From the Guidelines
Topical tretinoin cream is the most effective treatment for striae, particularly for newer stretch marks, due to its ability to stimulate collagen production and promote cell turnover. Although the provided evidence 1 focuses on the treatment of actinic keratoses, the principles of tretinoin's effects on skin can be applied to the treatment of stretch marks. The study 1 demonstrates a dose-response relationship with tretinoin, suggesting that higher concentrations may be more effective. However, it's essential to note that the optimal concentration for treating stretch marks may differ from that for actinic keratoses.
When using topical tretinoin for stretch marks, it's crucial to:
- Apply a product containing at least 0.05% tretinoin daily to clean, dry skin
- Massage the product into the affected areas
- Use consistently for at least 12 weeks to see significant improvement
- Be aware that tretinoin may cause initial irritation, which can worsen before improving, as seen in the study 1
Other treatments, such as hyaluronic acid serums, centella asiatica creams, vitamin E oil, and cocoa butter, may also be beneficial in improving skin elasticity and hydration, potentially reducing the appearance of stretch marks. However, tretinoin remains the most effective topical treatment option, especially when started early on newer stretch marks. For severe or persistent cases, prescription-strength retinoids like tretinoin (0.05-0.1%) may be necessary, but these require a doctor's prescription.
From the Research
Topical Treatments for Striae
- Topical tretinoin (retinoic acid) has been shown to improve the clinical appearance of early, active stretch marks, with significant improvements in severity scores and decreases in mean length and width of stretch marks 2.
- A cream containing Centella asiatica extract, alpha tocopherol, and collagen-elastin hydrolysates has been found to prevent the development of stretch marks in pregnant women who had previously suffered from stretch marks in pregnancy 3.
- Other topical treatments, such as glycolic acid, ascorbic acid, and beta-glucan, have also been used to treat stretch marks, with variable success 4, 5.
Laser and Light-Based Treatments
- Laser and light-based treatments, such as carbon dioxide, Er:YAG, diode, Q-switched Nd:YAG, pulse dye, and excimer laser, have been used to improve the appearance of stretch marks, particularly striae rubrae 4, 6.
- Microneedling and non-ablative and fractionated lasers have also been used to treat stretch marks, with some success 6.
Combination Therapies
- A novel treatment combining nanofractional radiofrequency plus magnetic nanofractional radiofrequency with topical formulations containing beta-glucan has been found to be effective and safe for the treatment of stretch marks 5.
- Combination therapies, such as topical treatments with laser or light-based treatments, may offer improved outcomes for the treatment of stretch marks, but more research is needed to determine the most effective combinations 4, 6.