Births in the United States were 3,605,201 in 2020.
The estimation in one study states between 50-90% of pregnant women get stretch marks.
Another study list 8 out of 10 pregnant females get stretch marks.
Incidence of total occurrence in genders 11% males and 88% females.
Stretch marks or striae or striae distensae are a form of skin scarring. Striae may disappear over time but most do not.
These red to blue scars are caused by a tearing of the dermis during rapid growth periods. In pregnancy, they usually appear during the last trimester. They commonly appear in areas where larger amounts of fat are stored. Although usually confined to the abdomen, they can also appear on the breasts, hips, buttocks and other areas of sudden rapid expansion of the skin. When stretching occurs, the dermis loses support and tearing occurs. The fibroblasts cannot keep the skin area taunt by producing the collagen and elastin fibers needed for support.
Risk factors for stretch marks
- Pregnancy especially at younger age
- Family history
- Using drugs such as corticosteroids
- Rapid growth in adolescence
- Rapid weight gain of loss for any reason
- Muscle growth or using anabolic steroids
- Medical conditions such as Adrenal Gland Diseases, Cushings Disease and Marfans Syndrome
Stretch marks are benign. Rarely, are they painful but can cause a burning or itching sensation. The common problem is emotional. People do not like how they appear. They are considered a cosmetic nuisance.
Pregnancy stretch marks are called Striae Gravidarum, caused by the rapid expansion of the uterus. The higher the birth weight the greater the likelihood of stretch marks. Younger mothers are more prone than older.
Tearing of the dermis causes a loss of the Rete Ridges which are the epithelial extensions that project into the underlying connective tissues in the skin.
Mechanical distension by rapid growth is the most common pathophysiology. It is also suggested that estrogen levels combined with cortisol causes an accumulation of mucopolysaccharides which in turn increases water in the connective tissues leading to lack of support and tearing of the dermis.
Creams applied topically during pregnancy have little or no value in the prevention or the treatment. Treatments are available to help improve the cosmetic appearance but none has been proven superior to another. They are commonly used in combination with:
- Topical corticosteroids- used to reduce inflammation can cause thinning and discoloration
- Retinoid- a vitamin A derivative used to rebuild collagen cannot be used in nursing as it could affect the newborn
- Pulsed dye lasers- used to reduce the erythema and increase the collagen and elasti
- Micro-needling- used to create injured column of cells and stimulating collagen production
- Other therapies- chemical peels, IPL lasers, phototherapy, superficial dermabrasion
Literature has limited data and or benefit for the use of the above
PRP is an autologous blood-derived product containing super-physiologic concentrations of platelets with associated growth factors and cytokines. In head- to- head studies comparing Platelet-Rich-Plasma vs topical tretinoin 0.05%, PRP was found to be more effective and it gave a better overall therapeutic response than tretinoin.
(Platelet-Rich-Plasma Versus Tretinoin in Treatment of Striae Distensae: A Comparative Study
Dermatol Surg 2018 May;44 (5): 697-704 PMID 29701622)
Another study comparing Platelet-Rich-Plasma vs, Microdermabrasion in the treatment of striae distensae concluded that PRP was superior both cosmetically and histopathologically to microdermabrasion but when used in combination the results were both better in the short duration and more efficacious
(Comparison Between the Efficacy and Safety of Platelet Rich Plasma vs. Microdermabrasion in the Treatment of Striae Distensae: Clinical and Histopathological Study Jour Cosmet Derm 2015 July 6 doi.org/10.1111/jocd.12160_)
An abstract article, the author stated “Aesthetic practitioners should be knowledgeable with the available evidence for PRP in the treatment of Striae Distensae”.
(Utility of Platelet Rich Plasma for Treatment of Striae Distensae: A Current Exploration
J of Cosm Derm 25 June 2020 Vol 20 437-441 doi.org/10.1111/jocd.13567)
The studies corroborate that PRP can be an efficacious tool in stretch mark management.
Juventix Regenerative Medical offers a FDA approved PRP processing kit that is cost effective, easy to use and produces reproducible product when taken from the same source. The PRP can be activated using the Juventix LED Activator without the addition of Calcium Chloride or Thrombin. Platelet Rich Fibrin can also be added with the use of the Juventix Bio Incubator and in combination , providing a superior result in these cases.
In cosmetic cases, such as Stretch Marks, the process makes a difference in the outcome.
Restore, Revive, Regenerate Juventix Regenerative Medical
Dr. Robert McGrath