What causes striae (stretch marks) in the absence of growth or weight fluctuations?

From the Guidelines

Stretch marks can occur even without growth or weight changes due to various factors, including hormonal fluctuations, certain medications, and medical conditions, with genetic factors playing a significant role. When considering the development of striae in the absence of growth or weight fluctuations, it's essential to look at the underlying causes that may not be directly related to changes in body size. Hormonal changes, particularly those involving cortisol, can affect skin elasticity regardless of weight changes 1. Additionally, certain medical conditions, such as neurofibromatosis type 1, may impose a cosmetic burden and have negative effects on emotions, physical symptoms, and functioning, which could be related to the development of stretch marks, although the exact relationship is not explicitly stated in the provided evidence. Some key factors to consider include:

• Hormonal fluctuations, such as those experienced during puberty, pregnancy, or menopause
• Certain medications, like corticosteroids, which can weaken collagen fibers in the skin
• Medical conditions, such as Marfan syndrome, Ehlers-Danlos syndrome, or adrenal disorders, which may cause stretch marks without weight fluctuation
• Genetic factors, which play a significant role in determining an individual's predisposition to developing stretch marks due to their skin's natural elasticity and collagen structure. It's also worth noting that rapid muscle growth from intense bodybuilding can create stretch marks even when overall weight remains stable. Treatment options for stretch marks include retinoid creams, laser therapy, microdermabrasion, and moisturizers containing hyaluronic acid, though complete removal is often difficult.

From the Research

Causes of Striae in the Absence of Growth or Weight Fluctuations

• Striae distensae, also known as stretch marks, can occur due to various factors beyond growth or weight fluctuations, including:
  • Prolonged use of topical or systemic corticosteroids 2
  • Cushing's syndrome, which can cause violaceous striae 3
  • Marfan's syndrome 2
  • Prolonged use of lightening creams 2
  • Cachexia 2
  • Use of androgenic and anabolic substances 2
  • Joint hypermobility syndrome, also known as Ehlers-Danlos Syndrome, Hypermobility Type (JHS/EDS-HT) 4

Underlying Mechanisms

• The exact mechanisms behind the formation of striae in these cases are not fully understood, but may involve:
  • Atrophy and flattening of the epidermis 2, 5
  • Changes in collagen and elastin production 5
  • Increased melanin production 5
  • Vascular changes, such as decreased vascularity 5

Associated Conditions

• Striae can be a symptom of various underlying conditions, including:
  • Cushing's syndrome 3
  • Marfan's syndrome 2
  • Joint hypermobility syndrome (JHS/EDS-HT) 4
  • Ehlers-Danlos Syndrome, Hypermobility Type 4