28 September 2010

Stretch marks

Whether you’re growing upwards or outwards, many men, women and teens develop annoying white or silvery stretch marks. But what causes these scars, and can you get rid of them?


Whether you’re growing upwards or outwards, many men, women and teens develop annoying white or silvery stretch marks. But what causes these scars, and can you get rid of them?

What are stretch marks?
Stretch marks, or striae, occur in the elastic middle layer of the skin, called the dermis. At first, they usually appear as wrinkled reddish or purple lines, but over time they fade to a lighter colour and become flatter and soft to the touch.

Stretch marks may appear anywhere on the body, although they are usually found in areas where there are large fatty deposits. Because of this, they are most commonly found around the abdominal area, as well as on the thighs, breasts, hips, upper arms, and lower back.

Both men and woman, of all races, are at risk of developing stretch marks. And although they pose no health risks, they can be an unsightly nuisance.

Unfortunately, the exact cause of stretch marks is still uncertain. Whilst some experts claim that the white or silvery scars are caused by rapid growth that puts intolerable strain on the skin’s elastic tissues, it’s possible that this is only half of the story.

Recent studies suggest that the hormones produced during times of growth are responsible for the development of stretch marks in both men and women. Hormones that are produced during periods such as puberty and pregnancy, for instance, seem to affect the cellular functioning of the skin.

These hormones may prevent fibroblasts (the cells responsible for the production of collagen) from forming collagen and elastin fibres (the protein fibres that give the skin its flexibility). This means that the rapidly growing skin is not adequately supported, and this leads to epidermal and dermal tearing, in other words, stretch mark scarring.

Between 75% and 90% of women develop stretch marks during pregnancy. But because the exact causes of stretch marks are not yet clear, and it is difficult to predict who will and will not develop stretch marks, it is also difficult to determine how to prevent them.

Moreover, despite the wealth of over-the-counter anti-stretch mark products currently available, very few studies have been conducted to investigate the effectiveness of these products.

But, considering that the rate at which the skin stretches may be a factor, it is a good idea to keep unnecessary weight gain in check during pregnancy, as this may reduce the appearance of stretch marks on the thighs and hips.

There are a number of treatment options that claim to improve the appearance of skins scarred by stretch marks.

Laser treatment
When stretch marks are new, lasers may effectively reduce redness and stop inflammation. Whilst red stretch marks are easier to improve, white stretch marks may not be as responsive to treatment, although improvements in texture have been noted. Some laser treatments may also induce collagen growth which can then improve the appearance of the skin.

One relatively new and effective laser treatment option is fractional laser therapy. This is when the laser issues a series of small, closely-spaced injuries to the skin, whilst preserving normal untreated skin in-between the treated areas. The normal skin then helps to heal the wound, replacing the treated area with healthy new skin.

That said, treating stretch marks on darker skins can be difficult and risky, as darker skins contain more of the pigment, melanin. This pigment is designed to absorb light and protect the skin from the sun. During laser therapy, then, the melanin may steal away and absorb the laser light, causing skin damage rather than improvement.

Surgical stretch mark removal
This technique involves removing the area of stretched skin. One example of surgical stretch-mark removal is the tummy tuck procedure, during which skin below the belly button is removed. But before you get too excited, there is a downside to these procedures: though they may remove the stretch marks, they may also leave behind surgical scars.

Non-invasive stretch mark removal options
Other stretch mark-removal options include chemical peels, microdermabrasion, and blue light therapy.

Microdermabrasion refers to the process of partially or completely removing the outer surface of the skin through light abrasion. Blue light therapy, on the other hand, involves exposing the damaged skin area to a continuous or intense pulsed light.

Although these are generally less expensive than more invasive techniques, they are also less effective and are best used on newer scars.

(Donna Steyn, Health24, updated September 2010)

Encyclopaedia of Family Health


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Skin expert

Dr Suretha Kannenberg holds a degree in Medicine and a Masters in Dermatology from the University of Stellenbosch. She is employed as a consultant dermatologist by Stellenbosch University and Tygerberg Academic Hospital, where she is involved in clinical duties and the training of medical students and dermatology residents. Her areas of interest and research include vitiligo, eczema and acne. She also performs limited private practice work in the Northern suburbs of Cape Town in general and cosmetic dermatology.

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