets and health and beauty shops.

If you decide to use creams, gels or lotions, you should apply them when your stretch marks are still red or purple. However, it is unlikely these types of treatments can prevent stretch marks.

Read more about preventing stretch marks.

Laser therapy

Laser therapy cannot completely remove stretch marks, but may help fade them and make them less noticeable.

Several different types of laser therapy are used to treat stretch marks.

Pulsed dye laser treatment is one of the laser treatments available. It is painless and can be used at an early stage, while your stretch marks are still red or purple.

The energy from the laser is absorbed by the blood vessels underneath your stretch marks. The blood vessels collapse and the red or purple colour either disappears completely or turns white. 

Laser therapy for stretch marks is usually expensive and is not available on the NHS. It is likely you will need a number of treatments to obtain visible results. The exact number will depend on your skin colour and type.

Cosmetic surgery

Cosmetic surgery for stretch marks is expensive and rarely recommended.

If you have stretch marks on your abdomen (tummy) and a large amount of loose skin, it may be possible to have an operation called an abdominoplasty, also known as a tummy tuck.

An abdominoplasty removes excess skin and fat from your abdomen, and also gets rid of stretch marks below your belly button at the same time.

As this type of surgery is carried out for cosmetic reasons (to improve your appearance), it is not available on the NHS. It also carries a number of associated risks and can cause considerable scarring.

Read more about cosmetic surgery.

Preventing stretch marks

Stretch marks are very common and cannot be prevented altogether. However, the following advice may help reduce your risk of developing stretch marks.

Stretch marks are very common and cannot be prevented altogether. However, the following advice may help reduce your risk of developing stretch marks.

Healthy weight

Gaining weight rapidly over a short period of time is one of the most common causes of stretch marks.

Diets that cause your weight to quickly go up and down can cause stretch marks to develop because your skin is stretched by the sudden increases and decreases in your size. Therefore, avoiding rapid weight gain and weight loss can help prevent stretch marks from occurring.

If you need to lose weight, you should do it slowly by eating a healthy, balanced diet and getting plenty of regular exercise. You should not lose more than 0.5kg (1lb) a week.

Read more about how to lose weight safely.

Skincare

Massaging your skin every day with moisturiser or a massage glove can help improve your circulation and encourage new tissue growth.

It is also important to eat a healthy, balanced diet rich in vitamins and minerals, particularly vitamin E, vitamin C, and the minerals zinc and silicon. These vitamins and minerals will help keep your skin healthy.

Read more about vitamins and minerals.

During pregnancy

Stretch marks that develop during pregnancy are usually due to hormonal changes that affect your skin. However, gaining pregnancy weight steadily may help minimise the effect of stretch marks.

During pregnancy, it is normal for a woman to put on weight over a relatively short period of time. However, it is a myth that you need to eat for two, even if you are expecting twins or triplets.

You do not need to go on a special diet if you are pregnant, but you should eat a variety of different foods every day to get the right balance of nutrients for you and your baby. Your diet should be rich in wholewheat carbohydrates, such as bread and pasta, as well as fruit and vegetables.

Read more information and advice about diet during pregnancy

During pregnancy, your weight gain should be slow and gradual. The amount of weight you put on will depend on the weight you were before you became pregnant. It is normal to gain 1-2kg (2.2-4.4lb) over the first 12 weeks of your pregnancy.
 
As a rough guide, during pregnancy, women who are:

  • underweight (have a BMI of less than 18.5) should gain 12.7-18.1kg (28-40lb)
  • a normal weight (have a BMI of 18.5-24.9) should gain 11.3-15.9kg (25-35lb)
  • overweight (have a BMI of more than 25) should gain 6.8-11.3kg (15-25lb)
  • obese (have a BMI of more than 30) should gain 5-9.1kg (11-20lb).

Speak to your GP, midwife, or health visitor if you are worried you are not gaining weight at a healthy rate, or if you are concerned about your stretch marks.