> An approach to stretch marks, how to get rid of them

Most women have stretch marks, which tend to show up on the breasts, thighs, hips, and butt. Many women get them during pregnancy. And while they're more common in girls, guys can get stretch marks, too.

People who are obese often have stretch marks. Bodybuilders are prone to getting stretch marks because of the rapid body changes that bodybuilding can produce. Stretch marks also may occur if a person uses steroid-containing skin creams or ointments (such as hydrocortisone) for more than a few weeks, or has to take high doses of oral corticosteroids for months or longer. Antiandrgens and also estrogen, progestin combinations may involve in formation of stretch marks.

Pathology

Stretch marks are a result of tears in the inner layers of the skin. These tears developed when the skin is stretched beyond its resiliency potential and as a result of a compromised supporting connective tissue fibers, more importantly elastin fibers. Hypofunctional fibroblasts, the cells responsible for production of elastin and collagen fibers are thought to play a significant role in pathology of stretch marks.So genetic predisposition is among the major etiological factors. As we observe patients with Ehler-Danlos syndrome and Marfan disease are more prone to development of stretch marks in which deficiency of elastin and collagen fibers are responsible respectively. This skin is literally more fragile, a property observed is aging skin. As a result older skin is more likely to produce stretch marks under the same conditions.In fact stretch marks are made up of internal scar tissue, covered by attenuated epidermis. It lacks hair follicles, sweat glands and sebum glands.

Manifestations

Stretch marks appear as streaks of a few millimeters wide, deep purple initially. As they mature they assume a whitish color. They cause a disfiguringly irregular and flabby aspect of the affected skin areas. The most affected areas are the tummy, breasts, hips and thighs and even upper arms. At first, stretch marks may show up as reddish or purplish lines that may appear indented and have a different texture from the surrounding skin. Fortunately, stretch marks often turn lighter and almost disappear over time. But the fact that stretch marks usually fade and become less noticeable over time can be little consolation if you plan to spend most of your summer in a bathing suit.

Contributing Factors

Genetic predisposition is the major factor in development as some women show no stretch marks following pregnancy and some show more severe forms. The following conditions may underlay the problem:

• pregnancy, in particular when associated with excessive weight gain.
• rapid weight gain, particularly during puberty.
• conditions that lead to hormonal abnormalities, among them chronic steroid use is more significant.

 TREATMENT

Initially, stretch marks are a pinkish-purple. At this early stage, their response to a treatment is more likely and this may consist of daily massage with a body oil and repeated micro-dermabrasion. This treatment is no different from daily scrubbing of your skin with a scrub cream. Applying keratolytic agents such as salicylic acid cream, glycolic acid cream, retin-a preparations may help get rid of stretch marks at this stage. This makes the attenuated epidermis to heal in more effectively. As a result stretch marks heal in and become much less noticeable.

Microdermabrasion

Micro-dermabrasion safely improves the epidermal structure and the condition of the deeper dermis. It is a medical “sand blasting” technique whereby microscopic particles abrade the treated skin. In the process of microscopic penetration and biological restitution, it stimulates the formation of new collagen and elastin. This is needed to help the healing and results in smoother skin. For the best result, micro-dermabrasion needs to be regularly repeated in 6 to 10 sessions.

Once mature and white, stretch marks will respond to a far lesser extend to this treatment. Should they, at this stage, still be disturbing the best alternative is to resect the affected skin by means of body contouring surgery. Stretch marks are a normal part of puberty for most girls. The lesions are seen with much less frequency in males especially those with normal body index. When a person grows or gains weight really quickly (like during puberty), that person may get fine lines on the body called stretch marks. Stretch marks happen when the tissue under the skin is pulled by rapid growth or stretching. Although the skin is usually fairly elastic, when it's overstretched, the normal production of collagen (the major protein that makes up the connective tissue in your skin) is disrupted. Simultaneously, arrangements of collagen fibers may alter and they form disorganized tangles. As a result, scars with hypopigmentations called stretch marks may form.

Some people find that sunless tanning treatments (both over-the-counter lotions and sprays and in-salon types of treatments) can help cover up stretch marks. This doesn't work for regular tanning or tanning beds, though, because stretch marks themselves are less likely to tan. And as everyone knows, the sun and tanning beds do more harm than good when it comes to the long-term health of your skin. You also can buy body makeup matched to the tone of your skin that can make stretch marks all but invisible. Although some manufacturers make these cover-up products water-resistant, makeup may not be the best solution if you'll be spending a lot of time in the water. None of the treatments mention above could effectively eliminate stretch marks.

Cream Treatments

Although there are tons of creams and other skin products on the market that claim to eliminate stretch marks, the truth is that most are ineffective and often costly. Skin resurfacing agents such as cream preparations of salicylic acid, alpha hydroxy acids such as glycolic acid and retin-a may produce some improvements. Total elimination is less likely. However, combination therapy with keratolytic creams is associated with a more satisfactory result. Dermatologists may use one of many forms of treatments from actual surgery to techniques such as microdermabrasion and laser treatment - that reduce the appearance of stretch marks.

Alpha lipoic acid

Lipoic acid has brought about extensive controversy over its effectiveness in treatment of scar tissue and stretch marks. Some claimed that oral ingestion of this anti oxidant could influence collagen arrangement in dermal layer. As a result many preparation of lipoic acid introduced into the market for treatment of stretch marks. Being a potent anti oxidant, alpha lipoic acid may act as an free radical scavenger and neutralize reactive oxygen species. This effect is elicited through inhibition of inflammatory mediators. As a result this anti oxidant could be used in prevention and treatment of acute phase of scar formation and while stretch marks are forming. Lipoic acid efficacy in treatment of already-formed scars and stretch marks may be viewed with serious skeptism. Neither topical preparations such as creams nor oral intake of lipoic acid could change already disrupted connective tissue fiber arrangement.

Laser Treatments

These techniques are expensive and are not usually recommended for people in their teen years because they are not finished growing and their stretch marks will probably diminish over time anyway. Dermatological solutions and surgical techniques are not a promise for removal of stretch marks. They may help reduce appearance of these lesions and the result vary in most cases. Many clinical studies support the idea that laser can not improve stretch marks. However, many plastic surgeons are in favor of using laser to get rid of these scars by claiming that laser stimulate fibroblast to produce collagen and elastin and that's how improvements is seen. It is true to certain extent that laser may induce fibroblast for production of elastin, however, laser fail to rearrange collagen and elastin fibers to their original form. What it is basically seen in stretch marks is rupture in the arrangements of the connective tissue fibers. This can not be repaired by laser treatments. Slight improvements is mainly due to the filling effect contributed by more production of connective tissue matrix induced by laser treatments.

| American Academy of Dermatology | Plastic Surgery and Laser Treatments | Stretch Marks in Pregnancy | Aging Skin |