Stretch marks: how to prevent, fade and treat them

Stretch marks are very common, and they are not a sign that you did anything wrong. They are a type of scar in the deeper layer of skin, so no cream can erase them, but new marks respond better to treatment than old ones.

Quick answer: Treat stretch marks early, while they are still red, pink or purple. Moisturizing, hyaluronic acid or centella creams may help a little, and a doctor can prescribe tretinoin (not in pregnancy). Old white marks may improve with clinic treatments such as lasers or microneedling, but none removes them. Oils and cocoa butter have not been shown to prevent them.

What are stretch marks and why do they form?

Stretch marks (the medical name is striae) appear when skin stretches or shrinks faster than it can adapt. The collagen and elastin that support the deeper skin layer (the dermis) are pulled apart, and the skin heals with thin, scar-like lines. Hormones also seem to play a role.

Common triggers include:

• growth spurts in puberty;
• pregnancy, especially the later months;
• fast weight gain or weight loss;
• fast muscle gain from weight training;
• long-term use of strong steroid creams or tablets.

Genes matter a lot. If your mother or sister has them, you are more likely to get them. They can affect anyone, including men and boys.

Two stages: red marks and white marks

Stretch marks change over time, and the stage decides what is most likely to help.

Over months to years, red marks usually fade to a lighter, paler color. This is normal and not a sign that treatment failed.

Can you prevent stretch marks?

Not reliably. A Cochrane review pooled six small trials of creams and oils used in pregnancy, involving about 800 women. It found no good evidence that any product prevents stretch marks, and the authors noted the studies were small. The NHS also says there is very little evidence that creams prevent or remove them.

What the evidence does and does not say:

• Cocoa butter, olive oil, almond oil and vitamin E did not prevent marks in studies, according to the American Academy of Dermatology. They can still feel pleasant and keep skin comfortable.
• Hyaluronic acid and centella creams may help, but the evidence is limited and the studies are small.
• Slow, steady weight change gives skin more time to adapt. This is sensible, but it cannot override genetics.
• Daily moisturizing may ease dryness and itching. Choose a plain body lotion, and see dry body skin if the skin also feels tight.

If you are pregnant, a gentle moisturizer is a safe choice. Ask your doctor before using any active ingredient on your belly.

Creams that may help new, red marks

Creams work best on early marks, applied every day for weeks to months. No cream makes marks disappear.

• Hyaluronic acid: a humectant, an ingredient that draws water into the skin. In two larger studies mentioned by the AAD, it made early marks less noticeable.
• Centella asiatica: a plant extract used in cosmetics for skin comfort. Evidence for stretch marks is weak, but it is gentle.
• Retinoids: these vitamin A ingredients are the most studied. In one study, prescription tretinoin used nightly for 24 weeks made early marks less noticeable. Retinol, the milder over-the-counter form, may also help new marks. If you are pregnant or breastfeeding, ask your doctor before using any retinoid. Retinoids can also make skin more sensitive, so use sunscreen every day on exposed areas.

Results tend to be better when a product is massaged in and used daily on early marks.

Clinic treatments for older marks

Dermatologists and trained clinicians use light, energy and needle-based treatments to stimulate collagen. These are cosmetic procedures. Results vary, and they depend on who does them.

• Pulsed dye laser: targets blood vessels, so it suits new red marks. It does little for white ones.
• Fractional lasers: make tiny controlled injuries in the skin to trigger remodeling. They can improve texture and color of older marks.
• Microneedling: a device with fine needles that creates tiny channels in the skin. Small studies suggest it can improve both red and white marks.
• Radiofrequency: uses heat energy to stimulate collagen, often combined with needling.
• Chemical peels and microdermabrasion: sometimes used, with modest effects.

Most people need several sessions, usually spaced about 4 weeks apart. Reviews of these treatments agree that results are modest, that many studies are small, and that no single treatment is clearly best. Side effects are usually temporary, such as redness, swelling, crusting or pain, but lasers can cause dark or light patches, especially in darker skin tones. If you have medium to deep skin tone, choose a clinician with experience in treating your skin type.

These treatments are often not covered by health systems or insurance, so costs are paid privately and vary widely. Always ask for a board-certified dermatologist or a qualified clinician, and avoid cheap offers from unlicensed providers. If you are pregnant or breastfeeding, ask your doctor before any procedure.

Camouflage and sun

• Sun and tanning: tanning makes pale marks stand out more, because the surrounding skin darkens while the marks do not. Daily body sunscreen helps marks blend in.
• Self-tanner: can hide the contrast between white marks and the skin around them, but it does not treat them. See self-tan options. Wait until skin has fully healed before using it after a procedure.
• Body makeup: can cover marks for a day or a special event.

How long until results?

Be realistic. Creams may take 8–16 weeks or more to make new marks look a little better. Clinic treatments are usually judged after a series of sessions. Many marks fade on their own as they age, but fully clearing them is not a realistic goal. Seeing them as part of your skin's story is a healthy goal too, and many people choose not to treat them at all.

What not to do

• Retinoids during pregnancy or breastfeeding: avoid unless your doctor says otherwise.
• Strong steroid creams on large areas for long periods: they can cause new stretch marks and thin skin. Use only as prescribed.
• Aggressive scrubbing or harsh "stretch mark" products: they are unlikely to help and may irritate.
• Self-tanner right after a laser or microneedling session: wait for the skin to heal.

When to see a doctor

• Wide, deep purple marks that appear quickly, especially together with more fat on the chest and tummy, a rounded red face, easy bruising or high blood pressure. These can be signs of Cushing's syndrome and need a medical check.
• Marks that are very itchy, sore or inflamed.
• Marks that appear without weight change, pregnancy or growth, or after using steroid medicines.
• You are considering a laser or needling treatment and want to know the options and risks for your skin tone.

FAQ

Can stretch marks go away completely?

Not completely. Treatment can make them less noticeable, and red marks tend to fade to pale lines over time.

Does cocoa butter or olive oil stop stretch marks?

Studies did not show that they prevent marks better than doing nothing. They are fine as moisturizers if you like them.

Do stretch marks mean I gained too much weight?

No. Growth, puberty, pregnancy, muscle gain, genes and hormones all play a part, and people of every body size get them.

Is it safe to treat stretch marks while pregnant or breastfeeding?

Gentle moisturizers are fine. Retinoids and many clinic treatments are not recommended, so ask your doctor first.

Should I treat them early?

Yes, if you want to treat them at all. New, red marks respond better than old white ones.

Sources

• Stretch marks (NHS)
• Stretch marks: why they appear and how to get rid of them (American Academy of Dermatology)
• Topical preparations for preventing stretch marks in pregnancy (Cochrane)
• Striae distensae treatment review and update (PubMed Central, NIH)