# Stretch marks

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Form of scarring

"Stria" redirects here. For inner ear structure, see [Stria vascularis of cochlear duct](/source/Stria_vascularis_of_cochlear_duct). For brain structure, see [Stria terminalis](/source/Stria_terminalis).

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Medical condition

Stretch marks Other names stria, striae distensae multiple recent (reddish) and a few older (white) stretch marks Specialty Dermatology

**Stretch marks**, also known as **striae** ([/ˈstraɪiː/](https://en.wikipedia.org/wiki/Help:IPA/English))[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*] or **striae distensae**,[1] are a form of [scarring](/source/Scar) on the [skin](/source/Human_skin) with an off-color hue. Over time, they may diminish, but will not disappear completely. Striae are caused by tearing of the [dermis](/source/Dermis) during periods of rapid growth of the body, such as during [puberty](/source/Puberty) or [pregnancy](/source/Pregnancy), in which they usually form during the [last trimester](/source/Pregnancy#Timeline). Usually on the belly, these striae also commonly occur on the breasts, thighs, hips, lower back, and buttocks. Pregnancy-related striae are known as *striae gravidarum*.[2] Striae may also be influenced by the [hormonal](/source/Hormone) changes associated with puberty, pregnancy, [bodybuilding](/source/Bodybuilding), or [hormone replacement therapy](/source/Hormone_replacement_therapy). There is no evidence that creams used during pregnancy prevent stretch marks.[3] Once they have formed, there is no clearly effective treatment, though various methods have been attempted and studied.[4]

## Signs and symptoms

Striae, or "stretch marks", begin as reddish or purple [lesions](/source/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](/source/Abdomen) (especially near the [navel](/source/Navel)), breasts, upper arms, underarms, back, thighs (both inner and outer), hips, and buttocks. Over time, they tend to [atrophy](/source/Atrophy) and lose [pigmentation](/source/Pigmentation). The affected areas appear empty, and are soft to the touch.[5]

Stretch marks occur in the [dermis](/source/Dermis), the resilient middle tissue layer that helps the [skin](/source/Human_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.

They can (but do not always) cause a burning and itching sensation, as well as emotional distress. They pose no inherent health risk on their own, and do not compromise the body's ability to function normally and repair itself. However, some people dislike the way stretch marks look.[6] Young women are generally affected the most and often seek treatment for them from a [dermatologist](/source/Dermatology)[7] and following [pregnancy](/source/Pregnancy).[8]

## Causes

Stretch marks appear to be caused by stretching of the skin. This is especially true when there is an increase in [cortisone](/source/Cortisone)[9] – 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](/source/Dermis) by preventing the [fibroblasts](/source/Fibroblast) from forming [collagen](/source/Collagen) and [elastin](/source/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 [epidermal](/source/Epidermis) 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.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

Examples of cases where stretch marks are common include weight gain (in the form of [fat](/source/Fat) and/or [muscle](/source/Muscle)), [pregnancy](/source/Pregnancy), and adolescent [growth spurts](/source/Growth_spurt), though it is also noted that some medications, as well as other medical conditions and diseases, may increase the likelihood of stretch marks appearing. Common medications that can contribute to stretch marks include "[corticosteroid](/source/Corticosteroid) creams, lotions and pills and chronic use of oral or systemic [steroids](/source/Steroid)".[9] Medical conditions that can contribute to stretch marks include [Ehlers–Danlos syndrome](/source/Ehlers%E2%80%93Danlos_syndrome), [Cushing's syndrome](/source/Cushing's_syndrome), [Marfan syndrome](/source/Marfan_syndrome), and [adrenal gland diseases](/source/Adrenal_gland_disorder).[10][11][12]

[Asians](/source/Asian_people) are more prone to stretch marks.[13]

### Pregnancy

Striae gravidarum in a pregnant woman at 38 weeks

Pregnancy stretch marks, also known as *striae gravidarum*, are a specific form of [scarring](/source/Scarring) of the skin of the abdominal area due to rapid expansion of the [uterus](/source/Uterus) as well as sudden weight gain during pregnancy. About 90% of pregnant women are affected.[14]

A number of additional factors appear to promote the appearance of stretch marks: one study of 324 women, done just after they had given birth, demonstrated that low maternal age, high [body mass index](/source/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.[15]

These skin marks are [symptoms of pregnancy](/source/Signs_and_symptoms_of_pregnancy) caused by the tearing of the [dermis](/source/Dermis), resulting in [atrophy](/source/Atrophy) and loss of [rete ridges](/source/Rete_pegs).[16] 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.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

