Children and teenagers get stretch marks regularly, and the marks are far more common in young people than most parents expect. Stretch marks rank among the most frequent skin concerns in adolescence, appearing during growth spurts that outpace the skin’s ability to keep up. While they are almost always harmless, the causes behind them in kids range from perfectly normal rapid growth to, in rarer cases, medication side effects or underlying health conditions that deserve attention.
How Common Are Stretch Marks in Young People
Stretch marks in adolescents are so widespread that dermatologists consider them a near-normal part of puberty for many teens. They show up most often between the ages of about 12 and 16, coinciding with the peak growth-spurt years. One study of teenage boys with stretch marks on the lower back found the average age of onset was around 14, and every boy in the group was above average height at the time the marks appeared.1PubMed. Demographic characteristics of teenage boys with horizontal striae distensae of the lower back About two-thirds of those boys reported a noticeable growth spurt just before the stretch marks showed up.
An interesting quirk is the sex difference. Stretch marks in the general population skew more female, largely because of pregnancy. But during adolescence specifically, the picture flips: physiological stretch marks are actually more common in boys than in girls.2PubMed Central. Striae distensae in adolescents: A mini review Boys tend to grow taller and faster in a shorter window, and that rapid vertical growth puts heavy mechanical stress on the skin of the back and knees.
What Causes Stretch Marks in Children and Teens
The underlying problem is a mismatch between how fast the body is growing and how fast the skin’s structural fibers can remodel. Skin gets its stretch and snap-back from a meshwork of collagen and elastic fibers in the deeper layer called the dermis. When the skin is forced to expand faster than these fibers can accommodate, the fibers tear or thin out, producing the characteristic streaked scars we call stretch marks. Research has shown that the primary damage is to the dermal fiber network, and hormonal factors play a role too: local receptors for sex hormones in the skin appear to influence how susceptible the tissue is to tearing.3PubMed Central. Management of stretch marks (with a focus on striae rubrae)
This is why puberty is such a hotspot for stretch marks. The body is doing several things at once: growing rapidly in height, adding muscle or fat in new places, and flooding tissues with sex hormones that change skin composition. A teenager who shoots up several inches in a year is essentially putting their skin through the same kind of rapid expansion that happens during pregnancy, just in different locations on the body.
Growth spurts are the most common trigger, but they are not the only one. Rapid weight gain, whether from lifestyle changes or medical conditions, can also produce stretch marks in kids. So can the weight fluctuations that sometimes accompany early-stage obesity in childhood. And in younger children who have not yet reached puberty, stretch marks are rarer but not impossible. When they appear in prepubescent kids, it is worth investigating whether there is a secondary cause such as a medication or a hormonal condition.
Where They Show Up on the Body
Stretch marks in teens do not appear randomly. Their location follows predictable patterns tied to where the body is growing fastest, and those patterns differ between boys and girls. A study of Korean adolescents found that in both sexes, the buttocks were the most common site for stretch marks. After that, the distribution diverged: boys were more likely to develop them on the lower back and knees, while girls saw them more on the thighs and calves.4PubMed. Clinical features and risk factors for striae distensae in Korean adolescents
The knee and lower back pattern in boys makes sense when you consider that these are areas under intense mechanical tension during a vertical growth spurt. The skin over the lower back stretches as the spine elongates, and the skin around the knees gets pulled as the long bones of the legs grow. In girls, estrogen-driven fat deposition on the thighs and hips during puberty adds a horizontal stretching force that explains the thigh and calf pattern.
Parents sometimes notice horizontal streaks across a teenager’s lower back and worry about injury or something more serious. In the vast majority of cases, those horizontal lines are simply stretch marks from a growth spurt. The orientation gives them away: they run perpendicular to the direction the skin is being stretched, which on the back means horizontal lines as the torso grows taller.
Genetics and Who Gets Them Worse
Not every kid who has a growth spurt gets stretch marks. Genetics play a substantial role in determining whose skin tears under stress and whose does not. A large genome-wide study involving over 33,000 participants identified specific genetic variants linked to stretch mark susceptibility. The strongest associations were near genes involved in building elastic microfibrils, the tiny scaffolding structures that give skin its elasticity. Variants near the elastin gene and the fibrillin-2 gene both reached strong statistical significance.5PubMed Central. Genome-wide association analysis implicates elastic microfibrils in the development of nonsyndromic striae distensae
What this means practically is that if one or both parents developed prominent stretch marks during their own growth spurts or pregnancies, their children are more likely to as well. The underlying elastic fiber structure of the skin is partly inherited. A teenager with genetically stiffer or less resilient elastic fibers will tear more easily under the same amount of stretching force that another teenager’s skin handles without a mark.
This genetic component also helps explain why some teens get severe, wide stretch marks from a modest growth spurt while others grow six inches in a year and show barely a line. It is not purely about how fast or how much you grow. It is about the interaction between the rate of growth and the structural resilience your skin inherited.
