Stretch marks are strips of skin which have a scar-like appearance and appear in the form of linear atrophic lesions. They are primarily found on the breasts, thighs, abdomen and hips.



The skin

The skin is made up of three different layers:

  • The epidermis plays a protective role against external attacks.
  • The dermis, which is 70 % water, keeps the skin firm and resistant thanks to its collagen fibres and keeps it supple thanks to its elastin fibres. It is also contains the sensory nerve endings, which convey the information received by the skin (touch, pain, temperature), and the blood vessels which feed the epidermis and regulate the body temperature.
  • Hypodermis: This is made of cells rich in fat (fatty tissue). It has blood vessels running through it and contains the sweat glands as well as the roots of the skin’s longer hairs.

What does histology tell us about stretch marks?

In the early stages, the skin is inflamed with dermal oedema. In later stages, the skin is sunken and thinner than healthy skin. The dermis is the layer that is most affected. The papillary der- mis becomes very thin, and is sometimes absent. The collagen fibres are positioned parallel to the skin, whereas in healthy skin they are perpendicular to the skin. The number and density of the collagen fibres are greatly reduced. The elastic fibres are broken up and their density is increased (like when the skin ages). The fibroblasts are inactive and fibrillary secretions have stopped.
There are two types of anomaly: a decrease in the number of fibroblasts and the degeneration of the elastic and collagen fibres.

What causes stretch marks?

A certain number of causes have been found:

  • Genetic and mechanical causes: physical stretching simply acts as a catalyst for the appearance of stretch marks in people who are genetically predisposed. Studies have shown that stretch marks appear due to malfunctioning fibroblasts resulting in cutaneous distension in people who are predisposed to the condition.
  • Hormonal: Stretch marks can also be caused by hyperactive adrenal glands (pregnancy, obesity, puberty, Cushing’s syndrome) and the distension simply acts as a catalyst.

Risk factors associated with pregnancy-related stretch marks

Stretch marks usually appear in the third trimester due to hy- peractive adrenal glands. The risk of developing stretch marks is increased if the mother has gained excessive weight (more than 15 kg), is expecting twins, during breastfeeding, and in overweight women whose skin is constantly stretched tight. The heavier the baby, the more likely the mother is to develop stretch marks. A lack of protein in the diet can also be res- ponsible for insufficient development of supporting tissue.

How to prevent stretch marks during pregnancy

  • Try to limit weight gain to between 9 and 12kg
  • Wear a comfortable, wireless bra day and night throughout your pregnancy and while breastfeeding
  • In the last three months of your pregnancy, gently support your bump with a pregnancy band or special elasticated belt
  • Massage the skin around susceptible areas, especially in the third trimester

Is there anything i can take to prevent stretch marks?

Certain molecules can be taken before pregnancy to strengthen the skin: Vitamin A acid (retinoids), Tretinoin, Jonctum, Defiltran, Madecassol.

Some practitioners recommend homeopathy: calcarea fluorica 9 CH and graphite 9 CH. Essential oils can also be helpful: carrot seed oil, Guyanese castor oil, marula oil.

What treatments are effective?

Laser treatments and microdermabrasion have little effect on stretch marks. Rollers, mesotherapy and peels are effective treatments, but their effects are limited if used on their own. LED treatments are the most highly recommended. This light treatment stimulates the cells’ “powerhouses” (mitochondria), which produce collagen and elastic fibres. LED therapy can be associated with other treatments, such as the relatively-new in- tradermal radiofrequency treatment. This involves applying ra- dio waves into the dermis via a needle. This stimulates fibroblast activity and encourages the gradual healing of the stretch mark.

About Dr Jean-Marc Chardonneau

Angiology degree from the French National College of Aesthetic Medicine, DIU (inter-university degree) in Obesity, Aging and Aesthetics of Superficial Tissue (Paris V). DIU in Morphological and Anti-Aging Medicine. Graduated in Phlebology from the Paris V Marie Curie Institute and the French National College of Aesthetic Medicine (Paris VI). President of the CIMEMI (International Congress for the Aesthetics of Legs). Inventor of the microsculpture and mesocannulation techniques for legs, the TC 3000 technique (radio waves to treat varicose veins), and the anti-aging filler Stylage Mesolift. Consultant for the companies FCARE, Auriga, Solidea, Cutera Servier, etc.