Striae Gravidarum

Aka: Striae Gravidarum, Striae Albicantes, Stretch Marks of Pregnancy

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II. Epidemiology

  1. Incidence: Up to 90% of pregnant women by third trimester

III. Risk Factors

  1. Younger age
  2. Fetal Macrosomia
  3. Obesity (higher prepregnancy BMI)
  4. Family History
  5. Non-caucasian

IV. Physiology

  1. Related to Stretching and skin distention with pregnancy
    1. Deep Collagen deposits break apart
  2. Also associated with increased ACTH secretion and other hormonal changes (Estrogen, relaxin)
    1. Affects connective tissue

V. Signs

  1. Red, pink, or purple depressed atrophic bands, streaks associated with skin distention
  2. Most commonly develop in third trimester
  3. Distribution (occurs in areas of higher fat)
    1. Abdomen
    2. Buttocks
    3. Breasts
    4. Thighs
    5. Arms
  4. Regress after delivery
    1. Residual white streaks remain (Striae Albicantes)

VI. Management: Antepartum

  1. Minimal evidence of benefit of any topical in pregnancy
  2. Combine topical agents with daily Skin Massage of the involved regions
  3. Topical agents that have used include cocoa butter, Vitamin E, olive oil, almond oil and aloe vera
  4. Combination products with possible benefit
    1. Tocopherol, Fatty Acids, panthenol, hyaluronic acid
    2. Centella asiatica, alpha-tocopherol, Collagen-elastin
      1. Unclear safety in pregnancy

VII. Management: Postpartum

  1. Typical course is for striae to fade postpartum
  2. Topical Retin A
    1. Indicated if striae in early stages (still red)
    2. May reduce residual changes
    3. Do not use concurrently in pregnancy or Lactation
    4. Systemic Retinoids have been used
  3. Other dermatologic procedures
    1. Pulsed dye laser at 585 nm
    2. Microdermabrasion
    3. Radiofrequency
    4. Microneedling

VIII. References

  1. Erlandson (2023) Am Fam Physician 107(2): 152-8 [PubMed]
  2. Farahnik (2016) Int J Womens Dermatol 3(2): 77-85 [PubMed]
  3. Kang (1998) J Am Acad Dermatol 39:S90-2 [PubMed]
  4. McDaniel (2002) Dermatol Clin 20:67-76 [PubMed]
  5. Tunzi (2007) Am Fam Physician 75:211-8 [PubMed]

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