Stretch Mark Removal Is Possible Twenty Years Of Treatment Laser And Ointment Revealed

Hello. I am Dr. Lee Sang-ju of Yonsei Star Dermatology. Today, I would like to answer your questions about stretch mark treatment, which many people are concerned about. Many people are stressed by stretch marks on exposed areas, especially in summer. Stretch marks are not only a cosmetic problem but can also sometimes be a sign of health issues, so I hope that through today's content, you will accurately understand stretch marks and find appropriate management and treatment methods.

Medically, stretch marks refer to atrophic linear band lesions that occur when the skin is excessively stretched, destroying the connections between collagen fibers. Simply put, they can be thought of as stretch marks that occur when the skin tears. In the past, they were considered only a cosmetic problem, but recently, they are also referred to as a form of scar. They appear more often in women and can occur at various ages, from young children to over 50.

The main causes of stretch marks are as follows:

• Pregnancy: Occurs in about 90% of pregnant women, often on the abdomen, breasts, and thighs. Fetal growth, weight gain, and hormonal changes (increased adrenal cortical hormones) are the main causes.
• Rapid growth during puberty: Stretch marks can appear on the chest, thighs, buttocks (women), waist, and outer thighs (men) due to sudden growth spurts or the onset of secondary sexual characteristics.
• Rapid weight changes: Stretch marks can also occur when the skin stretches or shrinks due to weight gain from obesity, or conversely, rapid weight loss.
• Increased muscle mass: Recently, cases of stretch marks appearing on the shoulders, arms, and other areas due to a rapid increase in muscle mass (especially in men) through exercise have been reported.
• Genetic predisposition: Given that stretch marks sometimes appear together in twins, genetic factors may also play a role.

In addition, stretch marks can occur due to pathological causes such as Cushing's syndrome and other adrenal cortical hormone excess diseases, Marfan syndrome and other genetic diseases, or the use of steroid ointments, injections, or medications. If stretch marks appear very severely, it may be necessary to consider these internal medical causes as well.

Stretch marks can be broadly divided into two types:

• Early red stretch marks: When stretch marks first appear, they take the form of red bands. They may be slightly sunken compared to normal skin and feel bumpy when touched.
• Late white stretch marks: This is the stage where red stretch marks gradually turn white over time. Some patients may have white stretch marks from the beginning. They are characterized by wrinkled and atrophied skin, often appearing slightly sunken and white compared to the surrounding skin.

If red stretch marks are discovered and treated early, there is a high possibility of preventing their progression to white stretch marks and improving them to be close to normal skin.

Stretch marks mainly occur in areas where the skin is prone to stretching. According to a study conducted with Myongji Hospital, in Korean women, they appear overwhelmingly on the thighs and calves. They can also appear on various other areas such as the abdomen, arms, shoulders, chest, and knees. In particular, stretch marks on the calves or knees are often exposed when wearing shorts or skirts, causing many people stress and a desire for treatment.

While stretch marks do not pose medical problems, they often cause cosmetic stress. They can be difficult to cover with clothing, leading to a loss of confidence in social interactions or, in severe cases, avoiding certain outfits, which can result in psychological stress. Also, as mentioned earlier, if stretch marks appear excessively compared to others, it may be related to internal medical conditions or the use of certain medications, so it is advisable to get checked at least once.

In the following cases, it is advisable to consult a dermatologist and consider appropriate treatment:

• Immediately after discovering red stretch marks: Treating red stretch marks early can prevent their progression to white stretch marks and increase the likelihood of recovery to normal skin.
• When psychological stress is very severe: If stretch marks cause difficulties in daily life or social interactions, it is good to seek professional help.
• When an internal medical condition or specific medication use is suspected: Especially if you have been using certain medications such as endocrine disorders or steroids for a long time, it is necessary to check the correlation with stretch marks.

Diagnosis of stretch marks is mainly made through medical history and visual inspection, and a dermatologist can easily identify them by their characteristic shape and location. However, if stretch marks are very severe or need to be differentiated from other diseases, skin tissue biopsy, ultrasound examination, or internal medical examinations may be performed.

In the past, stretch mark treatment was known to be difficult, but with recent advancements in various treatment methods, stretch marks can be treated relatively well. Currently, five main treatment methods are primarily used in Korea:

• Topical treatment (topical medication)
• Chemical peeling and microdermabrasion
• Carboxytherapy
• Radiofrequency treatment
• Laser treatment

Stretch mark management you can try at home

Stretch mark creams or oils are mainly used for preventing stretch marks in pregnant women. They contain various ingredients such as hyaluronic acid, centella, silicone, vitamin C, and cocoa butter, and olive oil, almond oil, etc., are also used. Although there is not enough medical evidence, it can be more helpful than not using anything. This is mainly because skin moisturizing prevents the skin from drying out, and the massage effect using oil can partially help improve stretch marks.

Professional medical institution's stretch mark treatment methods

1. Retinoid ointment: Stieva-A ointment is a representative example, which promotes collagen synthesis and helps improve stretch marks. It is particularly effective for early red stretch marks but is known to be less effective for late white stretch marks. Skin irritation (redness, stinging) may occur, so caution is needed, and pregnant women should not use it.
2. Chemical peeling and microdermabrasion: This method uses ingredients such as TCA and glycolic acid to stimulate the skin, induce an inflammatory response, and increase collagen synthesis. It was widely used in the past, but due to the possibility of side effects such as skin irritation or pigmentation, laser treatment is now preferred.
3. Carboxytherapy: This method involves injecting carbon dioxide gas into the stretch mark area to help blood circulation and increase collagen synthesis. It was widely used in Europe, but due to severe pain and the possibility of hematoma (blood accumulation), it has not become widespread in Korea.
4. Radiofrequency treatment: Fractional microneedle radiofrequency devices (Potenza, Genesis, etc.) are used to insert needles into the skin and deliver energy to increase collagen and elastic fibers in the dermis. Treatment is usually performed 3-6 times once a month, and side effects such as blisters, scabs, pigmentation, and scars can occur, so it is important to be treated by experienced medical staff. In stretch mark treatment, pigmentation is considered one of the biggest problems.
5. Laser treatment: With recent advancements in laser technology, it is widely used for stretch mark treatment.
   • Red stretch marks: Vascular lasers (Vbeam, Synergy) are representative. They are effective in restoring red skin to normal skin color and also help prevent the progression of stretch marks. Treatment is usually performed about 5 times at 4-week intervals, and although bruising or blisters may occur, safe treatment is possible.
   • White stretch marks: Fractional lasers (Ultrapulse Encore, Fraxel) are mainly used. They induce skin regeneration by increasing collagen and elastic fibers, and good results can be expected with treatment at 4-8 week intervals. A study conducted with Yonsei University Dermatology also reported clinical improvement in over 50% of patients after using the Ultrapulse Encore laser.

Above all, prevention and early treatment of stretch marks are important. Treatment is most effective when stretch marks are red. However, white stretch marks can also be treated, and with consistent treatment, they can be improved to the point where they do not significantly interfere with social interactions. Stretch mark treatment is not like erasing with an eraser, where they disappear perfectly at once; patience and persistence with consistent treatment are necessary to achieve good results.

For stretch mark prevention, high-risk groups such as athletes, adolescents, and pregnant women should avoid rapid weight gain or loss and establish appropriate dietary and exercise plans.