FAQ on Stretch Mark

by Dr. Yap Lok Huei

You do not have to live with embarrassing stretch marks because there are ways to reduce them. The following are some questions that are frequently asked by patients.

What is a stretch mark?

A stretch mark occurs when the deeper layer of skin, called the dermis, is stretched beyond its elasticity point and begins to rupture.

With progressive stretching, the outer layer of skin, called the epidermis, is also thinned out. As the epidermis has little or no elastic tissue, it is less tolerant to stretching. The thinned epidermis becomes almost translucent, so its colour lightens.

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Inflammation and injury in the dermis causes both microscopic bleeding points and new vessel formation. This is why new stretch marks may look reddish or purplish. With time, the injury of stretching starts to heal and the inflammation reduces.

The red/purple discolouration fades over a period of weeks to months and the overlying skin changes its characteristics to become more like a scar, which is a few tones lighter than surrounding skin.

What causes stretch marks?

Stretch marks occur in patients whose skin is stretched rapidly, beyond the limits of elasticity for that individual. It commonly occurs in the arms, shoulders, thigh, abdominal, and buttock areas. Stretch marks are quite frequent in pregnant women both during and after. Stretch marks can occur in people who have sudden weight gain, in younger individuals such as adolescents who undergo a rapid growth surge, and even in athletes and bodybuilders.

It may be more visible in patients with darker skin colour, and a patient is more likely to have stretch marks if other family members have had previous stretch marks.

What is the best treatment for stretch marks?

There are a large variety of treatments. These include IPL (intense pulsed light), chemical peeling, radiofrequency treatment, microdermabrasion, ultrasound, infrared light treatment, lasers, collagen creams, herbal remedies, and injectable preparations. According to the latest medical research, there is no single treatment which is significantly better; nor is there any treatment which can completely treat stretch marks.

Ideally, each treatment regimen should be individualised for you. It is important to have a professional opinion from a dermatologist or a plastic surgeon, as the treatment depends on the patient's age, skin type, health condition, depth and severity of stretch mark, and response to previous treatment.

Other considerations include cost, risk, likelihood of benefits, and possible time off work.

Are there any foods or supplements that make stretch marks more likely?

Some patients believe that eating dark soy sauce, seafood, various local freshwater fish, eggs, or prawns can lead to excessive scarring or stretch marks. There is no medical evidence that this is the case.

However, some over-the-counter preparations which are not licensed by the Health Ministry are easily available in the form of supplements. Some of these supplements are advertised as containing natural ingredients, but have been shown to contain strong anti-inflammatory substances such as steroids. These can reduce symptoms such as pain and discomfort due to the steroid action, but may have undesirable general effects on the body. If taken in incorrect doses, these substances can make stretch marks worse, amongst other things.

Does surgery work for stretch marks?

Surgical removal of the affected skin can be used but the amount of skin excised is limited according to area and it leaves a surgical scar.

Do collagen preparations work for stretch marks?

Collagen preparations have been popularised by marketing campaigns which highlight the change of collagen formation and composition in ageing and scarred skin. Such preparations include collagen creams for application on skin, collagen tablets, collagen supplements in milk, and vitamin drinks.

It is not possible to absorb liquid collagen molecules through the skin, and there is no evidence to suggest that applying this will improve collagen deposition on the skin. Furthermore, collagen taken orally is broken down in the digestive tract to its constituent building blocks of amino acids before it can be used by the body.

There is thus no medical advantage in taking oral or topical collagen preparations for improvement of stretch marks or scarring.

How about purcellin oil?

Purcellin oil preparations work well as a hydrating agent. Initial impressions are that it can help soften skin and keep it supple.

What can I do to prevent stretch marks?

The best approach in the prevention of stretch marks is to ensure that the skin maintains its maximum elasticity – by keeping skin well-hydrated and supple at all times.

Healthy skin requires the presence of normal collagen and elastin fibres. These are damaged by excessive sun exposure and smoking, both of which should be avoided. For times when exposure to the sun is prolonged, such as on the beach, a good sun block should be used.

A well-balanced diet with adequate supplies of vitamin E, C, zinc, magnesium, and silica is essential. The B-group vitamins such as riboflavin and niacin are also helpful to promote healthy skin.

A good source of protein such as fish or chicken will help provide the necessary building blocks for collagen. Drinking adequate amounts of water – 1.5 to 2 litres of water a day for the normal adult – will help maintain skin hydration and prevent drying out of the skin.

A healthy regimen of exercise will help stimulate circulation and maintain general skin tone. A topical moisturising product may be helpful as part of your general regimen.

More info on STRETCH MARK here.

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