Stretch marks in pregnancy (striae gravidarum)

It’s assumed that all you want when you’re a pregnant lady is a healthy happy child, and of course, world peace. In fact it seems rather taboo to mention any ‘cosmetic concerns’.

But let’s face it, carrying an extra XX kilos, being sleep-deprived, and feeling like a Jersey cow would be worse if you were crisscrossed with stretch marks like a circus freak.

Don’t tut tut me… you know it’s true.

Stretch marks developing during pregnancy are known as striae gravidarum, and they occur in up to 90% of pregnant ladies. They appear as red or purple lines or streaks and fade slowly to form silvery lines on the skin. The most commonly affected areas are the abdomen, breasts and thighs.

Stretch marks are considered ‘undesirable’ to many pregnant women and one study carried out in Japan found that pregnant women with severe stretch marks had impairment of their dermatology (skin) -related quality of life. The authors recommend that it is therefore important to reduce the severity of stretch marks. Yah, no kidding.

Are there any factors that would make you more likely to develop stretch marks?

  • A Turkish study found that you were more likely to develop stretch marks if there was a family history of stretch marks. No significant relationship was found between stretch marks and age, weight gained during pregnancy, abdominal and thigh circumference, or smoking status.
  • This is in contrast to another study that found that stretch marks are more common with low maternal age (eg. teenagers), maternal BMI >26, maternal weight gain >15kg, and high neonatal birth weight.

Can we apply anything to the skin that will prevent stretch marks? What about creams?

  • An anti-stretch mark cream (containing hydroxyprolisilane-C, rosehip oil, Centella asiatica triterpenes and vitamin E) was found to be useful at preventing stretch marks from forming, and if already formed, reduced their severity during pregnancy.
  • Another study looked at the effectiveness of topical silicone gel in reducing stretch marks (measured by tissue biopsies – these researchers were obviously hard core) and found that silicon gel was better than placebo at increasing skin collagen levels.
  • Lots of people swear by cocoa butter to prevent stretch marks – it was found in one study that cocoa butter had no effect on the development of stretch marks.
  • Two other studies unfortunately found no evidence for topical preparations in preventing stretch marks in pregnancy. Boo hoo.  One of these was a Cochrane review (the mother of all reviews) but that being said, it doesn’t mean that nothing works; it means that larger and better quality trials are necessary before a conclusion can be made.

What about oils?

  • One study found that there was no difference in stretch marks between applying (without massaging) olive oil twice daily compared with using no cream or oil.
  • This ‘nil’ effect of olive oil was shown in another study, which found that 40% of women using olive oil had stretch marks, whereas 50% of the control group (not using olive oil) had stretch marks. You may think ‘hey, but the control group had more stretch marks’ but unfortunately the difference was not statistically significant.
  • Interestingly, it was found that a 15-minute massage with almond oil during pregnancy reduced the development of stretch marks, while using the oil without massage had no effect. This suggests an effect of massage (which is why maybe there was no effect of olive oil in an earlier study; because it was simply applied and not actually massaged into the skin).

And finally… an interesting (and slightly terrifying) study

  • It found that abdominal stretch marks during pregnancy are statistically significant predictors of lacerations during delivery.
  • This makes sense as one who does not have stretch marks may have better skin elasticity and may be less likely to tear perineal and vaginal tissue during delivery. Don’t let that depress you however, there are a lot of other factors that affect the risk of tearing… ask your midwife/doctor for more information. Here is one of the many websites that offers tips on how to avoid tearing, and here is a study that looked at the incidence and risk factors for perineal trauma.

Seriously, thinking about this is already giving me trauma…

Bottom line: the evidence regarding the prevention and treatment of stretch marks in pregnancy is slightly ‘meh’. There is evidence that stretch marks are more likely if your mother has stretch marks, you’re large, the baby’s large, and/or you gain a lot of weight during pregnancy. There is also evidence that massaging (and not simply applying) oil will help. To me this makes sense because stretch marks are essentially a type of scarring, where the skin is stretched beyond normal limits of elasticity; by not stretching the skin too far, too fast, and by keeping it as elastic as possible, you will hopefully have fewer/ less severe stretch marks.  That and you can make offerings to the Stretch Mark gods.

Ud-Din S, McAnelly SL, Bowring A, Whiteside S, Morris J, Chaudhry I, Bayat A. A double-blind controlled clinical trial assessing the effect of topical gels on striae distensae (stretch marks): a non-invasive imaging, morphological and immunohistochemical study. Arch Dermatol Res. 2013 Apr 12.
 McAvoy BR. No evidence for topical preparations in preventing stretch marks in pregnancy. Br J Gen Pract. 2013 Apr;63(609):212.
 García Hernández JA, Madera González D, Padilla Castillo M, Figueras Falcón T. Use of a specific anti-stretch mark cream for preventing or reducing the severity of striae gravidarum. Randomized, double-blind, controlled trial. Int J Cosmet Sci. 2012 Dec 12.
 Brennan M, Young G, Devane D. Topical preparations for preventing stretch marks in pregnancy. Cochrane Database Syst Rev. 2012 Nov 14;11:CD000066.
 Soltanipoor F, Delaram M, Taavoni S, Haghani H. The effect of olive oil on prevention of striae gravidarum: a randomized controlled clinical trial. Complement Ther Med. 2012 Oct;20(5):263-6.
 Taavoni S, Soltanipour F, Haghani H, Ansarian H, Kheirkhah M. Effects of olive oil on striae gravidarum in the second trimester of pregnancy. Complement Ther Clin Pract. 2011 Aug;17(3):167-9.
 Yamaguchi K, Suganuma N, Ohashi K. Quality of life evaluation in Japanese pregnant women with striae gravidarum: a cross-sectional study. BMC Res Notes. 2012 Aug 21;5:450. doi: 10.1186/1756-0500-5-450.
 Timur Taşhan S, Kafkasli A. The effect of bitter almond oil and massaging on striae gravidarum in primiparaous women. J Clin Nurs. 2012 Jun;21(11-12):1570-6.
 Findik RB, Hascelik NK, Akin KO, Unluer AN, Karakaya J. Striae gravidarum, vitamin C and other related factors. Int J Vitam Nutr Res. 2011 Jan;81(1):43-8. doi: 10.1024/0300-9831/a000049.
 Osman H, Usta IM, Rubeiz N, Abu-Rustum R, Charara I, Nassar AH. Cocoa butter lotion for prevention of striae gravidarum: a double-blind, randomised and placebo-controlled trial. BJOG. 2008 Aug;115(9):1138-42.
 Atwal GS, Manku LK, Griffiths CE, Polson DW. Striae gravidarum in primiparae. Br J Dermatol. 2006 Nov;155(5):965-9.
 Wahman AJ, Finan MA, Emerson SC. Striae gravidarum as a predictor of vaginal lacerations at delivery. South Med J. 2000 Sep;93(9):873-6.
Smith LA, Price N, Simonite V, Burns EE. Incidence of and risk factors for perineal trauma: a prospective observational study. BMC Pregnancy Childbirth. 2013 Mar 7;13:59. doi: 10.1186/1471-2393-13-59.

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  1. I’m intrigued by this “specific anti-stretch mark cream” that was found to be effective. I can’t find any place that identifies what it actually is, though, and searching for the ingredients just yields posts about the study itself. If only I had some hydroxyprolisilane-C, rosehip oil, Centella asiatica triterpenes and vitamin E lying around the house. Sigh.

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