Children and adolescents can develop stretch marks, medically known as striae distensae. These visible lines are a form of scarring that occurs when the skin is rapidly stretched beyond its limit of elasticity. This sudden force ruptures the connective tissue, specifically the collagen and elastin fibers, within the dermis layer. While often associated with adults, stretch marks frequently occur during the intense physical changes of youth, affecting up to 70% of adolescent girls and 40% of adolescent boys.
Specific Causes of Stretch Marks in Children and Adolescents
The primary driver for striae formation is the rapid physical expansion that occurs during growth spurts, particularly throughout puberty. Underlying bone and muscle growth can outpace the skin’s ability to produce collagen and elastin fibers quickly enough. This mechanical shearing and stretching of the skin leads to the visible tears that form the stretch marks.
Hormonal fluctuations also compromise the skin’s structural integrity. Elevated levels of hormones like cortisol, whether natural or administered, can reduce fibroblasts—the cells responsible for producing collagen and elastin. This reduction makes the skin thinner and more fragile, increasing its susceptibility to tearing under tension.
External factors, including certain medications, can contribute to striae development. Prolonged use of topical steroid creams or high doses of oral corticosteroids are known to weaken the skin and increase the risk of stretch marks. Rapid changes in body mass, such as significant weight gain or loss, also place immense strain on the skin’s connective tissue.
Adolescents involved in intensive muscle-building or weightlifting may develop striae due to rapid muscle hypertrophy. In rare cases, the sudden appearance of widespread striae without an obvious cause can be a sign of an underlying medical condition, such as Cushing’s syndrome, which involves overproduction of cortisol.
How Striae Appear and Change Over Time
Stretch marks follow a predictable course of appearance, beginning as an inflammatory phase known as striae rubrae. In this initial stage, the lines appear reddish, pink, or purplish and may be slightly raised or itchy. The red or purple color reflects the active inflammation and increased blood flow in the newly formed scar tissue.
These early marks often appear in areas undergoing the most rapid expansion, running perpendicular to the direction of skin tension. Common locations include the thighs, hips, and buttocks for both boys and girls, with girls also frequently developing them on the breasts. Boys may also see them on the lower back and shoulders, especially if they are experiencing rapid increases in height or muscle mass.
Over a period ranging from several months to a few years, the stretch marks mature and enter the chronic phase, termed striae albae. As the inflammation subsides and the blood vessels contract, the lines lose their color and become white, silvery, or flesh-toned. The mature striae albae are generally depressed, atrophic, and may have a slightly wrinkled or finely textured surface.
Treatment and Management Options
Stretch marks are a form of permanent scarring, but they naturally fade and become less noticeable over time. The transition from the reddish striae rubrae to the silvery striae albae significantly improves their cosmetic appearance without any intervention. For many adolescents, simply being patient is the most effective management strategy.
Topical products are often sought out, but their effectiveness is limited, especially once the marks have matured to the white stage. Prescription-strength retinoid creams, which are vitamin A derivatives, can sometimes help rebuild collagen and improve the appearance of newer, reddish marks. However, these require consultation with a healthcare provider and must be used cautiously, particularly in younger individuals.
Many over-the-counter creams are marketed for stretch marks, but scientific evidence supporting their ability to make marks disappear is weak. While these products are harmless and can help keep the skin moisturized and elastic, they are unlikely to provide a dramatic corrective effect. Professional treatments are typically reserved for severe cases or for adults, as new striae can still appear while a person is growing.
Dermatologists offer various in-office procedures for deeply concerning marks, including pulsed dye laser therapy, which targets the redness of striae rubrae. For older, white marks, treatments like fractional laser therapy or microneedling can stimulate collagen production and improve skin texture. These procedures are often considered cosmetic, may not be covered by insurance, and require consultation with a specialist to determine the most appropriate approach for the individual.