Between 75% and 90% of women develop some degree of stretch marks during pregnancy. The rapid weight gain during pregnancy subjects skin to more stretching force than it can handle. Stretch marks usually appear during the sixth or seventh month, as that is when a quick increase in weight is experienced. Stretch marks may also occur during puberty and in transsexuals undergoing hormonal replacement therapy.
Cause. Stretching alone is not the cause. The glucocortinoid hormone has been identified as responsible for the development of stretch marks. It prevents the formation of collagen and elastin fibers necessary to keep rapidly growing skin taut. This creates a lack of supportive material, as the skin is stretched and leads to dermal and epidermal tearing.
Prevention. Can cocoa butter prevent stretch marks? A study on the popular ingredient produced no significant difference between those who applied cocoa butter cream and those given placebo. The clinical trial was done on 300 women, randomized, placebo-controlled and double-blind. There maybe hope in creams containing Centella asiatica (Gotu kola) extract and vitamin E. A randomized controlled study found a daily application of the cream produced fewer stretch marks during pregnancy. Another study on a cream containing vitamin E, panthenol, hyaluronic acid, elastin and menthol showed similar stretch marks prevention activity.
Removal. There are various treatments being offered claiming to improve the appearance of stretch marks, including creams & oils, micro-needling, and fractional laser treatments. Many cream manufacturers claim having the best results especially on recent stretch marks; however, few studies exist to support claims that these topical treatments can cause statistically significant improvement.
Micro-needling (dermaroller) and fractional (non-ablative) laser resurfacing treatment are similar in their approach: they trigger the body’s natural ability to heal itself and produce collagen and elastin. They both create microscopic wounds, but the laser option produces faster and better results. Micro-needling may require 8 to 10 sessions; fractional laser, 5 to 6 sessions, with improvement of up to 75% reported.
Fractional laser, with the advantage of faster healing, has replaced the ablative laser approach. Many fractional laser manufacturers have collaborated with various clinics for their clinical studies, all reporting good results with erbium and CO2 fractional lasers. The USFDA has approved a fractional laser brand for stretch marks removal, giving credibility to the results of these clinical trials. A novel approach to fractional laser treatment is the addition of hyaluronic acid and vitamin C serum to the procedure. This has resulted in significant improvement versus the modality of laser alone.
Bottomline. Stretch marks are difficult to prevent, much more difficult to treat. In fact, stretch marks are permanent breaks in the skin and improvement in appearance is the best that can be hoped for. Creams may work in prevention, but they cannot be relied upon for cure. What will work are the more expensive procedures. Fractional laser resurfacing appears to be the best option, with assistance by serum that helps boost collagen production.
______________________________________________________________________________________This column was published on May 1, 2012 in the Lifestyle Section of the Manila Bulletin. The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulations Commission for his achievements in the field of cosmetic chemistry. He can be reached at firstname.lastname@example.org.