The how and the why of striae distensae
Most people think those red wiggly lines often forming on breasts, abdomens and buttocks come from over stretching causing tearing. Thinking that, it was blamed on the top layer of the skin (epidermis). Actually the marks are from inflammation and scar reaction in the most active layer – the dermis. Bundles of collagen are ruptured and the stretchy fiber elastin thins until it disappears.
What’s to blame?
HORMONES! Stretch marks develop from over secretion from the adrenal glands which sit above the kidneys. Any disturbance creating an imbalance of body cortisone or glucocorticosteroids disturbs the programming process on the fibroblasts, interfering with building and repairing tissue.
Causes
- Puberty.
- Pregnancy.
- Rapid weight gain – whatever the cause.
- Intense power training.
- Taking oral creatine or steroids as part of muscle bulking.
- Chronic application of topical steroids, example: for eczema, psoriasis or other skin conditions.
- Excessive steroid stress stimulation – the “Super Woman Syndrome” – particularly a problem for women which creates an average higher cortisol level than normal.
- Some metabolic chronic diseases such as Cushings Disease/Marfan Syndrome.
Weight training, specifically lifting impressive weights without a graduated program causes severe muscle strain which yields micro tearing in the muscle strands. This will send a cascade of pain and inflammation causing the adrenals to produce cortisols. These cortisols are directed to damaged muscle to decrease the pain and inflammation and start a cascade of healing but in the process the excessive steroid in the area stimulates the imbalance and starts the cascade in a different direction towards dermal damage and developing stretch marks.
Puberty
By definition this is the time frame when hormonal secretions take off. This is the first time that there is a perfect storm for tissue tearing to occur. Often girls will notice initially marks coming on the breasts followed by the abdomen, thighs and buttocks. Generally the timing will be linked to the start of menstruation. Pubescent boys may notice less dramatic changes but will still see marks commonly showing on the lower back and buttocks.
Pregnancy
Generally from 6 months to term massive doses of hormones are directed to a woman’s abdomen to accelerate fetal development. The dermis is stretched from the inside and weakens creating inflammation and tearing resulting in red marks. Contrary to popular belief rubbing oil/vitamin E and tummy cream concoctions can’t prevent striae – it’s not a dryness issue.
Treatments
Forever the answer was no as topical concoctions were unsatisfactory, then happily, yes! With the technology that brought us lasers and medical skin products. Lasers like the Pulse Dye and the CO2 laser create stimulation and restructuring and are best employed during the red phase of this scarring. The new classifications of fractional lasers, which involve microscopic needling of the skin, stimulate the healing factors in the dermis and can be used on red or white striae.
The gold standard, which is most effective, is the newest treatment – PRP (Platelet Rich Plasma) – which contains the growth factors that stimulate new cell development. A persons own blood sample is spun and the clear gold plasma is drawn off which has the concentration of platelets. These are re-injected into the tissue with micro-needling equipment like the Innopen. Stretch marks do best with 3-4 treatments’ at 4 week intervals. PRP is extremely effective on any scar tissue or where reversal of damage and aging is required.
Effective Topicals
Application of potent retinols (Vitamin A) work by increasing the production of collagen, the main building block of skin. They also stimulate the production of new blood vessels in the skin, improving skin color. Additional benefits include fading age spots and softening the texture of the skin. It usually takes 3-6 months of regular use to see the benefits of applying retinols to damaged skin. Since ancient times people have tried various herbal formulas to try and achieve some improvement for scars and stretch marks. Since ancient times all kinds of topical concoctions were created to try to improve scars and striae. A popular formula in ancient France was a combination of vegetable extracts from the Horsetail plant, English Ivy and Alchemilla (Ladies Mantle Plant). This through time has evolved into a French skin care product (Lierac). Medical grade products include silicon. Organic silicon works on the building blocks – fibroblasts, by increasing the protein synthesis which inhibits the effect measurably of the hormone influence.
The star of best active ingredients (besides Vitamin A) for prevention and treatment is from recent advanced medical cosmetology research. Products such as Registro and Striover which was launched in 2019 have melded herbal products and products from traditional Chinese medicine with advanced science to produce products that topically have the mechanism of repair similar to PRP but are considerably slower and probably best for mild to moderate striae.
At Laser and Skin Care Medspa we offer a treatment model that involves all these multiple modalities – topicals containing silicon, fractional lasers, Vitamin A and Platelet Rich Plasma to give the maximum effective results.
No longer do you have to be self-conscious and embarrassed and trying to hide those ugly stretch marks. No matter the color or the age of the stretch mark or scar there are effective treatments available.