Can stretch marks be cured in individuals, particularly women, regardless of age or sex, especially during pregnancy?

Can Stretch Marks Be Cured?

Stretch marks cannot be cured or completely eliminated, but their appearance can be significantly improved through combination treatments, particularly when initiated early during the red/inflammatory phase. 1

Understanding Stretch Marks (Striae Distensae)

Stretch marks are permanent dermal scars resulting from elastic fiber destruction and structural alteration of the collagen network. 1 They histologically resemble scars with flattening atrophy of the epidermis and are therapeutically challenging. 1 The condition is particularly associated with:

• Female sex, pregnancy, and hormonal changes 1
• Rapid weight gain or loss 2, 3
• Adolescence and rapid muscle growth 4
• Chronic corticosteroid use 1

Critical caveat: Stretch marks progress through two phases—early red/inflammatory (striae rubrae) and late white/atrophic (striae albae). 2 Treatment is substantially more effective when initiated early. 1

Evidence-Based Treatment Approach

Most Effective: Combination Therapy with Autologous Platelet Concentrates (APCs/PRP)

The strongest evidence supports combining PRP with energy-based devices, particularly CO2 laser, which demonstrates superior outcomes over other modalities. 1

The 2025 guidelines from Periodontology 2000 reviewed 6 studies showing:

• Significant subjective and objective improvement when combining APCs with other modalities versus those modalities alone 1
• Histopathological improvements including increased epidermal thickness, enhanced rete ridge formation, decreased perivascular inflammation, and normalized collagen fiber orientation 1
• PRP plus CO2 laser showed better patient satisfaction and fewer side effects compared to PRP plus pulsed dye laser 1

Alternative Combination Approaches

Other effective combinations with PRP include:

• Microneedling 1
• Intradermal radiofrequency 1
• Carboxytherapy 1
• Microdermabrasion 1

Standalone Procedural Options

When PRP is unavailable, consider:

• Microneedling alone (can modify abnormal texture) 2
• Nonablative laser treatment 2
• Microdermabrasion 2
• Medical tattooing (corrects pigmentation but not texture) 2

Topical Treatments: Limited Evidence

Topical treatments show minimal to no benefit for established stretch marks. 1

For prevention during pregnancy:

• One Cochrane review found a cream containing Centella asiatica extract, alpha tocopherol, and collagen-elastin hydrolysates reduced stretch mark development (OR 0.41,95% CI 0.17-0.99), but only in women with prior pregnancy stretch marks—no benefit for general use 5
• A 2021 observational study of topical oil with plant extracts and vitamins showed 71% improvement at 4 months with increased hydration and collagen remodeling on confocal microscopy, but this was lower-quality evidence 3

Clinical Recommendations

Timing is critical: Earlier treatment initiation yields better outcomes. 1

Prevention strategies:

• Avoid excessive weight gain or loss 1
• Minimize chronic corticosteroid use when possible 1
• Maintain skin hydration (though evidence for prevention is weak) 6

Treatment algorithm:

1. First-line: PRP combined with CO2 fractional laser for optimal results 1
2. Second-line: PRP with alternative energy devices (RF, pulsed dye laser, microneedling) 1
3. Third-line: Standalone procedural treatments (microneedling, lasers, microdermabrasion) for those unable to access PRP 2

Important limitation: No standardized assessment scale exists for objective evaluation of stretch marks, making treatment comparisons difficult. 1 The evidence base consists mostly of small studies with poor quality, though combination PRP therapy shows the most consistent positive results. 1