Stretch marks (striae) are common skin changes resulting from the rapid stretching of the skin. They are essentially small tears that occur in the dermis, the resilient middle layer of the skin. Children can develop them, though they are most frequently associated with the rapid body changes of adolescence. Striae are a benign cosmetic issue that often fade naturally over time.
Primary Causes in Children and Adolescents
Striae in young people primarily result from the body growing faster than the skin can keep up. During adolescence, rapid physical growth (a growth spurt) places intense mechanical stress on the skin’s connective tissue. This stress causes the collagen and elastin fibers in the dermis to rupture, often leading to horizontal streaking across the lower back and other areas during periods of height increase.
Significant and rapid fluctuations in weight, both gain and loss, also contribute to mechanical stretching. For children who have not yet reached puberty, striae are most often seen in those who are overweight. The sudden expansion or contraction of the skin strains the dermis, disrupting the normal production of collagen, the major protein that provides structural integrity.
Certain medications can weaken the skin’s structure, increasing the likelihood of striae formation. Prolonged or high-dose use of oral or topical corticosteroids is a known cause, as these drugs mimic the effects of cortisol. Corticosteroids inhibit fibroblasts, the cells responsible for producing collagen and elastin, leading to skin thinning and increased tearing. In rare cases, widespread or unusually large marks may signal an underlying medical condition, such as Cushing syndrome, characterized by excessive cortisol levels.
How Stretch Marks Appear on Young Skin
The physical characteristics of striae change depending on their age. When they first appear (striae rubrae), they present as reddish, pink, or purplish lines. These initial marks may be slightly raised, feel indented, or cause mild itching. This vibrant coloring is due to inflammation and blood vessels visible beneath the torn dermis.
Over time, often within months to a few years, the marks naturally mature and fade in color. They eventually become striae albae, appearing white, silver, or flesh-colored, and are lighter than the surrounding skin. In this later stage, the marks are typically depressed, atrophic, and may have a finely wrinkled texture due to the loss of elastic fibers.
The location of striae often correlates with the cause of the stretching. In adolescents experiencing growth spurts, marks frequently appear on the lower back and sometimes the knees. For those with rapid weight changes, the marks are commonly found symmetrically on the thighs, buttocks, abdomen, and arms. Striae caused by high-dose corticosteroid use or Cushing syndrome can be wider and more widespread across the body.
Treatment Options and Medical Consultation
For most children and adolescents, stretch marks are a physiological change that becomes less noticeable over time, even without intervention. While many over-the-counter products claim to eliminate striae, scientific evidence supporting the complete removal of these scars with topical products is limited. Applying rich moisturizers or oils may help keep the skin hydrated and improve elasticity, but they will not reverse the dermal tearing that has already occurred.
For marks that are cosmetically distressing, a dermatologist may suggest clinical treatments, though these are often reserved for older adolescents and may not be covered by insurance. These professional options focus on stimulating collagen production in the dermis.
Clinical Treatment Options
- Pulsed dye laser therapy targets the redness in early striae rubrae.
- Lasers and microneedling aim to improve the appearance of both new and older marks.
- Prescription retinoid creams, such as tretinoin, stimulate fibroblasts to increase collagen production.
A medical consultation is important if stretch marks appear without an obvious cause like rapid growth or weight change. Consultation is also necessary if the striae are widespread or accompanied by other unusual symptoms. These symptoms include easy bruising, unexplained weight gain concentrated in the face or torso, or slowed vertical growth, which can indicate an underlying medical condition like Cushing syndrome.