STRETCH MARKS

Stretch marks are narrow, streak-like lines that can develop on the surface of the skin. Stretch marks are often red or purple at first, before gradually fading to a silvery-white color. Stretch marks appear when your skin is stretched suddenly over a short period of time. They occur in the strong middle layer of your skin (the dermis), which supports your skin's outer surface (the epidermis).

Who gets stretch marks?

Anyone can get stretch marks and they are very common, although they tend to occur more often in women than in men. The areas of the body most commonly affected by stretch marks are the abdomen (stomach), the buttocks and the thighs.
Stretch marks can appear on the skin wherever it is stretched as a result of sudden growth, such as during pregnancy, weight gain or growth spurts during puberty.

In some cases, stretch marks can also be a symptom of an underlying health condition, such as Cushing's syndrome. Cushing's syndrome is caused by an excess (over-production) of steroid hormones. The condition has several associated symptoms, such as weight gain and high blood pressure (hypertension), which are the result of the body producing too much of a particular hormone.

Symptoms of stretch marks 

Stretch marks first appear as red streaks or lines on the surface of your skin that are slightly raised to the touch. Depending on the color of your skin they may also look pink, reddish brown or dark brown.
The lines will often change to appear purple or blue in color, before slowly flattening out. As the lines get flatter, they also fade and usually end up a few shades lighter than your natural skin tone.
If you have stretch marks, you may notice that they usually appear in patches of parallel lines on your body. Your skin over the stretch marks may look thin and silvery, and can often look scar-like.
In many cases, stretch marks fade and become less noticeable over time, but this can take years.

Where do stretch marks appear?

You may develop stretch marks anywhere on your body where your skin has been stretched. However, they usually occur on the parts of your body where fat is stored, such as your:

• abdomen (stomach),
• buttocks,
• thighs,
• upper arms, and
• breasts (in women).

Causes of stretch marks 

	Rapid growth. If a part of your body grows rapidly over a short period of time, the fibres can become thin and over-stretched and some of them may break. Not everyone gets stretch marks. It may be that some people are more likely to develop stretch marks than others because their bodies produce a larger amount of a hormone called cortisol. Cortisol decreases the amount of collagen in your skin, which is a protein in the skin fibres that helps to keep it stretchy.
	Pregnancy. If you are pregnant, it is likely that you will develop stretch marks, particularly after the sixth month of your pregnancy. Hormones that are produced by your body during pregnancy help to soften the ligaments (strong bands of tissue connecting joints) in your pelvis, so that they give more when you come to deliver your baby. However, these hormones also soften the fibres in your skin, making you prone to stretch marks. As your baby grows, you may develop stretch marks on your abdomen (stomach) as your skin is gradually stretched further and further. Stretch marks may also appear on your thighs and breasts as they get bigger and heavier.
	Gaining weight quickly. You may find that you have stretch marks if you put on a lot of weight over a short period of time. The stretch marks may remain even if you lose the weight that you have gained. However, they should fade over time. If you diet regularly, stretch marks can form as your weight goes up and down rapidly. If you are dieting, it is important to lose weight slowly and steadily so that your skin is not put under strain.
	Puberty. Young people tend to grow very quickly during puberty. During puberty your body develops in growth spurts, bit by bit. Males often get stretch marks on their shoulders and back, whereas females tend to get them on their hips, thighs and breasts.
	Family history. If you have close relatives who have stretch marks (such as your mother) you may be more likely to develop them yourself. Stretch marks may affect both male and female members of your family, although they are more likely to occur in women.
	Certain medications. You may find that you develop stretch marks if you use corticosteroid medicines, such as creams, lotions or tablets. Corticosteroids work in a similar way to the hormone cortisol, which is produced naturally in your body. Medicines that contain corticosteroids can ease the inflammation that is caused by skin conditions, but they can also decrease the amount of collagen that is in your skin. Collagen is needed to keep your skin stretchy, so the less there is in your skin, the more likely it is that stretch marks will develop.
	Certain health conditions. Sometimes, stretch marks can be caused by a rare underlying condition, such as Cushing's syndrome or Marfan syndrome. Cushing's syndrome occurs when the body produces an excess amount of cortisol, the same hormone that may make some people more prone to stretch marks than others. Marfan syndrome is caused by a faulty gene that affects your body's connective tissues, including your skin. It weakens your body's tissues and affects their elasticity (ability to stretch), so that your skin is not as resistant to stretch marks as it should be.

Stretch marks treatment

There is no specific medical treatment for stretch marks and in most cases there is no need to see your GP about them. Most stretch marks fade over time and are not that noticeable.
If you have a lot of stretch marks, if they affect a large part of your body or if you are worried that they look unsightly there may be treatments available that can help. However, there is little or no medical evidence to show that any of these treatments will work, so it is important that you are realistic about what they can achieve.

Preventing stretch marks 

Stretch marks are very common and they cannot be prevented altogether. However, the following advice may help you to reduce your risk of developing stretch marks.

Maintain a healthy weight. One of the most common causes of stretch marks is gaining weight in a short period of time. Putting on a lot of weight and diets that cause your weight to change rapidly can cause stretch marks to form because your skin is literally stretched by the sudden growth. If you need to lose weight, aim to do it slowly by ensuring that you get plenty of regular exercise and by eating a healthy, balanced diet. You can also find out if you are overweight or obese by using body mass index (BMI) calculator.

Look after your skin. Massaging your skin everyday with moisturizer or a massage glove can help to improve your circulation and encourage new tissue growth. It is also important for you to eat a healthy, balanced diet that is rich in vitamins and minerals - particularly vitamins E and C and the minerals zinc and silicon. These vitamins and minerals help to keep your skin healthy.

Gain weight steadily during pregnancy. If you are pregnant, it is normal and healthy to put on a lot of weight in a short space of time but it is a myth that you need to 'eat for two'. You are more likely to get stretch marks during pregnancy due to hormonal changes that affect your skin. However, you may be able to minimize their appearance by gaining pregnancy weight steadily. While you are pregnant you need to take in approximately 2,500 calories a day. However, this is only 500 calories more than a woman's normal recommended calorie intake. It is important that these calories come from a well-balanced diet that is rich in whole-wheat carbohydrates, such as bread and pasta as well as fruit and vegetables.

During pregnancy, your weight gain should be slow and gradual. As a rough guide:

• it is normal to gain 1-2kg (2-4lb) over the first 12 weeks,
• from week 12-28, it is normal to gain 300-400g (10-14oz) a week, and
• from week 28-40 (the last three months) it is normal to gain 1-3kg (2-6lb) a month.

See your GP, midwife or health visitor if you are worried that you are not gaining weight at a healthy rate.

extracts from NHS CHOICE