Prab at 23:41, 26 April 2025

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	{{Infobox medical condition (new)		{{Infobox medical condition (new)
	\| name = Stretch Marks		\| name = Stretch Marks
	~~\| image = Belly Stretch Marks.jpg~~
	~~\| caption = Stretch marks on the abdomen.~~
	\| field = [[Dermatology]]		\| field = [[Dermatology]]
	\| synonyms = Striae, striae distensae, striae gravidarum (pregnancy-related)		\| synonyms = Striae, striae distensae, striae gravidarum (pregnancy-related)

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{{Use dmy dates|date=February 2014}}
:''"[[wikt:striae|Striae]]" is also a general term referring to thin, narrow grooves or channels, or a thin line or band especially if several of them are parallel or close together.''
{{Infobox medical condition (new)
| name = Stretch marks
| image = Belly Strech Marks.jpg
| caption =
| pronounce =
| field = [[Dermatology]]
| synonyms = stria, striae distensae
| symptoms =
| complications =
| onset =
| duration =
| types =
| causes =
| risks =
| diagnosis =
| differential =
| prevention =
| treatment =
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| prognosis =
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}}


'''Stretch marks''', also known as '''striae''', are a form of [[scar]]ring on the [[skin]] with an off-color hue. Over time they may diminish, but will not disappear completely. Stretch marks form during rapid growth of the body, such as during puberty or pregnancy. In pregnancy they usually form during the last trimester, and usually on the belly, but also commonly occur on the breasts, thighs, hips, lower back and buttocks. These are known as striae gravidarum.<ref>{{cite web|url=http://americanpregnancy.org/your-pregnancy/are-pregnancy-stretchmarks-different/ |title=Are Pregnancy Stretch Marks Different?|publisher=American Pregnancy Association|deadurl=yes|archiveurl=https://web.archive.org/web/20130119091203/http://americanpregnancy.org/commondiscomforts/PE-pregnancy-stretchmarks-different.html|archivedate=19 January 2013|df=dmy-all|date=19 January 2013}}</ref>


Stretch marks are caused by tearing of the [[dermis]]. This is often from the rapid stretching of the skin associated with rapid growth or rapid weight changes. Stretch marks may also be influenced by hormonal changes associated with puberty, [[pregnancy]], [[bodybuilding]], or [[hormone replacement therapy]].


There is no evidence that creams used during pregnancy prevent stretch marks.<ref name=CC-Brennan-2012 /> Once they have formed there is no clearly effective treatment, though various methods have been attempted and studied.<ref name=L2014/>

== Signs and symptoms ==
Striae, or "stretch marks", begin as [[red]]dish or [[purple]] [[lesions]], which can appear anywhere on the body, but are most likely to appear in places where larger amounts of [[fat]] are stored; the most common places are the [[abdomen]] (especially near the [[navel]]), [[breast]]s, upper [[arm]]s, underarms, [[back]], [[thigh]]s (both inner and outer), [[hip]]s, and [[buttocks]]. Over time, they tend to [[atrophy]] and lose [[pigmentation]]. The affected areas appear empty, and are soft to the touch.<ref>{{cite web|url=http://www.britannica.com/EBchecked/topic/568975/stretch-mark|title=Stretch Mark|accessdate=1 November 2009|work=Encyclopædia Britannica}}</ref>

