Dr. Bryant Esquejo, ND • Holistic Acne & Eczema Expert

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Stretch Marks & Pregnancy

Intro

Skin changes can happen during pregnancy. A study completed in 2018 where 1935 pregnant females were asked to fill out a questionnaire concerning their skin during pregnancy, 74.78% of females reported skin changes during pregnancy, with: 77.4% of them experiencing stretch marks, and 21.6% of them experiencing acne. Another study completed in 2016 with 600 pregnant females saw that 99% of those females experienced skin changes, and that the most common skin changes were hyperpigmentation (87.6%) and stretch marks (72.8%).

In addition to these common skin changes, pregnant females can also experience:

  • Vascular changes

  • Changes to the skin of the vulva and the vagina

  • Gingivitis

  • Facial and/or body growth

    & more!


This is an ongoing series on skin health during pregnancy, and we have been focusing on the more-common skin changes in pregnancy. In this blog post you will learn more about:

  • What science has to say about why stretch marks happen during pregnancy

  • What science has to say about skin support during pregnancy


NOTE: THIS BLOG POST IS MEANT TO BE EDUCATIONAL ONLY, AND IS NOT MEANT TO DIAGNOSE, PREVENT, TREAT, OR CURE. PEOPLE SHOULD ALWAYS CONSULT THEIR TRUSTED LICENSED PROVIDER BEFORE TRYING ANY NEW TREATMENTS


Stretch Marks (striae gravidarum)

Striae gravidarum (SG), or stretch marks during pregnancy, are described as linear atrophic scars that typically arise during the late second trimester or early third trimester and happens due to changes in connective tissue in the skin. In regards to how stretch marks appear, stretch marks first appear as flat, pink-red bands and then evolve to look raised and longer. And, stretch marks eventually fade overtime and turn hypopigmented/pale. Common locations of stretch marks are: the breasts, abdomen, hips, and thighs. Some reported causes of stretch marks are:


SKIN SUPPORT DURING PREGNANCY

Before starting anything new to address stretch marks, make sure to speak to your doctor to see if it is safe for you.

In regards to what science says about some options for stretch marks, evidence has shown the following:

  1. Cocoa butter & olive oil:

    For prevention, many people are told to put on cocoa butter & olive oil. But, what does science have to say about this?

    Studies completed in 2008 and 2010 revealed that topical application of cocoa butter did not significantly prevent stretch marks.

    In regards to olive oil, studies completed in 2011 revealed that “the use of olive oil to the end of the second trimester in pregnancy was not effective in reducing the occurrence of striae gravidarum” and a study completed in 2012 stated that “olive oil reduces the incidence of severe SG and increases the incidence of mild SG, but it does not significantly reduce the incidence and the severity of SG and it could not be recommended for SG prevention.”

  2. Centella asiatica:

    Centella asiatica (Gotu kola, Tiger grass, Cica) is popping up in many skincare products. In a study published in 2013, this herb has been used in combination with moisturizing ingredients in a cream base, and has shown it was effective at reducing the severity of stretch marks during pregnancy, prevented the progression of stretch marks, and prevented the appearance of new stretch marks. And, when this was used in when who initially had no stretch marks, it was more effective in preventing new stretch marks compared to placebo.

    Centella has also been studied for postpartum management of stretch marks, and a 2018 study revealed that oral supplementation of Centella appeared to improve the appearance of stretch marks in 6 weeks by reducing the number of visible stretch marks and improving skin elasticity.

  3. Tretinoin cream:

    Tretinoin is a vitamin A derivative (called a retinoid), and retinoids are not safe during pregnancy and are not safe during lactation/breastfeeding. Meaning, that it might be recommended by a provider to use postpartum to manage stretch marks. There are minimal studies looking at the effect of tretinoin on pregnancy-related stretch marks, but what a small study completed in 2001 showed was that topical tretinoin used daily for 3 months “significantly improved the clinical appearance of pregnancy-related stretch marks.”

    There are multiple studies that has evaluated tretinoin and non-pregnancy-related stretch marks. A study completed in 2014 comparing topical tretinoin to microdermabrasion for non-pregnancy-related stretch marks showed that “both treatments had similar efficacy,” with significant improvement of early stretch marks compared to their baseline appearance. And a study completed in 2018 comparing topical tretinoin to platelet-rich plasma (PRP) injections for non-pregnancy-related stretch marks show that there was signficaing improvement of stretch marks with both tretinoin and PRP infections, but that “PRP is more effective and it gives better therapeutic response than tretinoin,”

    All in all, more studies need to be completed on pregnancy-related stretch marks, but there is promising evidence from studies evaluating the effect of tretinoin on non-pregnancy-related stretch marks.

  4. Laser treatments & light treatments:

    Fractional lasers have been shown to be helpful for reducing stretch marks, with a small study completed in 2014 revealing that 4 treatments given at 4-week intervals improved the appearance of stretch marks. And, another small study completed in 2015 revealing that 3 non-consecutive treatments improved the appearance of stretch marks.

    In regards to light treatments, one type of light treatment that is widely available is intense-pulsed light (IPL). And, IPL has been shown a promising options for stretch marks as a 2013 study comparing different wavelengths of IPL showing that different wavelengths were all effective at reducing the appearance of stretch marks. And, a study comparing pulse dye lasers (PDL) and IPL for stretch marks revealed that both PDL and IPL were effective at reducing the appearance of stretch marks, that both were effective at inducing collagen production in stretch marks, and that PDL was more effective at producing type 1 collagen.


Summary & Takeaways

This is just Part 1 of an ongoing series about skin health during pregnancy. In this part, we only covered stretch marks during pregnancy and spoke about why stretch marks happen and what evidence-based options a licensed provider may recommend to their patients. In future posts, I will cover acne during pregnancy and hyperpigmentation during pregnancy!

Here’s a summary of what was spoken about in this blog:

  1. Always speak to your trusted provider before buying and starting any new products or treatments to see if it’s safe for you, to get the best recommendations for brands, and to get the best recommendations for how to use them. And take note that retinoids are NOT SAFE DURING PREGNANCY AND ARE NOT SAFE DURING BREASTFEEDING.

  2. Stretch marks during pregnancy typically arise during late second trimester or early third trimester, and common locations for stretch marks during pregnancy are the breasts, abdomen, hips, and thighs.

  3. Evidence reveals that cocoa butter and olive oil are not effective at preventing stretch mark during pregnancys. Centella, however, has been shown to be effective at preventing stretch marks during pregnancy, and is something to speak to a provider about before starting topical Centella, as there are SO MANY different product options out there.

  4. There are various postpartum options for managing stretch marks, which include laser treatments, light treatments, microdermabrasion, platelet-rich-plasma (PRP) treatments, and more.

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DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. DR. BRYANT ESQUEJO, ND HAS NO FINANCIAL TIES TO ANY SUPPLEMENT COMPANIES, PHARMACEUTICAL COMPANIES, OR TO ANY OF THE PRODUCTS MENTIONED IN THIS POST. THIS POST IS NOT MEANT TO TREAT, CURE, PREVENT, OR DIAGNOSE CONDITIONS OR DISEASES AND IS MEANT FOR EDUCATIONAL PURPOSES. AS ALWAYS, PLEASE CONSULT YOUR DOCTOR BEFORE TRYING ANY NEW TREATMENTS OR SUPPLEMENTS.