Stretch marks during pregnancy: a review of topical prevention

Abstract

Striae gravidarum (SG), or stretch marks developing during pregnancy, affect up to 90% of women. While not medically dangerous, SG can be disfiguring, causing emotional and psychological distress. However, studies specifically addressing the prevention of SG, especially during pregnancy, are sparse. Furthermore, the molecular pathogenesis of SG is unclear and may differ from that of striae from other causes. Considering these factors, we review topical modalities that have been used specifically for preventing SG during pregnancy. We identify two major strategies (end points) addressed by these modalities, namely (i) preventing the de novo development of SG and (ii) reducing the severity of SG that have recently developed. We also identify risk factors for the development of SG and suggest that pregnant women with these risk factors are an appropriate target population for prevention. In reviewing the literature, we find that there is limited evidence that centella, and possibly massage with bitter almond oil, may prevent SG and/or reduce their severity. There is weak evidence that hyaluronic acid prevents SG. Tretinoin holds promise for reducing the severity of new-onset SG, but its use is limited by its pregnancy category. Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce. Furthermore, available topical modalities generally lack strong evidence from rigorous, well-designed, randomized controlled trials with ample numbers of subjects. Thus, further research is necessary to elucidate SG pathogenesis, which may lead to effective prevention modalities.

Striae gravidarum: Risk factors, prevention, and management

“…Hyaluronic acid, the active ingredient in both creams, is thought to increase resistance to mechanical forces and oppose atrophy through stimulation of fibroblast activity and collagen production (Elsaie et al, 2009, Korgavkar and Wang, 2015). In both studies, the creams were applied through massage during the second trimester, which poses the question of whether the creams were truly beneficial or whether the results reflected the benefits of massage alone.…”

“…SG presents as atrophic linear scars and can cause distress, often leading to a decrease in quality of life (Korgavkar and Wang, 2015, Park and Murase, 2013). SG are often overlooked as a cosmetic concern, which does not make the patient burden any less.…”

Fractionated CO2 Laser in the Treatment of Striae Alba in Darker Skinned Patients - A Prospective Study

“…17,18 Topical tretinoin improve the appearance of striae rubra significantly [19][20][21][22] ; however, it is contraindicated in breastfeeding or pregnant women due to its probable teratogenic side effects. 23,24 Several studies have reported the improvement of the clinical appearance of striae with 585-nm pulsed dye laser (PDL) via enhancement of the extracellular matrix collagen. [25][26][27][28] In addition, it has a modest efficacy in decreasing the erythema of striae rubra; however, it has [29][30][31][32] More recently, there has been evidence that indicates the benefits of both fractionated non-ablative and ablative lasers in increasing collagen fibers, and improving the appearance of striae alba.…”

Natūralių Aliejų Ir Cheminių Preparatų, Naudojamų Strijų Prevencijai Nėštumo Metu, Efektyvumo Palyginimas

“…), dėl kurių oda ruožais pakeičia natūralų atspalvį. Rašoma, kad pagal genetinius veiksnius galima prognozuoti ne tik strijų atsiradimą, bet jų išvaizdą [1][2][3] Nustatyta, kad moterims, kurių didesnis kūno masės indeksas, ir moterims, nešiojančioms didesnius kūdikius, strijos atsiranda dažniau [4 -6]. Buvo nustatytas reikšmingas ryšys tarp strijų atsiradimo ir nėščiųjų amžiaus bei svorio, įgyto nėštumo metu, pilvo ir šlaunų perimetro padidėjimo ar rūkymo [7], bet buvo gauta prieštaringų duomenų, nepatvirtinančių nei šeimos genetikos, nei kūno masės indekso prieš nėštumą, nei svorio priaugimo nėštumo metu reikšmės strijoms atsirasti [8].…”