STRETCH MARKS & COMMON RISK FACTORS

Stretch marks

Are you pregnant and experiencing itchy pink marks popping up on your belly or are you just worried that you might get them? You are not alone! #stretchies are really common during pregnancy, hence they are one of the most feared pregnancy-related skin changes. Honestly, I was also very worried about them, when I was expecting my twins, as I know that my chances of getting the stretch marks increases, when you are expecting more than one baby. In addition, I developed stretch marks during puberty, which again increased the chances of me developing stretchies during pregnancy.

I believe that knowledge is the key here – I want you ladies to understand what exactly stretch marks are, and why some people get them, and others not….so let’s dive into it.

WHAT ARE STRETCH MARKS?

Stretch marks during pregnancy (also called Striae gravidarum) are very common as they are caused by the stretching of skin in order to accommodate the little growing baby. It has been reported that around 55-90% of pregnant women will get some degree of stretchies (this number variers from study to study).  These marks are linear scars commonly seen in the connective tissue of pregnant women and are often found on the belly, breasts, upper arms, lower back, buttocks, thighs and groin (Figure 1).

Common locations affected by stretch marks.

Stretchies normally start appearing during 6th and 7th months of pregnancy. Initially, the marks are pink to violet and sometimes slightly raised and itchy (Striae rubrae). After the delivery of baby it might take months or even years for the stretch marks to mature into white, shiny and crinkly streaks that are permanent (Striae albae – see Figure 2).

STRETCH MARK DEVELOPMENT DURING PREGNANCY.
FIGURE 2: STRETCH MARK DEVELOPMENT DURING PREGNANCY.
A) Before pregnancy. B) During the 2nd and 3rd trimester pregnant women might start developing visible, raised red/purple marks (Striae rubrae) on the belly, breasts, buttocks, thighs, lower back and/or groin. These marks can be very itchy. C) After the delivery of baby it might take months or even years for the stretch marks to mature into pearl white, shiny and crinkly streaks that are permanent (Striae albae).

Even though stretch marks do not cause any health concerns, the permanent scar tissue may cause itching and burning sensations. In addition, they may be a source of emotional stress amongst new Mums.

Various factors have been found to be associated with the development of the marks, even though they are not fully understood yet…but let’s dive into some of these and try to get a nice overview….

COMMON “RISK FACTORS” for stretchies:

Researchers around the world have identified several things that may play a big role in the creation of stretch marks, such as GENETICS (of course!!!), HORMONE CHANGES, AGE, BMI, MECHANICAL STRESS OF THE SKIN, etc. In order to get a better idea of the “risk factors” I have tried to make a simplified illustration showing four different main pillars/contributors that have found to be associated with stretch marks (Figure 3).

Risk factors for stretch marks.
FIGURE 3: Common “risk factors” for the development of stretch marks.

1. FACTORS RELATED TO GENETICS (=FAMILY HISTORY):

  • if your Mum or sister developed stretch marks during pregnancy, the possibility of you getting stretch marks is around THREE times bigger compared to women who have Mums/sisters who didn’t get them.
  • if you developed stretch marks during puberty, there’s a higher risk of them during pregnancy.

2. FACTORS RELATED TO MECHANICAL STRESS OF THE SKIN:

  • during this stage the connective tissue is damaged, resulting in decreased strengths and elasticity. This process is indirectly connected to genetics.
  • hormones such as Glucocorticoids may affect the production of collagen and elastic fibres.
  • the beginning of an inflammation phase.
  • visual vascular changes (i.e. making the stretch marks red/purple).

3. FACTORS RELATED TO THE EXPECTANT MUM:

The following factors have been found to affect the severity of stretch marks:

  • excess weight gain during pregnancy .
  • high BMI before pregnancy.
  • chronic steroid use.
  • age – younger women (under 20 years of age) might be at “higher risk” at developing them.

4. FACTORS RELATED TO THE BABY:

  • the larger the baby, the higher chance of getting stretch marks.
  • if you are expecting more than one baby, there’s a higher risk of developing stretchies.

THE BIG QUESTION – Is it even possible to prevent or treat them?

If we have another look at Figure 3, there are few sub-groups within two of the pillars that we can try to change.

  • Mums-to-be (BEFORE GETTING PREGNANT): try to decrease your BMI if it is higher than 30kg/m2.
  • Disruption of the connective tissue due to mechanical stress – here we need to look at treatments can that can help to:
    • increase collagen & elastin production (fibroblastic activity).
    • improve cell growth.
    • increase skin hydration.
    • decrease inflammation of the skin (when the marks are red/purple).
    • increase pigmentation (when the scars have matured).

So, which kind of treatments can exactly help with all these? The billion dollar question!!!! After reading numerous scientific reviews about possible stretch marks treatments such as creams/lotions, lasers, chemical peels, microdermabrasions etc., it looks like there might be some few good safe options available for pregnant women, and a little bit more options for women, who have given birth. I will write another blog specifically about all the treatment options tested – both pro, cons and the outcomes.

But before I end this blog, I just want to let you know that a plant extract (Centella asiatica) was repeatedly mentioned in various studies as a great ingredient, as it seemed to be able to stimulate the production of collagen and elastin – which we want!

Stay tuned for next blog post, where we are going to dive into various treatment options for stretchies! Until then, why not read about other common pregnancy-related skin changes here?

xx Charlie