When Stretch Marks Point to Something Medical
In most adolescents, stretch marks are a cosmetic nuisance and nothing more. But there are situations where they signal an underlying issue that warrants a doctor’s attention.
Corticosteroid medications are a well-known trigger. Children who take oral corticosteroids for conditions like asthma, lupus, or inflammatory bowel disease are at elevated risk. A study of children with systemic lupus who were treated with corticosteroids found that about half developed stretch marks, and the association was particularly strong at higher doses.6Rheumatology. Use of corticosteroids in childhood systemic lupus erythematosus: experience from a pediatric rheumatology center Even topical corticosteroid creams, when used excessively on thin skin areas, can cause localized stretch marks in children. If your child is on steroids and developing new marks, the prescribing doctor should know, though stopping the medication without guidance is not the answer.
More rarely, stretch marks in a child who is not going through a growth spurt and is not on corticosteroids can be a sign of Cushing syndrome, a condition where the body produces too much cortisol on its own. The stretch marks associated with Cushing syndrome tend to be wide (more than a centimeter across), deeply purple or red, and found on the abdomen. They look distinctly different from the thinner, paler marks of a normal growth spurt. If you notice wide, deeply colored stretch marks on a child who is also gaining weight rapidly, especially around the face and midsection, a pediatrician visit is warranted.
Certain genetic connective tissue conditions, such as Marfan syndrome or Ehlers-Danlos syndrome, also predispose children to stretch marks because the structural proteins in their skin are inherently weaker. In these cases, stretch marks tend to appear earlier, more extensively, and in unusual locations.
The Color Timeline and What It Means for Treatment
Stretch marks change over time, and understanding that progression matters because it determines which treatments are worth trying. Fresh stretch marks start out red, pink, or purple. This early phase, sometimes called striae rubrae, reflects active inflammation and increased blood flow in the damaged tissue. Over months to a couple of years, the marks gradually fade to white or silvery. This mature phase, striae albae, represents fully scarred tissue where the inflammatory process has resolved and the collagen has reorganized into scar-like bands.
This matters for treatment because nearly every intervention works better on newer, red-phase marks than on old, white ones. The window of opportunity is roughly the first six months to a year after a stretch mark appears. After that, the tissue becomes much harder to remodel. For parents noticing new stretch marks on their teenager, acting sooner rather than later gives any treatment its best shot.
Topical Treatments That Have Evidence
The strongest evidence for any topical treatment of stretch marks belongs to tretinoin, a prescription retinoid. In one controlled trial, 80% of patients treated with tretinoin cream showed definite or marked improvement after six months, compared with just 8% of those using a plain moisturizer. The treated stretch marks actually shrank in both length and width, while untreated marks continued to grow.7PubMed. Topical tretinoin (retinoic acid) improves early stretch marks That said, the study also noted that there were no significant changes in collagen or elastic fiber quantity under the microscope. The visible improvement seems to come from surface-level remodeling rather than deep structural repair.
Tretinoin does come with side effects. Redness and itching at the application site are common, though these can usually be managed with a good moisturizer.8PubMed Central. Advancements in treating stretch marks across all skin types: a comprehensive review of therapeutic modalities For teenagers, tretinoin is generally considered safe to use under medical supervision, but it is absolutely contraindicated during pregnancy, which is relevant for older adolescents. Clinical guidance positions topical retinoids as the first-line treatment for early stretch marks in non-pregnant individuals, with the caveat that patients should expect some irritation during the initial weeks.9Archiv EuroMedica. Efficacy of Topical Therapies in Treating Stretch Marks: An Evidence-Based Review
Beyond tretinoin, the evidence gets thinner. Hyaluronic acid has shown some benefit, especially when combined with plant extracts like Centella asiatica, but the improvement is modest.10JEADV Clinical Practice. Dual Topical Therapy. The Future of Stretch Marks? Glycolic acid and silicone gels may help as add-ons. Cocoa butter and olive oil, despite being among the most commonly purchased products for stretch marks, have not shown any meaningful effect in controlled studies.11PubMed Central. Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae The popularity of cocoa butter for stretch marks is one of those persistent consumer beliefs that the research simply does not support.
Laser and In-Office Procedures
For stretch marks that do not respond adequately to topical treatment, or for older white-phase marks where topicals are unlikely to help much, laser therapy is the main escalation option. Several types of lasers have been studied, and the approach for adolescents and young adults has been explored specifically.
