The truth about stretch marks, according to a dermatologist

Whether they develop from puberty, pregnancy, or weight gains and losses, stretch marks are an exceedingly common form of scarring on the skin—in fact, it's hard to find an adult who doesn't have any. Some see them as a badge of honor for having given birth to a healthy child or for putting on much-desired muscle, while others go to many lengths to get rid of them.

For those in either camp but especially the second, it’s important to understand how and why they got there in the first place. To shed some light, we enlisted the help of Dr. Isha Tiernan, a dermatologist at Tufts Medical Center in Boston.

What causes stretch marks?

When you examine your stretch marks, you’ll see or feel a slight depression in the skin at each mark. These indentations are due to a lack of collagen and elastin, both of which are proteins the body produces that act as connective tissue to uphold the skin’s structure.

Rapid growth of underlying tissues causes the skin to stretch faster than it can adapt, resulting in tears in the collagen and elastin and leaving behind those telltale lines. They may also appear after weight loss or pregnancy because the skin is no longer stretched beyond its bounds.

You won’t actually see the tears in the proteins, as the process occurs far below the skin’s surface.

“We have the top of the skin called the epidermis and then we have the layer below that called the dermis, and the reason it’s important to mention that is it has to do with the kind of things you can do to treat stretch marks,” Tiernan says. “This is not a superficial process.”

In addition, stretch marks are often discolored—sometimes they’re red, purple, or deeper or lighter than your natural skin tone. Like many physical injuries, your body responds by sending blood to the area, resulting in inflammation, which can cause the red or purple hues. This same thing happens with your skin, but when the inflammation goes away, the marks should fade to a color closer to your skin tone.

Who gets stretch marks?

Everyone can get stretch marks, but women are more likely to develop them than men, likely because females tend to have curvier body shapes (stretch marks often occur on the breasts, hips, buttocks, and thighs) and, of course, pregnancy is a major cause of them.

Some people are also genetically predisposed to stretch marks, so if your parents have them, you may develop them, too.

It’s worth noting that cellulite, a condition that causes dimpling of the skin, may be confused with stretch marks because it occurs in similar areas like the buttocks and thighs, particularly on females, but the cause and treatment for the two are not the same.

“Cellulite has to do with fat deposition underneath the skin. Fat is even lower than the dermis,” Teirnan says. “It’s a different process altogether.”

Can you prevent stretch marks?

The best thing you can do to prevent stretch marks is to avoid rapid weight changes that cause tears in the dermis, which is (mostly) achievable through eating a balanced diet and staying active.

However, if you want to take an abundance of caution, or if you can predict the likelihood of getting stretch marks, like during pregnancy, there are some things you can do. Tiernan recommends three prevention tactics: moisturizing, hydrating, and massaging.

Unfortunately, topical treatments won’t take you very far to improve the appearance of stretch marks. Tiernan explains, as creams, ointments, and oils may only reach the very top layer of the dermis after absorbing through the epidermis.

“That said, I do tell patients that anything you can do that will preserve the elasticity of the skin and keep the skin as supple as possible can help,” Tiernan says. “So if you moisturize the skin, that will help in general because dry skin is less elastic, so it’s more prone to injuries and tears.”

Moisturizing and hydrating the skin with common ingredients such as hyaluronic acid, almond oil, or cocoa butter can help improve skin elasticity. In conjunction, Tiernan recommends staying on top of your water intake to hydrate your body, which promotes suppleness in your skin at the same time.

Lastly, you can massage stretch mark-prone areas to promote circulation. The idea behind this is a similar school of thought that leads to beauty bloggers using jade rollers on the face: increasing blood flow to the area can boost tissue growth and help active ingredients penetrate deeper into the skin.

None of these methods guarantee the complete prevention of stretch marks and there’s ultimately no way to know what stretch marks would or would not have occurred without these efforts, but these are all healthy habits for the skin and they may make you feel better.

“After all that, if you develop stretch marks, don't lose sleep over it,” Tiernan says. “This is a very natural process.”

Can you get rid of stretch marks?

While there are methods to reduce stretch marks and speed up the healing process in a more immediate sense, it's possible your body would have naturally produced the same results over time, so it's up to you whether you want to incur the effort and expense of treatments. “All of these are cosmetic—they’re not usually covered by insurance,” Tiernan says.

The first treatment Tiernan recommends is a prescription topical retinoid, a vitamin A-derived ingredient often used for anti-aging, such as a tretinoin cream to help plump up the skin and reduce fine lines and wrinkles.

“Because [retinoids] can potentially help build collagen, which is the thing getting affected by the stretch marks, there is some thought that using them early on when stretch marks first happen could potentially improve the appearance.”

Tiernan says there are also procedures that work deeper down into the skin, such as chemical peels, laser treatments, or microneedling, all of which cause intentional injury to the deeper structures of the skin, forcing the skin to rebuild collagen.

“For people who are bothered by the redness, we have ocular lasers that specifically target blood vessels, so that can be used to decrease the redness associated with stretch marks.”

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