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Stretch marks: a review

Stretch marks (SM) feature visible linear scars developing on the body in the areas of excessive stretching of the skin. This is a benign skin condition, but because of their aesthetic implications, they can cause distress among their sufferers. SM show high prevalence, probably more than 50 % among pregnant women, and 50 to 90 % in the general population. SM affect more likely certain ethnic groups, especially dark-skinned patients. During pregnancy, risk factors include family history, but also important weight gain whilst more generally elevated body mass index also constitutes a risk factor. Clinically, the initial erythematous and violaceous lesions referred to as striae rubrae fade into wrinkled, hypo-pigmented, atrophic scar-like marks named striae albae. Four main theories support SM formation: 1) mechanical stretching of the skin; 2) hormonal changes; 3) an innate structural disturbance of the integument; 4) genetic predispo­sitions. Histologically various abnormalities of collagen and elastic fibres are described at dermal level. The treatment of SM is always deceptive. Topical treatments are the commonest, among them Centella asiatica or hyaluronic acid creams, almond oil, topical retinoids, cocoa butter or olive oil are the most popular. Chemical peels may also be used with limited success. Various office procedures may also be performed, such as microdermabrasion, radiofrequency, laser/light therapy, platelet-rich plasma and others, but the results are often limited and deceptive for both the patient and the dermatologist. More remains to be done about the study of this frequent dermatological disorder.