A case series evaluating a non-ablative fractional laser on adolescents and young adults with stretch marks found strong results. Scar-scale scores dropped significantly at both three and six months after treatment, with 88% of patients showing what the researchers rated as excellent improvement. The treatment was well tolerated, with very low pain scores and no long-term side effects.12PubMed Central. Clinical Evaluation on the Performance and Safety of a Non-Ablative Fractional 1340 nm Laser for the Treatment of Stretch Marks in Adolescents and Young Adults: A Case Series Non-ablative fractional lasers work by creating tiny columns of heat in the dermis to stimulate collagen remodeling without damaging the skin surface, which means less downtime and lower risk of scarring or pigment changes.
Other laser types, including pulsed dye lasers for red stretch marks and fractional CO2 lasers for more established ones, have also shown benefit in broader adult studies. The challenge for families is access and cost. Laser treatment for stretch marks is considered cosmetic and is almost never covered by insurance. A typical course involves multiple sessions spaced weeks apart, and each session can run several hundred dollars. For a teenager whose marks are likely to continue fading naturally over time, the cost-benefit calculation is worth discussing with a dermatologist before committing.
Can You Prevent Stretch Marks in a Growing Kid
The honest answer is that no product has been convincingly shown to prevent stretch marks. A handful of specific cream formulations, Trofolastin cream and Alphastria cream among them, showed some positive results in prevention trials, but these studies were small and the evidence is considered moderate at best.11PubMed Central. Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae Most of the prevention research has focused on pregnancy rather than adolescent growth, and no topical agent has strong evidence for preventing stretch marks during pregnancy either, so the outlook for prevention in growing teens is similarly uncertain.9Archiv EuroMedica. Efficacy of Topical Therapies in Treating Stretch Marks: An Evidence-Based Review
Keeping skin well moisturized is unlikely to prevent stretch marks, but it is also not harmful, and there is some logic in the idea that well-hydrated skin may be slightly more pliable. Emollients can be recommended for general skin comfort, but parents should not expect them to stop marks from forming during a major growth spurt. The mechanical forces involved in rapid skeletal growth are simply too strong for any cream to counteract.
What you can address is controllable weight gain. While you obviously cannot and should not try to slow a child’s natural growth, avoiding excessive weight gain on top of a growth spurt reduces the total stretching force on the skin. A teenager who gains significant excess weight during the same period they are shooting up in height is putting their skin under compounding mechanical stress from two directions.
The Emotional Side for Teens
Stretch marks are medically harmless, but dismissing them as “just cosmetic” misses the point for many teenagers. Adolescents are at a life stage where body image is deeply tied to self-worth, and visible skin changes they did not expect can cause real distress. Boys who develop horizontal marks across their lower back may avoid taking their shirts off at the pool. Girls with marks on their thighs may stop wearing shorts. The distress is genuine even when the marks are completely normal and expected to fade.
For parents, the most helpful response is a combination of normalization and practical information. Letting a teenager know that stretch marks are extremely common during growth spurts, that they fade substantially with time, and that treatment options exist if the marks are still bothersome after they have matured can go a long way. If a teen is very distressed, a visit to a dermatologist can serve a dual purpose: it reassures them that the marks are normal while also opening a conversation about whether any intervention makes sense for their specific situation.
Stretch Marks in Younger Children
While most of the research and clinical attention focuses on adolescents, younger children can develop stretch marks too. Pre-pubertal stretch marks are uncommon enough that they should prompt at least a conversation with a pediatrician. In most cases, the explanation turns out to be rapid weight gain or a growth spurt that started earlier than average. But as discussed in the section on medical causes, conditions like Cushing syndrome or prolonged corticosteroid use are more likely to be the explanation when marks appear on a child who is not yet in puberty.
The location and appearance of the marks give clues. Wide, purple, abdominal stretch marks in a young child who is gaining weight and developing other unusual symptoms like a rounded face or easy bruising call for hormonal testing. Thin, pale marks on the knees or hips of a child who has recently had a growth spurt and is otherwise healthy are far more likely to be benign. Pediatric dermatologists can generally distinguish between the two based on the clinical picture, but a primary care visit is a reasonable first step for any parent who is uncertain.
How Much Stretch Marks Actually Fade on Their Own
One of the most reassuring facts about adolescent stretch marks is that time itself is the most reliable treatment. Fresh red or purple marks look alarming, but nearly all of them fade to a much less noticeable white or silver over one to three years. The texture flattens, the color drains, and in many cases the marks become visible only under certain lighting or when the skin is stretched taut. They do not disappear completely. Stretch marks are scars, and scars are permanent to some degree. But the dramatic red-purple phase that causes the most distress is temporary.
This natural fading process is worth considering before investing in expensive treatments. For a 14-year-old with new stretch marks from a growth spurt, waiting six months to a year while the marks are still in the red phase, then reassessing whether the fading trajectory is satisfactory, is a perfectly reasonable approach. If the marks are still prominent and bothersome after that window, tretinoin or laser therapy can be explored. Rushing into treatment the week marks appear means treating a condition that may resolve adequately on its own, though catching them in the red phase does give topical treatments their best chance of working.