Stretch marks
Stretch marks are linear marks that appear when the skin stretches faster than the dermis can adapt and the collagen and elastin fibres tear.
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Stretch marks are linear marks that appear when the skin stretches faster than the dermis can adapt and the collagen and elastin fibres tear. A large proportion of the population has them and they are not a disease. No treatment removes them completely, but they can be made considerably less visible, and one rule decides almost everything: the newer they are, the better they respond.
The two phases
- red or purple stretch marks: these are the recent ones, slightly raised and sometimes itchy. At this stage there is inflammation and active blood vessels, and this is when treatment works;
- white, pearly stretch marks: these are old and mature, slightly depressed and without vessels. Here the results are far more limited.
The change from one phase to the other happens over 6–12 months. That is the reason not to postpone treatment.
When they appear
- pregnancy, particularly the third trimester;
- adolescence and growth spurts;
- rapid weight gain or loss;
- rapid gain in muscle mass;
- prolonged treatment with corticosteroids, both oral and potent topical;
- Cushing's syndrome;
- Marfan syndrome and other connective tissue disorders;
- family predisposition, which counts for a great deal;
- typical sites: abdomen, breasts, hips, buttocks, thighs, arms, lower back.
When to see a doctor
Ordinary stretch marks do not require medical attention. It is worth attending if:
- they have appeared rapidly and are wide and deeply purple, with no pregnancy or weight change to explain them;
- they come with weight gain around the trunk, a rounded face, muscle weakness or easy bruising: Cushing's syndrome needs excluding;
- they have appeared in a child or adolescent with no growth spurt or weight change;
- you use topical corticosteroids frequently;
- a woman has irregular periods and increased body hair;
- they affect you psychologically and you want to consider treatment.
What works
It is worth being realistic: no treatment eliminates them. What can be achieved is reduced colour, improved texture and much less visibility.
- topical tretinoin on recent red stretch marks: this has the strongest evidence. Not for use in pregnancy or breastfeeding;
- vascular laser on red stretch marks: it targets the vascular component and gives its best results at this stage;
- fractional laser on white stretch marks, to improve texture;
- microneedling, alone or combined with radiofrequency;
- chemical peels;
- topical hyaluronic acid and centella asiatica: moderate evidence, mainly in prevention;
- daily moisturising and massage: a modest effect, but it is what you can do at home from the start;
- several sessions of any technique are needed and results are partial.
What does not work
- creams promising to remove them completely;
- vegetable oils on their own: they moisturise but do not restructure the dermis;
- body wraps and anti-cellulite massage;
- oral collagen supplements for this specific purpose;
- cocoa butter, which has a good reputation but no demonstrated effectiveness.
Prevention
- avoid sudden weight changes;
- moisturise the skin daily during pregnancy and growth phases, with massage;
- a diet with enough protein, vitamin C and zinc;
- drink enough water;
- do not use potent topical corticosteroids for long periods, particularly in the skin folds;
- in pregnancy, supportive garments for the abdomen and breasts;
- in the gym, increase load and muscle mass progressively;
- bear in mind that family predisposition counts heavily: some people never develop them whatever they do, and others develop them despite doing everything right.
Common questions
Do they go on their own? No, but they fade a great deal with time: from purple they turn white and become far less noticeable.
Are they dangerous? No. Only the cause is, when there is excess cortisol behind them.
Can I treat them in pregnancy? Only with moisturising and massage. Retinoids and most procedures are postponed.
Does tanning disguise them? The opposite: a stretch mark does not tan and stands out more. Sun also damages that skin.
Can they be tattooed over? It is possible on mature, stable stretch marks, but the result is unpredictable because the ink settles differently.
Online consultation
In an online consultation the doctor reviews photographs, establishes which phase your stretch marks are in — which determines what can be achieved — excludes hormonal causes where the pattern is striking, reviews corticosteroid use and proposes options with realistic expectations.
This material is for information only and does not replace a medical consultation.
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Reviewed on Jul 13, 2026
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