Rapid growth spurts can cause stretch marks, known medically as striae distensae. They are a common skin reaction and a form of scarring that appears when the skin is stretched beyond its natural capacity over a short period. This phenomenon is frequently observed during life stages involving quick physical changes, such as puberty. These linear scars result from the skin attempting to accommodate a sudden increase in volume or height.
The Mechanical Failure of the Dermis
Stretch marks form due to a mechanical failure within the skin’s structure, specifically in the dermis layer. The dermis is the middle layer of the skin, containing a network of protein fibers that provide strength and elasticity. Collagen and elastin are the main proteins responsible for the skin’s ability to resist tearing and return to its original shape.
When the skin expands too quickly, the tension exceeds the physical limits of these supportive fibers. This excessive stretching causes the collagen and elastin fibers to rupture or tear, disrupting their organized structure. This disorganization initiates an abnormal healing response, which manifests as a visible scar on the skin’s surface. Early lesions often appear inflamed with colors like red or purple, reflecting underlying vascular changes.
Rapid Height Increase as a Specific Trigger
Rapid vertical growth, such as skeletal growth spurts during adolescence, is a significant trigger for stretch marks. This quick development often outpaces the skin’s ability to adapt smoothly. The marks typically appear where the skin is subjected to the most intense vertical tension from bone elongation.
In boys, rapid vertical growth can cause marks to appear on the back, shoulders, and hips as the skeletal frame broadens and lengthens. Girls commonly see marks on the thighs, hips, and breasts as the body contours change. Hormonal shifts associated with puberty also play a role, as increased levels of corticosteroids reduce the skin’s overall elasticity, making it more prone to tearing.
Options for Minimizing Their Appearance
Treatment efficacy is significantly higher when the marks are in their early stage, known as striae rubrae, appearing red or purple. Once they mature into white or silver lines, known as striae albae, they become much more difficult to treat.
Topical treatments can offer modest improvement, particularly on newer marks. Prescription retinoids, such as tretinoin, have been shown to improve the appearance of early, red stretch marks by promoting collagen synthesis. Over-the-counter options, including hyaluronic acid and intensive moisturizers, are often recommended, though scientific evidence for their effectiveness is less consistent.
In-Office Procedures
For more noticeable improvement, dermatologists often use in-office procedures.
##### Laser Therapies
Laser therapies, such as the 585-nm pulsed dye laser, target the redness and stimulate dermal elastin and collagen production. Fractional lasers, like the fractional carbon dioxide laser, work by creating microscopic injuries to encourage deep tissue remodeling and regeneration.
##### Other Clinical Methods
Other clinical methods, including microdermabrasion and microneedling, physically resurface the skin or stimulate collagen deposition. These methods are often used in combination with other treatments.