Will anything get rid of them? Here's the skinny.

Elinor Carucci

There are many old wives’ tales about stretch marks—and how to prevent or erase them. (Ever slather your pregnant belly with cocoa butter?) The truth is, there’s no way to avoid them entirely. But you can make the marks you have less visible.

What Causes Them?

"Stretch marks are scars that can form when collagen and elastin fibers tear during puberty, pregnancy, or significant weight gain or loss that occurs in a short period of time," says New York City dermatologist Francesca Fusco. But they aren’t simply the result of skin overstretching, as is often thought. "During puberty, pregnancy, and weight changes, elevated levels of hormones called glucocorticoids are produced by the adrenal glands," says Zoe Diana Draelos, a consulting professor of dermatology at the Duke University School of Medicine, in Durham, North Carolina. Those hormones are what can cause the collagen and elastin fibers to tear when the skin is stretched. "Weight gain itself doesn’t cause stretch marks—it promotes the hormonal changes that cause them," says Draelos. Doctors agree that you can’t prevent marks (so forget about that cocoa butter). Rather, "genetics play a big role in whether someone gets them," says New York City dermatologist Bruce Katz.

How Do I Minimize Stretch Marks?

Treat them early. Doctors classify stretch marks as rubra (striae rubra) or alba (striae alba). At first, they appear as rubra: pink, red, or purplish and inflamed. Over time, they turn silvery white, becoming alba. "Then they’re fully mature, so there’s not as much you can do," says Draelos. To reduce the appearance of minor new marks, apply a vitamin A oil or an over-the-counter cream with retinol (a vitamin A derivative that stimulates collagen production) once a day. (Try Bio-Oil Scar Treatment, $20, drugstore.com.) "You’ll start to see results in six weeks or more," says Fusco. Since many body creams don’t contain retinol, try using face creams on the affected area instead, says Audrey Kunin, a dermatologist in Kansas City, Missouri. (Try REN Bio Retinoid, $65, sephora.com.) On larger, deeper rubra marks, use a prescription form of retinol, like Retin-A. One caveat: Retinol can’t be used during pregnancy, so save such treatments until after your baby arrives.

If retinols irritate your skin (they can cause redness and peeling), there’s a new option, which has been recently tested. A clinical study of Mederma Stretch Marks Therapy ($33, walmart.com), an over-the-counter cream that contains onion extract and the herb Centella asiatica, which are both anti-inflammatories, as well as hyaluronic acid, which hydrates skin, found that among 50 women, 80 percent reported their marks were smoother and less red after 12 weeks of twice-daily use. (Check with a doctor before using if you’re pregnant.) Products with vitamin C or peptides, which both stimulate collagen, may also help, though to a lesser degree, says Kunin. And they should be safe to use during pregnancy.

The most effective (and costly) option for rubra and alba stretch marks is laser treatment. For rubra marks, Katz uses a pulsed-dye laser. "The redness in striae rubra is from increased blood flow," he says. "The laser’s light is absorbed by hemoglobin in the blood, causing vessels and visible redness to disappear." On alba marks, he uses a fractional-CO2 laser to "drill microscopic holes into skin to take away scar tissue so new collagen is stimulated.” Both pulsed-dye and fractional-CO2 laser treatments require three to four visits to the dermatologist (at $500 to $800 each) and are not generally covered by insurance. Looking for a much cheaper option? "Self-tanner," says Fusco. "It’s helpful in camouflaging rubra and alba stretch marks." (Try Clarins self Tanning Instant Gel, $37, sephora.com.)

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