Stretch marks occur in the [[dermis]], the resilient middle tissue layer that helps the [[skin]] retain its shape. No stretch marks will form as long as there is support within the dermis; stretching plays a role in where the marks occur and in what direction they run, however, there are a number of contributing factors (see: "Causes", below) to their formation.
They can (but do not always) cause a burning and itching sensation, as well as emotional distress. They pose no health risk in and of themselves, and do not compromise the body's ability to function normally and repair itself, however, they are often considered a [[Beauty|cosmetic]] nuisance.<ref name="Stretch Mark"/> Young women are generally affected the most and often seek treatment for them from a dermatologist<ref name="ReferenceA">{{cite journal |last1=Chang |first1=AL|last2=Agredano| first2=YZ| last3=Kimball| first3=AB| title=Risk factors associated with striae gravidarum| journal=J Am Acad Dermatol| year=2004| volume=51|issue=6| pages=881–5| doi=10.1016/j.jaad.2004.05.030|pmid=15583577}}</ref> and following [[pregnancy]].<ref name="Andrews">{{cite book |author1=James, William D. |author2=Berger, Timothy G. |title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |location= |year=2006 |pages= |isbn=978-0-7216-2921-6 |oclc= |doi= |display-authors=etal}}</ref>
<gallery>
File:Squircle belly (19004951).jpg|Striae gravidarum in a pregnant woman at 38 weeks.
File:Female Torso with Tiger Stripes (Stretch Marks) from Pregnancy.JPG|Stretch marks from pregnancy >1 year [[Postpartum period|postpartum]].
File:StretchMark.jpg|Normal stretch marks in a teenage male
File:Stretch marks on female breast.jpg|Stretch marks in a female breast
File:Central Obesity 008.jpg|Striae distensae on an obese male
</gallery>

== Causes ==
Stretch marks appear to be caused by stretching of the skin. This is especially true when there is an increase in [[cortisone]].<ref>{{cite web|url=http://www.mayoclinic.org/diseases-conditions/stretch-marks/basics/causes/con-20032624|title=Stretch marks - Symptoms and causes|author=|date=|website=mayoclinic.org|accessdate=4 April 2018}}</ref>

In other words, an increase in cortisone levels can increase the probability or severity of stretch marks by reducing the skin's pliability; more specifically, it affects the [[dermis]] by preventing the [[fibroblast]]s from forming [[collagen]] and [[elastin]] fibers, necessary to keep rapidly growing skin taut. This can create a lack of supportive material as the skin is stretched, and lead to dermal and [[epidermis|epidermal]] tearing, which in turn can produce scarring in the form of stretch marks. This is particularly the case when there is new tissue growth (which can interfere with the underlying physical support of the dermis or epidermis, by displacing the supportive tissue).

Examples of cases where stretch marks are common, also given by the Mayo Clinic, include weight gain (in the form of [[fat]] and/or [[muscle]]), [[pregnancy]], and [[adolescence|adolescent]] [[growth spurt]]s, though it is also noted that some medications, as well as other medical conditions and diseases, may increase the likelihood of stretch marks appearing. In the case of medication, the Clinic points to "[[Corticosteroid]] creams, lotions and pills and chronic use of oral or systemic [[steroid]]s" as a common contributing factor; in the case of medical conditions that can contribute to stretch marks, examples given include [[Ehlers-Danlos syndrome]], [[Cushing's syndrome]], [[Marfan syndrome]], and "adrenal gland diseases".

===Pregnancy===
Pregnancy stretch marks, also known as striae gravidarum, is a specific form of [[scarring]] of the [[skin]] of the abdominal area due to rapid expansion of the [[uterus]] as well as sudden weight gain during pregnancy. About 90% of women are affected.<ref name=BJD2015>{{cite journal|last1=Korgavkar|first1=K|last2=Wang|first2=F|title=Stretch marks during pregnancy: a review of topical prevention.|journal=The British Journal of Dermatology|date=March 2015|volume=172|issue=3|pages=606–15|pmid=25255817|doi=10.1111/bjd.13426|url=https://deepblue.lib.umich.edu/bitstream/2027.42/110856/1/bjd13426.pdf}}</ref>

