Topicals for stretch marks: magic wand or marketing ploy?

So, now that we have delved into the depths of WHAT are the human analog of tiger stripes we so boringly call “stretch marks”, I bet you’re asking yourself: "well, are there any affordable at-home topical treatments one might use for improvement and prevention of striae?”


Ladies and gentlemen, I hate to break it to you, but you heard it here first: there is no scientifically backed data to support the claim that ANY topical has an effect on treating or even preventing (!!!) stretch marks.


As much as it is heart-breaking, there are still great benefits to these topical products, starting from increasing skin hydration to just being a pleasant self-pampering treatment. With all that said, there are some gems in the neverending INCI lists, that were definitively shown to lessen the degree of severity of stretch marks, albeit not preventing their appearance completely.


And if you are interested in skincare that truly works or just want to be more vigilant, today I will drop off some knowledge on the worthwhile ingredients you can look for in body care products.


As we have already addressed, stretch marks are generally divided into two groups: rubrae and albae, which differ in the stage of maturity and, therefore, differ in the ability to be resolved. But it is not the only factor critical for the

the therapeutic outcome, it turns out your skin type according to the Fitzpatrick scale has a major role in the healing results [1].


The Fitzpatrick scale is a somewhat crude number-like classification for human skin color type (Figure 1). It was developed essentially as a method of estimation of how skin reacts to ultraviolet light.*





Figure 1 Types of skin according to the Fitzpatrick scale. I through VI (left to right). Type I always burns, never tans;

Type II usually burns, tans minimally; Type III occasional mild burn, uniform tan;






Type IV burns minimally always tans well (moderate brown); Type V very rarely burns, tans very easily (dark brown); Type VI never burns (deeply pigmented dark brown to darkest brown) [6].







Results of therapeutic intervention are reliant on this scale and the most adverse effects, specifically with laser treatments, occur in patients with darker skin types (Fitzpatrick types III-IV) [2].


Which begs the question, what are the alternative non-invasive ways to treat stretch marks in all skin types avoiding unwanted irritation and pigmentation?


The answer lies on the surface (pun absolutely intended). Yes, the most commonly sold and purchased products for our problem are topicals. Aiming at providing long-term improvements in pigmentation and texture of striae, they are also a safe and affordable treatment for all.



 Leave cocoa butter and olive oil in the kitchen.


There are plenty of products, containing all kinds of different oils, from simple sunflower seed to grapefruit peel and geranium flower oils with claims of magical striae healing but unfortunately, there is no sufficient data or scientific research supporting these claims. So, leave cocoa butter and olive oil in the kitchen [4,5].


However, there are specific ‘ingredients’ that do show potential for if not curing stretch marks but definitely improving their appearance and overall skin health.


The all-star ingredient seen in the most ‘hot’ topical products at the moment claiming to prevent or treat stretch marks is Centella asiatica (or Gotu Kola) extract. It bottles up high levels of Madecassoside and Asiaticoside (glycosylated triterpenes), notable for facilitating the elevation of collagen I and III synthesis in perivascular tissues, while also reducing irritation and inflammation [7].




Next on our list is topical silicone.

And the reason behind those honors is that it has been actually clinically proven to have an effect on striae-affected skin! Silicone increases collagen levels and reduces pigmentation, while simultaneously providing hydration and bumping up elasticity in the skin [3].**



Closing the top three is not a particular active ingredient, but rather a group. This group of ingredients serves a very important purpose - chemical peeling of the affected skin [3]. Acid peel treatments (such as glycolic acid, trichloroacetic acid, mandelic acid, and glucono delta-lactone, and many others) are incorporated into a treatment product (usually in a form of serum) and are thought to act by increasing collagen synthesis. These chemical agents are considered to initiate an inflammatory response, with subsequent neocollagenesis.


With the ever-flourishing skincare market and the abundance of products it brings with itself, it can be quite a challenge to pick and choose something that works well for you. And, unfortunately, there are no easy sure-fire products that will help with existing scarring of any kind. But if you are determined to rid your skin of "imperfections" and are ready to go through lasers/injections always consult a medical professional first.


*On the importance of skin protection, please enjoy these articles created by my colleagues: Exploring the Evolution of Melanoma; Potential damages of visible light on the skin; Sunscreens: A powerful tool for a younger skin; Do It Yourself Sunscreen: A Recipe For Disaster.


**Kelo-Cote (Sinclair Pharma plc) is a great example of silicone gel treatment. It is clinically proven to significantly increase levels of collagen while lowering levels of melanin and is recommended for use on atrophic scars resulting from acne vulgaris, chickenpox, and striae.

References

1. Ud-Din, S., McGeorge, D., & Bayat, A. (2016). Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae. Journal of the European Academy of Dermatology and Venereology : JEADV, 30(2), 211–222. https://doi.org/10.1111/jdv.13223

2. Elbuluk N, Kang S, Hamilton T. Differences in clinical features and risk

factors for striae distensae in African American and white women. J Am

Acad Dermatol 2009; 1: AB56.

3. Al-Himdani, S., Ud-Din, S., Gilmore, S., & Bayat, A. (2014). Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. The British journal of dermatology, 170(3), 527–547. https://doi.org/10.1111/bjd.12681

4. Osman H, Usta IM, Rubeiz N et al. Cocoa butter lotion for prevention of striae

gravidarum: a double-blind, randomised and placebo-controlled trial. BJOG: An

International Journal of Obstetrics & Gynaecology 2008; 115:1138-42.

5. Taavoni S, Soltanipour F, Haghani H et al. Effects of olive oil on striae gravidarum in the second trimester of pregnancy. Complementary Therapies in Clinical Practice 2011; 17:167-9.

6. D'Orazio, J., Jarrett, S., Amaro-Ortiz, A., & Scott, T. (2013). UV radiation and the skin. International journal of molecular sciences, 14(6), 12222–12248. https://doi.org/10.3390/ijms140612222

7. Hu, S., Belcaro, G., Hosoi, M., Feragalli, B., Luzzi, R., & Dugall, M. (2018). Postpartum stretchmarks: repairing activity of an oral Centella asiatica supplementation (Centellicum®). Minerva ginecologica, 70(5), 629–634. https://doi.org/10.23736/S0026-4784.18.04254-5





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