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](/source/Relaxin) and [estrogen](/source/Estrogen) combined with higher levels of [cortisol](/source/Cortisol) during pregnancy can cause an accumulation of [mucopolysaccharides](/source/Mucopolysaccharide), which increases water absorption of [connective tissue](/source/Connective_tissue), making it prime for tearing under mechanical [stress](/source/Stress_(mechanics)).[7][15] 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.[7][17]

The prevalence and severity of striae gravidarum varies among populations. The current literature suggest that in the general population of the United States, there is a 50% to 90% prevalence of striae associated with pregnancy,[17] partly as a result of the normal hormonal changes associated with pregnancy and partly due to stretching of skin fibers.[3][18] Many women experience striae gravidarum during their first pregnancy. Nearly 45% percent of women develop striae gravidarum before 24 weeks of gestation.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*] Many women who develop lesions during the first pregnancy do not develop them during later pregnancies. Genetic factors such as [genealogy](/source/Genealogy) and race also seem to be predictive in the appearance of striae.[18]

## Prevention

Collagen and elastin are proteins in the skin that contribute to the skin's strength, resilience, flexibility, and help skin that has been stretched to recover its original state. Boosting the production of collagen and elastin helps prevent stretch marks from occurring.[19] Stretch marks can also derive from [nutritional deficiencies](/source/Malnutrition). Consuming foods that contribute to the skin's health, such as [zinc](/source/Zinc)-rich foods, protein-rich foods, and foods high in vitamin A, C, and D, can help suppress stretch marks.[20] A systematic review has not found evidence that creams and oils are useful for preventing or reducing stretch marks in pregnancy.[3] The safety in pregnancy of one ingredient, *[Centella asiatica](/source/Centella_asiatica)*, has been questioned.[18] Evidence on treatments for reducing the appearance of the scars after pregnancy is limited.[18]

## 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.[4]

Various efforts that have been tried including [laser treatments](/source/Laser_resurfacing), [glycolic acid](/source/Glycolic_acid), and [microdermabrasion](/source/Microdermabrasion).[21] [Tretinoin](/source/Tretinoin) (0.1% w/w), which is a [retinoid](/source/Retinoid), has found to be effective on early stretch marks in several studies. [Hyaluronic acid](/source/Hyaluronic_acid) also improves the appearance of stretch marks.[22][23] Topical tretinoin is categorized by the [United States Food and Drug Administration](/source/Food_and_Drug_Administration) (FDA) as a known [teratogen](/source/Teratogen) (causing malformations in fetuses) in animals, without adequate human studies on safety in pregnancy.[24]

[Carboxytherapy](/source/Carboxytherapy) is a known procedure; however, there is a lack of evidence to support how effective it is.[25]

Research into a new [skin grafting](/source/Skin_grafting) technique called "microcolumn grafting / micrografting", which uses needles to take autologous full-thickness [skin biopsies](/source/Skin_biopsy), is also being investigated as a potential treatment for stretch marks.[26][27][28]

## History

Since ancient times, people have sought remedies to prevent stretch marks during pregnancy. Both ancient [Greeks](/source/Ancient_Greece) and [Romans](/source/Ancient_Rome) used [olive oil](/source/Olive_oil), while [Ethiopians](/source/People_of_Ethiopia) and [Somalis](/source/Somalis) used [frankincense](/source/Frankincense).[29]

Striae were first recognized by [Roederer](/source/Johann_Georg_Roederer) in 1773, and were later histologically described by [Troisier](/source/Charles_%C3%89mile_Troisier) and [Ménétrier](/source/Pierre_Eug%C3%A8ne_M%C3%A9n%C3%A9trier) in 1889.[30] In 1936, Nardelli made the first morphologically correct descriptions.[31]

## Terminology

[Medical terminology](/source/Medical_terminology) for these kinds of markings includes: striae atrophicae, vergetures, stria distensae, striae cutis distensae, lineae atrophicae, linea albicante, or simply striae.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

## Gallery

		- Stretch marks from pregnancy >1 year [postpartum](/source/Postpartum_period)

		- Normal stretch marks on a teenage male[*[clarification needed](https://en.wikipedia.org/wiki/Wikipedia:Please_clarify)*]

		- Stretch marks in a female breast

		- Striae distensae on an [obese](/source/Obesity) male

## References

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1. **[^](#cite_ref-Elsaie_Baumann_Elsaaiee_2009_pp._563–573_31-0)** Elsaie ML, Baumann LS, Elsaaiee LT (April 2009). "Striae distensae (stretch marks) and different modalities of therapy: an update". *Dermatologic Surgery*. **35** (4). Ovid Technologies (Wolters Kluwer Health): 563–573. [doi](/source/Doi_(identifier)):[10.1111/j.1524-4725.2009.01094.x](https://doi.org/10.1111%2Fj.1524-4725.2009.01094.x). [PMID](/source/PMID_(identifier)) [19400881](https://pubmed.ncbi.nlm.nih.gov/19400881). [S2CID](/source/S2CID_(identifier)) [7887237](https://api.semanticscholar.org/CorpusID:7887237).

