Stretch marks (striae) are a common type of scarring that occurs when the skin is expanded too rapidly for collagen and elastin formation to keep up. This can happen during rapid growth spurts or weight gain. The problem can be compounded by hormonal changes such as those that occur during pregnancy. When the fibrous structures in the skin tissue are stretched enough to cause damage, this triggers a line of scar tissue to form. Like other types of atrophic scars, these start out reddish or purple and then fade to a lighter shade than the surrounding skin. Complete stretch mark removal is not possible, but there are many therapies available that can fade the striae and make them less noticeable. This includes the use of topical creams containing Retin-A and microdermabrasion to resurface the skin.
Laser Treatment Options
Lasers are also used by some dermatologists to treat severe stretch marks. During the inflammatory stage (when the marks are still red), pulsed-dye lasers may be used to fade the marks to a more normal skin color. If collagen production is triggered as a result of the laser treatment, the final texture of the scar may also be improved. Multiple sessions may be required to achieve the desired results.
For scars that have already faded to white, stretch mark removal may be attempted with fractional lasers that resurface the skin. These lasers work by vaporizing tiny columns of dermal tissue while leaving surrounding skin intact to speed the healing process. This therapy has a well-established track record for treating atrophic scars caused by acne or surgery and it works in a similar manner for striae. The goal of this treatment is to replace scar tissue with normal skin improving both the texture and color of the stretch mark. Laser treatment carries a risk of hyperpigmentation for patients with darker skin. This darkening may or may not fade over time and must sometimes be treated with a skin lightening cream such as hydroquinone.
An excimer laser may also be used for stretch mark removal. It is a cool laser that ablates tissue by causing disintegration at a molecular level rather than by directly generating heat. The excimer is a UVB light based laser that can stimulate melanin production in the skin. The combination of ablation to prompt the development of healthy tissue and the triggering of repigmentation is designed to reduce the appearance of white stretch marks. This type of device is sometimes used for vitiligo as well as surgical scars with documented benefits.