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"Striae" is also a general term referring to thin, narrow grooves or channels, or a thin line or band especially if several of them are parallel or close together.
Striae atrophicae
Classification and external resources

Stretch marks near the Navel
ICD-10 L90.6
ICD-9 701.3
DiseasesDB 30027
MedlinePlus 003287
eMedicine derm/406

Stretch marks or striae (singular stria), as they are called in dermatology, are a form of scarring on the skin with an off-color hue. They are caused by tearing of the dermis, and over time can diminish but not disappear completely.

Stretch marks are often the result of the rapid stretching of the skin associated with rapid growth (common in puberty) or weight gain (e.g. pregnancy or muscle building) or in some cases, severe pulling force on skin that overcomes the dermis's elasticity.[citation needed] Stretch marks may also be influenced by hormonal changes associated with puberty, pregnancy, muscle building etc.[1] Medical terminology for these kinds of markings includes striae atrophicae, vergetures, stria distensae, striae cutis distensae, striae gravidarum (in cases where it is caused by pregnancy), lineae atrophicae, striae distensae, linea albicante, or simply striae.

Contents

Symptoms and signs

They first appear as reddish or purple lines, but tend to gradually fade to a lighter range. The affected areas appear empty and are soft to the touch.[2]

Stretch marks occur in the dermis, the resilient middle layer that helps the skin retain its shape. No stretch marks will form as long as there is support within the dermis. Stretching plays more of a role in where the marks occur and in what direction they run. Stretching alone is not the cause.[3]

Stretch marks can appear anywhere on the body, but are most likely to appear in places where larger amounts of fat are stored. Most common places are the abdomen (especially near the navel), breasts, upper arms, underarms, thighs (both inner and outer), hips, and buttocks. They pose no health risk in and of themselves, and do not compromise the body's ability to function normally and repair itself.[4]

Causes

The glucocorticoid hormones responsible for the development of stretch marks affect the epidermis by preventing the fibroblasts from forming collagen and elastin fibers, necessary to keep rapidly growing skin taut. This creates a lack of supportive material, as the skin is stretched and leads to dermal and epidermal tearing. If the epidermis and the dermis has been penetrated, laser will not remove the stretch marks.[5]

Skin subjected to more stretching force than it can handle will tear. Hormonal changes and genetics influence the skin's capacity to withstand stretching forces, as do diet and [possibly] exercise.[6]

Prevention and removal

Between 75% and 90% of women develop stretch marks to some degree during pregnancy. The sustained hormonal levels as a result of pregnancy usually means stretch marks may appear during the sixth or seventh month, primarily during the 3rd trimester, as that is when skin tends to be subjected to higher levels of stretching forces.

Only one randomized controlled study has been published which claimed to test whether oils or creams prevent the development of stretchmarks. This study found a daily application of a cream containing Gotu Kola extract, vitamin E, and collagen hydrolysates was associated with fewer stretch marks during pregnancy.[7][8] Another study, though lacking a placebo control, examined a cream (Verum) containing vitamin E, panthenol, hyaluronic acid, elastin and menthol. It was associated with fewer stretch marks during pregnancy versus no treatment.[9]

Though cocoa butter is an effective moisturizer, no research studies have shown its ability to either prevent stretchmarks, or to reduce their appearance once a stretch mark has already formed.

Various treatments are available for the purpose of improving the appearance of existing stretch marks, including laser treatments, dermabrasion, and prescription retinoids.[citation needed] Some cream manufacturers claim the best results are achieved on recent stretch marks; however, few studies exist to support these claims.

A study in the journal Dermatologic Surgery showed that radiofrequency combined with 585-nm pulsed dye laser treatment gave "good and very good" subjective improvement in stretch marks in 33 of 37 patients, although further studies would be required to follow up on these results. In addition, the use of a pulsed dye laser was shown to increase pigmentation in darker skinned individuals with repeated treatments.[10]

A surgical procedure for removing lower abdominal stretch marks is the tummy tuck, which removes the skin below the navel where stretch marks frequently occur.

