Striae Gravidarum

1. Epidemiology
   1. Incidence: 90% of pregnant women by third trimester
2. Risk Factors
   1. Fetal Macrosomia
   2. Obesity
   3. Family History
   4. Non-caucasian
3. Physiology
   1. Related to Stretching with pregnancy
      1. Deep collagen deposits break apart
   2. Also associated with increased ACTH secretion
      1. Affects connective tissue
4. Signs
   1. Red, pink, or purple depressed atrophic bands, streaks
   2. Distribution (occurs in areas of higher fat)
      1. Abdomen
      2. Buttocks
      3. Breasts
      4. Thighs
      5. Arms
   3. Regress after delivery
      1. Residual white streaks remain (Striae Albicantes)
5. Management: Antepartum
   1. Minimal evidence of benefit of any topical in pregnancy
   2. Combination products with possible benefit
      1. Tocopherol, Fatty Acids, panthenol, hyaluronic acid
      2. Centella asiatica, alpha-tocopherol, collagen-elastin
         1. Unclear safety in pregnancy
6. 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
   3. System retinoids have been used
   4. Pulsed dye laser at 585 nm
7. References
   1. Kang (1998) J Am Acad Dermatol 39:S90-2 [PubMed]
   2. McDaniel (2002) Dermatol Clin 20:67-76 [PubMed]
   3. Tunzi (2007) Am Fam Physician 75:211-8 [PubMed]