Stretch marks generally occur on the upper most layer of the skin called dermis, the resilient middle layer that helps the skin retain its shape. No stretch marks will form as long as there is support within the dermis. Stretching plays more of a role in where the marks occur and in what direction they run. Stretching alone is not the cause.
Between 75% and 90% of women develop stretch marks to some degree during pregnancy. The sustained hormonal levels as a result of pregnancy usually means stretch marks may appear during the sixth or seventh month, primarily during the 3rd trimester, as that is when skin tends to be subjected to higher levels of stretching forces. Often, of all the factors involved in stretch mark development, the only one over which an individual can retain control is that of diet.
Only one randomized controlled study has been published which claimed to test whether oils or creams prevent the development of stretchmarks. This study found a daily application of a cream (Trofolastin) containing Centella asiatica extract, vitamin E, and collagen-elastin hydrolysates was associated with fewer stretch marks during pregnancy. Another study, though lacking a placebo control, examined a cream (Verum) containing vitamin E, panthenol, hyaluronic acid, elastin and menthol. It was associated with fewer stretch marks during pregnancy versus no treatment.
Though cocoa butter is an effective moisturizer, no research studies have shown its ability to either prevent stretchmarks, or to reduce their appearance once a stretch mark has already formed.
Treatments are available for the purpose of improving the appearance of existing stretch marks, including laser treatments, dermabrasion, and prescription retinoids.] Some cream manufacturers claim the best results are achieved on recent stretch marks; however, few studies exist to support these claims.
A surgical procedure for removing lower abdominal stretch marks is the tummy tuck, which removes the skin below the navel where stretch marks frequently occur.
A new modality, fractional laser resurfacing, offers a novel approach to treating striae. Using scattered pulses of light only a fraction of the scar is zapped by the laser over the course of several treatments. This creates microscopic wounds.
The body responds to each treatment by producing new collagen and epithelium. In a 2007 clinical trial, 5-6 treatments resulted in striae improving by as much as 75 percent. A 2007 Brazilian clinical study showed that fractional laser resurfacing improved both texture and appearance of mature, white striae in skin types I-IV.
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