Treatment of Stretch Marks with Retinoids
No matter our age or gender, stretch marks (or striae) can affect us all. Contrary to popular belief, stretch marks may even affect thin people. We commonly associate them with pregnancy, but striae also frequently occur in young patients after rapid height or muscle mass increase. Typical areas of involvement include the abdomen, breasts, arms, back and inner thighs. Hormones and predisposing genetic factors can also play a role. Stretch marks often begin as pink to red in color (because they are highly vascular) and lighten to a white or silver color with age.
Before treatment with lasers or excisional surgery, I find retinoids to be extremely successful. Retinoids (such as Retin A, Tazorac and generic tretinion) may be applied in a thin layer to the marks on a nightly basis. For patients whose skin gets too irritated by the medicine, I recommend application less frequently (2 to 3 times per week). Retinoids stimulate cell turnover and collagen formation. Although striae are dermal injuries, the retinoid goes a long way (literally) in helping with textural discrepancies. I explain to patients that this treatment is likely to improve stretch marks and make them less noticeable, but it will not make them disappear completely.
For further success, follow a 2- to 3-month treatment course of retinoids with Fraxel laser treatments, which resurface the skin using thermal energy. Vascular lasers or light treatments are effective in treating red stretch marks (striae rubra). I would strongly consider retinoids as a firstline treatment for stretch marks. From there, you may re-evaluate and decide if additional care is appropriate.