A number of additional factors appear to promote the appearance of stretchmarks: one study of 324 women, done just after they had given birth, demonstrated that low maternal age, high body mass index, weight gain over 15 kg (33 pounds) and higher neonatal birth weight were independently correlated with the occurrence of striae. Teenagers were found to be at the highest risk of developing severe striae.<ref name="Striae gravidarum in primiparae">{{cite journal |last1=Atwal |first1=G.S.S. |last2=Manku |first2=L.K. |last3=Griffiths |first3=C.E.M. |last4=Polson |first4=D.W. |authorlink3=Chris Griffiths (dermatologist) |title=Striae gravidarum in primiparae |journal=British Journal of Dermatology |volume=155 |issue=5 |pages=965–9 |year=2006 |pmid=17034526 |doi=10.1111/j.1365-2133.2006.07427.x}}</ref>

These off-color blemishes are [[Symptoms and discomforts of pregnancy|symptoms of pregnancy]] caused by the tearing of the [[dermis]], resulting in [[atrophy]] and loss of [[rete ridges]].<ref>{{cite journal |last1=Kroumpouzos |first1=G |last2=Cohen |first2=LM| title=Specific dermatoses of pregnancy: an evidenced-based systematic review| journal=Am J Obstet Gynecol| year=2003| volume=188|issue=4 | pages=1083–92|doi=10.1067/mob.2003.129 |pmid=12712115 }}</ref> These scars often appear as reddish or bluish streaks on the abdomen, and can also appear on the breasts and thighs. Some of these striae disappear with time, while others remain as permanent discolorations of the body.<ref name="Stretch Mark">{{cite web|url=http://www.mayoclinic.com/health/stretch-marks/DS01081k |title=Stretch Mark |accessdate=2011-11-10 }}</ref>

Mechanical distension and rapidly developing areas of the body during [[pregnancy]] (such as the [[abdomen]], [[breasts]], and [[thighs]]) are most commonly associated with striae formation. Some have suggested that [[relaxin]] and [[estrogen]] combined with higher levels of [[cortisol]] during pregnancy can cause an accumulation of muocopolysaccharides, which increases water absorption of [[connective tissue]], making it prime for tearing under mechanical stress.<ref name="ReferenceA"/><ref name="Striae gravidarum in primiparae"/> There also seems to be an association between higher body mass indices and in women with bigger babies and the incidence and severity of striae. Also, younger women seem to be at higher risk of developing striae during pregnancy.<ref name="ReferenceA"/><ref name="ReferenceB">{{cite journal|last1=Thomas| first1=RGR| last2=Liston| first2=WA| title=Clinical associations of striae gravidarum| journal=Journal of Obstetrics and Gynaecology| year=2004| volume=24| number=3| pages=270–27| doi=10.1080/014436104101001660779| pmid=15203623}}</ref>

The prevalence and severity of striae gravidarum varies among populations. The current literature suggest that in the general population of the [[US]], there is a 50%-90% prevalence of striae associated with pregnancy,<ref name="ReferenceB"/> partly as a result of the normal hormonal changes of pregnancy and partly due to stretching of skin fibers.<ref name=CC-Brennan-2012>{{cite journal|last=Brennan|first=M|author2=Young, G |author3=Devane, D |title=Topical preparations for preventing stretch marks in pregnancy.|journal=The Cochrane Database of Systematic Reviews|date=14 November 2012|volume=11|pages=CD000066|pmid=23152199|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010450/|doi=10.1002/14651858.CD000066.pub2}}</ref><ref name=Tunzi-2007>{{cite journal|last=Tunzi|first=M|author2=Gray, GR |title=Common skin conditions during pregnancy|journal=American Family Physician|date=15 January 2007|volume=75|issue=2|pages=211–8|pmid=17263216}}</ref> Many women experience striae gravidarum during their first pregnancy. Nearly 45% percent of women develop striae gravidarum before 24 weeks of gestation.<ref name="Stretch Mark"/> Many women who develop lesions during the first pregnancy do not develop them during later pregnancies. Genetic factors such as family history and race also seem to be predictive in the appearance of striae.<ref name="pmid17263216">{{cite journal |vauthors=Tunzi M, Gray GR |title=Common skin conditions during pregnancy |journal=Am Fam Physician |volume=75 |issue=2 |pages=211–8 |date=January 2007 |pmid=17263216 |doi= |url=}}</ref>