Classification D ICD-10: L90.6 ICD-9-CM: 701.3 MeSH: D057896 DiseasesDB: 30027 SNOMED CT: 271674009 External resources MedlinePlus: 003287 eMedicine: derm/406

v t e Cutaneous keratosis, ulcer, atrophy, and necrobiosis Epidermal thickening keratoderma: Keratoderma climactericum Paraneoplastic keratoderma Acrokeratosis paraneoplastica of Bazex Aquagenic keratoderma Drug-induced keratoderma psoriasis Keratoderma blennorrhagicum keratosis: Seborrheic keratosis Clonal seborrheic keratosis Common seborrheic keratosis Irritated seborrheic keratosis Seborrheic keratosis with squamous atypia Reticulated seborrheic keratosis Dermatosis papulosa nigra Keratosis punctata of the palmar creases other hyperkeratosis: Acanthosis nigricans Confluent and reticulated papillomatosis Callus Ichthyosis acquisita Arsenical keratosis Chronic scar keratosis Hyperkeratosis lenticularis perstans Hydrocarbon keratosis Hyperkeratosis of the nipple and areola Inverted follicular keratosis Lichenoid keratosis Multiple minute digitate hyperkeratosis PUVA keratosis Reactional keratosis Stucco keratosis Thermal keratosis Viral keratosis Warty dyskeratoma Waxy keratosis of childhood other hypertrophy: Keloid Hypertrophic scar Cutis verticis gyrata Necrobiosis/granuloma Necrobiotic/palisading Granuloma annulare Perforating Generalized Subcutaneous Granuloma annulare in HIV disease Localized granuloma annulare Patch-type granuloma annulare Necrobiosis lipoidica Annular elastolytic giant-cell granuloma Granuloma multiforme Necrobiotic xanthogranuloma Palisaded neutrophilic and granulomatous dermatitis Rheumatoid nodulosis Interstitial granulomatous dermatitis/Interstitial granulomatous drug reaction Foreign body granuloma Beryllium granuloma Mercury granuloma Silica granuloma Silicone granuloma Zirconium granuloma Tattoo Carbon stain Other/ungrouped eosinophilic dermatosis Granuloma faciale Dermis/ localized CTD Cutaneous lupus erythematosus chronic: Discoid Panniculitis subacute: Neonatal ungrouped: Chilblain Lupus erythematosus–lichen planus overlap syndrome Tumid Verrucous Rowell's syndrome Scleroderma/ Morphea Localized scleroderma Localized morphea Morphea–lichen sclerosus et atrophicus overlap Generalized morphea Atrophoderma of Pasini and Pierini Pansclerotic morphea Morphea profunda Linear scleroderma Atrophic/ atrophoderma Lichen sclerosus Anetoderma Schweninger–Buzzi anetoderma Jadassohn–Pellizzari anetoderma Atrophoderma of Pasini and Pierini Acrodermatitis chronica atrophicans Semicircular lipoatrophy Follicular atrophoderma Linear atrophoderma of Moulin Atrophia maculosa varioliformis cutis Perforating Kyrle disease Reactive perforating collagenosis Elastosis perforans serpiginosa Perforating folliculitis Acquired perforating dermatosis Skin ulcer Pyoderma gangrenosum Other Calcinosis cutis Sclerodactyly Poikiloderma vasculare atrophicans Ainhum/Pseudo-ainhum

**Stretch marks** at Wikipedia's [sister projects](https://en.wikipedia.org/wiki/Wikipedia:Wikimedia_sister_projects):

- [**Definitions**](https://en.wiktionary.org/wiki/stria) from Wiktionary
- [**Media**](https://commons.wikimedia.org/wiki/Category:Stretch_marks) from Commons

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Adapted from the Wikipedia article [Stretch marks](https://en.wikipedia.org/wiki/Stretch_marks) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Stretch_marks?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.