From the Guidelines
Hormone replacement therapy (HRT) is not typically used as a treatment for existing stretch marks, but it can be associated with the development of striae (stretch marks) in some cases. The relationship between HRT and striae is based on how hormones affect skin elasticity, collagen production, and body composition rather than a direct therapeutic effect on existing stretch marks 1. HRT, which involves supplementing estrogen and sometimes progesterone, can cause skin changes including increased skin thickness and collagen production. However, when HRT leads to rapid weight gain or fluid retention, it may contribute to the formation of stretch marks as the skin stretches quickly. Some studies have shown that HRT can increase the risk of certain health conditions, such as cholecystitis and cardiovascular disease, but the evidence is not strong enough to support its use for the primary prevention of chronic conditions 1. For those concerned about developing stretch marks while on HRT, maintaining stable weight, staying hydrated, and using moisturizers may help minimize their appearance. If stretch marks do develop, topical retinoids, laser therapy, or microdermabrasion would be more appropriate treatments than HRT itself. It is essential to weigh the benefits and harms of HRT and consider alternative therapies for the prevention of chronic diseases. Women considering taking HRT for prevention should make that decision with their clinician in the context of a discussion of benefits and harms of HRT and alternatives to HRT for the prevention of chronic diseases. Most organizations with guidelines on postmenopausal HRT recommend against the use of HRT for the primary or secondary prevention of cardiovascular disease and suggest caution in using HRT solely to prevent osteoporosis. The American College of Obstetricians and Gynecologists and the North American Menopause Society consider HRT an acceptable treatment option for menopausal symptoms but advise caution about the prolonged use of HRT for the relief of symptoms. In summary, while HRT may be associated with the development of stretch marks, it is not a recommended treatment for existing stretch marks, and its use should be carefully considered in the context of individual benefits and harms.
From the Research
Association between HRT and Striae
- There is no direct evidence to suggest that hormone replacement therapy (HRT) is associated with the development of striae (stretch marks) 2, 3, 4.
- However, some studies suggest that HRT may have a positive effect on skin health, including improving skin thickness, collagen content, and reducing the appearance of wrinkles and fine lines 5, 6.
- Estrogen replacement therapy has been shown to increase skin thickness, mitotic activity of keratinocytes, and dermal collagen content in postmenopausal women, which may help to improve the appearance of stretch marks 5, 6.
- Additionally, HRT may alleviate some symptoms of skin aging, such as dryness and roughness, which may also help to improve the appearance of stretch marks 5, 6.
Treatment of Striae with HRT
- There is no conclusive evidence to suggest that HRT is an effective treatment for stretch marks 2, 3, 4.
- However, some studies suggest that topical treatments, such as tretinoin (retinoic acid) cream, may be effective in improving the appearance of early, active stretch marks 2.
- Further research is needed to determine the effectiveness of HRT in the treatment of stretch marks and to fully understand its effects on skin health 3, 4, 5, 6.