== Prevention ==
A systematic review has not found evidence that creams and oils are useful for preventing or reducing stretch marks in pregnancy.<ref name=CC-Brennan-2012 /> The safety in pregnancy of one ingredient, [[Centella asiatica]], has been questioned.<ref name=Tunzi-2007 /> Evidence on treatments for reducing the appearance of the scars after pregnancy is limited.<ref name=Tunzi-2007 />

== Treatment ==
There are no clearly useful treatments for stretch marks, although there are many different suggestions on how to remove them or lessen their appearance.<ref name=L2014>{{cite journal|last1=Liu|first1=L|last2=Ma|first2=H|last3=Li|first3=Y|title=Interventions for the treatment of stretch marks: a systematic review.|journal=Cutis|date=August 2014|volume=94|issue=2|pages=66–72|pmid=25184641}}</ref>

Various efforts that have been tried including [[Laser resurfacing|laser treatments]], [[glycolic acid]], and [[microdermabrasion]].<ref>{{cite journal|last1=Al-Himdani|first1=S|last2=Ud-Din|first2=S|last3=Gilmore|first3=S|last4=Bayat|first4=A|title=Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment.|journal=The British Journal of Dermatology|date=March 2014|volume=170|issue=3|pages=527–47|pmid=24125059|doi=10.1111/bjd.12681}}</ref> Topical [[tretinoin]] is categorized by the FDA as a known [[teratogen]] (causing malformations in fetuses) in animals, without adequate human studies on safety in pregnancy.<ref name=DailyMed-Tretinoin>{{cite web|title=Renova (tretinoin) cream|url=http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ad4cd608-ee26-4467-9957-a95b33101f9a|work=DailyMed|publisher=FDA and National Library of Medicine}}</ref>

[[Carboxytherapy]] is a known procedure; however, there is a lack of evidence to support how effective it is.<ref>{{cite press release | year=2009 | title=Carboxytherapy And Mesotherapy Unproven |url=http://www.medicalnewstoday.com/releases/159481.php}}</ref>

==History==
Since ancient times, pregnant women have sought remedies to prevent stretch marks during pregnancy. Both ancient [[ancient Greece|Greeks]] and [[Ancient Rome|Romans]] used [[olive oil]], while [[People of Ethiopia|Ethiopians]] and [[Somalis]] used [[frankincense]].<ref>{{cite web|url=http://www.botanical.com/botanical/mgmh/f/franki31.html |title=Botany |accessdate=2009-11-10 }}</ref>

==Terminology==
[[Medical terminology]] for these kinds of markings includes striae atrophicae, vergetures, stria distensae, striae cutis distensae, lineae atrophicae, linea albicante, or simply striae.

== References ==
{{Reflist}}
== External links ==
{{Medical resources
| DiseasesDB = 30027
| ICD10 = {{ICD10|L|90|6|l|80}}
| ICD9 = {{ICD9|701.3}}
| ICDO =
| OMIM =
| MedlinePlus = 003287
| eMedicineSubj = derm
| eMedicineTopic = 406
| MeshID =
}}
{{Wiktionary|stria}}
{{Localized connective tissue diseases}}

{{DEFAULTSORT:Stretch Marks}}
[[Category:Abnormalities of dermal fibrous and elastic tissue]]
[[Category:Human pregnancy]]
[[Category:Obstetrics]]
[[Category:Medical conditions related to obesity]]
[[Category:Health issues in pregnancy]]
[[Category:Pregnancy-related cutaneous conditions]]
[[Category:Pathology of pregnancy, childbirth and the puerperium]]

Stretch marks - Revision history

Prab at 23:41, 26 April 2025

Prab at 04:18, 20 March 2025

Prab: 1 revision imported