Stretch marks are caused when skin changes shape too quickly (think weight gain, weight loss, or pregnancy). This sudden change causes a tear in the middle layer of your skin, the dermis. The collagen and elastin fibers in the dermis rupture, and you end up with "underground" scars that look like stripes on the affected area. The sooner you treat them, the better your chances of removing them, but that doesn't mean you're out of options if you've had your stretch marks for years.


Steps

1. Start early. Once they pass the initial stage (when they are red, purple, pink, or brown, depending on the color of your skin) and become white or silver (usually with deep indentation), it's going to be far more difficult to minimize them.
2. Massage the area with stretch marks three or four times a day with moisturizers that contain cocoa butter or shea butter as a prime ingredient. This hydrates the skin, making it more pliant. Again, this is most effective in the initial stage.
3. Apply self-tanner. It will help minimize the appearance of stretch marks. Exfoliate beforehand for best results.
4. Educate yourself about topical treatments. Many are advertised to "repair" stretch marks, but few have actually been proven to be effective. Here's the scoop on what's available:
   
   
   • Wheat germ oil - may help improve stretch marks in their early phase.
   • Glycolic acid - increases collagen production; can be administered in higher doses by a dermatologist (costs about $100 USD and requires three or four office visits before you see results); has not been fully studied by itself
   • Vitamin C - certain formulations might increase collagen production, but they'll only help with early-stage stretch marks; for best results, combine with glycolic acid; taking 500 mg of Vitamin C supplements three times a day may also help.
   • Relastin - the effectiveness of this product is unknown and unverified
   • Peptide-containing products - these "repair" creams are ineffective; there's no evidence that they work.
   • Retinoids - they're fairly effective in increasing collagen and elastic production in the early stages, but they should be avoided if you're pregnant or nursing; they're more effective when used in combination with glycolic acid.
   • Topical tretinoin can lighten stretch marks and reduce their size if applied in the earlier stages. Specifically, tretinoin cream is effective against stretch marks that are less than 6 weeks old, and are still pink or red, but it should not be used during pregnancy. It works by helping to rebuild collagen, but it's not effective against older stretch marks.
5. Consider laser treatment. It's used to treat both red/purple and white stretch marks, and generally it works by promoting the formation of collagen. It can be expensive, however, and effectiveness is limited.
   
   
   • vascular lasers - won't remove superficial skin, but are effective against redness by treating the blood vessels behind it; E.g. V-Beam, requires three to six sessions, about $450 per session
   • fractionated laser - minimizes older, more entrenched stretch marks in a process comparable to "smudging"; expect to pay around $1000 USD per session, and you'll need at least three sessions; yields about a 30% improvement. new generation fractional lasers can improve depressed skin, whiteness, and redness in one to three sessions
   • pulsed dye laser therapy "remodels" the underlying layers of skin and trigger the production of collagen and elastin; it's most effective on new stretch marks, but might be effective on older ones. The light heats blood vessels and makes them collapse so that the color is reduced, but it doesn't affect texture. Five treatments, one month apart, $500-800 per treatment. It is not recommended for anyone with a dark skin tone (Fitzpatrick Skin Type IV, V or VI) because of the potential for skin discoloration, and it should not be used while pregnant or nursing.
   • fractional photothermolysis also targets the underlying layers of skin; it damages small dot-like areas, not the entire area.
   • the excimer laser triggers melanin production so that stretch marks take on the same color as the surrounding skin. This can be effective against older stretch marks. Excimer laser is for older marks. 10-20 treatments, two weeks apart, $200-700 per treatment.
6. Look into microdermabrasion. Microdermabrasion works by blowing crystals onto the skin to "polish" the surface; it's followed by a vacuum tube that removes the crystals and skin cells, stimulating new skin growth. This is effective against older stretch marks.

Tips

• Stretch mark removal is usually not covered by insurance because it's a cosmetic procedure.
• There's no evidence that alternative therapies (castor or olive oil, seaweed wraps, or combinations of botanicals, vitamins and fruit acids) work on stretch marks.

Warnings

• Always check the ingredients list before applying a new skin care product. This is especially important when you are pregnant or nursing.
• Most treatments are partially effective, at best. Keep your expectations realistic.