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Stretch marks: Causes, Prevention and Treatment

By Dr Joe Kabyemela, MD

Pregnancy is (in most cases) greeted with a great deal of excitement. There is just so much to take in. Then, inevitably, worries start creeping in. One of those could be the subject of stretch marks. It would be churlish for anybody to consider this a vanity trip. It is a legitimate concern. So what are the facts about why these dreaded skin changes?

Why stretch marks develop

Skin has got underlying connective tissue in the form of collagen. This is responsible for the ‘tone’ of the skin in the sense that its quantity and integrity determines how firm or loose the skin is. When there is rapid distension of the skin, the integrity of this underlying connective tissue could be breached. This can happen in any part of the body. It is often seen in a non-pregnant state and even in men when there is marked weight gain, especially when this happens over a relatively short time. It means, the fibres do not get enough time to stretch and they end up breaking. This is particularly common in areas where the skin is meant to be tight such as the back of the thighs, lower back and the hip area. Stretch marks are also seen in some disease condition where the underlying problem is overproduction of steroids with resultant thinning of skin and rapid weight gain. Cushing’s syndrome is one such condition.

With pregnancy, the abdomen naturally distends. It is designed to do so and therefore can cope with the process comfortably over the 40 weeks or so for a human pregnancy.  However, whilst the abdominal wall can cope with this, the overlying skin may not ‘give’ so easily. As a result of that, the elastic tissue within the inner (dermis) layer of the skin continually stretches and in some cases this gets beyond the breaking point and it starts to give way. The result is those lines (striae gravidarum) or, as we all call them; stretch marks. Stretch marks are therefore the visible evidence of broken skin supporting fibres. The process tends to start in late pregnancy. The stretch marks, when raw or newly broken tend to appear pink or dark red. They then heal with fibrous tissue (scar tissue) forming and the colour changes to off-white or silvery. These, like all forms of scars, are more or less permanent.

Preventing stretch marks: next page

Stretch marks, as can be seen in the images above and below, are found in other parts of the body (other than the abdomen) and pregnancy or obesity are not the only causes