A new modality, fractional laser resurfacing, offers a novel approach to treating striae. Using scattered pulses of light only a fraction of the scar is zapped by the laser over the course of several treatments. This creates microscopic wounds. The body responds to each treatment by producing new collagen and epithelium. In a 2007 clinical trial, 5-6 treatments resulted in striae improving by as much as 75 percent.[11] A 2007 Brazilian clinical study showed that fractional laser resurfacing improved both texture and appearance of mature, white striae in skin types I-IV.[12]

A recent study of new modality for the treatment of stretch mark published in the Journal of Dermatological Treatment. The study entitled “Treatment of striae distensae with a TriPollar radiofrequency device: A pilot study" by Dr. Manuskiatti et al. - See full article[1] was done on seventeen females with stretch marks that underwent six weekly treatments. Results showed that at one week after the final (sixth) treatment 38.2% and 11.8% of the patients were assessed to have 25-50% and 51-75% improvement in the appearance of their stretch marks, respectively. The long term effect of the treatment was confirmed during the 6 weeks follow up which showed that a higher percentage of the patients were rated to have improvement of their stretch marks, including 26.5% and 5.9% showing 51-75% and >75% improvement, respectively. None of the participants was rated as having no improvement in their clinical appearance of stretch marks. Patient satisfaction was also measured and 65% of patients reported that they were very satisfied with the treatment, 23% were satisfied and 12% were slightly satisfied.

See also

References

  1. ^ Bernstein, Eric. What Causes Stretch Marks?. 15 December 2008. The Patient's Guide to Stretch Marks. 10 Feb 2009
  2. ^ "Stretch Mark". Encyclopedia Britannica. http://www.britannica.com/EBchecked/topic/568975/stretch-mark. Retrieved 2009-11-01. 
  3. ^ "About Stretch Marks". All About Stretch Marks. AllAboutStretchMarks.com. http://www.allaboutstretchmarks.com/. Retrieved 2009-11-01. 
  4. ^ "How to prevent and treat stretch marks". www.ivillage.co.uk. iVillage. http://www.ivillage.co.uk/beauty/bodybasics/stretch/articles/0,,548150_183143,00.html. Retrieved 2009-11-01. 
  5. ^ "Cell Therapy Targets Gum Disease, Stretch Marks". Sexual Health. sexualhealth.com. http://sexualhealth.e-healthsource.com/?p=news1&id=525439. Retrieved 2009-11-01. 
  6. ^ "Role of Hormones In the Development of Stretch Marks". Stretch Marks. nostrechmarks.com. http://www.nostrechmarks.com/hormones-stretch-marks.html. Retrieved 2009-11-01. 
  7. ^ Mallol, Belda, Costa, Noval, and Sola. (1991). "Prophylaxis of Striae gravidarum with a topical formulation. A double blind trial.”". International Journal of Cosmetic Science 13 (13, 51-57): 51. doi:10.1111/j.1467-2494.1991.tb00547.x. 
  8. ^ Young GL, Jewell D. (2000). "Creams for preventing stretch marks in pregnancy". Cochrane Database Syst Rev (2): CD000066. doi:10.1002/14651858.CD000066. PMID 10796111. 
  9. ^ Young GL, Jewell D. (1996). "Creams for preventing stretch marks in pregnancy". Cochrane Database of Systematic Reviews (1). doi:10.1002/14651858.CD000066. http://www.cochrane.org/reviews/en/ab000066.html. 
  10. ^ Suh D, Chang K, Son H, Ryu J, Lee S, Song K (2007). "Radiofrequency and 585-nm pulsed dye laser treatment of striae distensae: a report of 37 Asian patients". Dermatol Surg 33 (1): 29–34. doi:10.1111/j.1524-4725.2007.33004.x. PMID 17214676. 
  11. ^ Petrou I (February 2007). "Fractional photothermolysis tackles striae distensae". Dermatology Times 28 (2): 94–106. http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=401949. Retrieved 2007-05-23. 
  12. ^ "Fractional Photothermolysis for the treatment of Striae Distensae" Otavio Macedo, Consultório Clínico Dr. Otávio Macedo Ltda, Brazil, 2007.







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