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Striae Gravidarum

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Striae Gravidarum, Striae Albicantes, Stretch Marks of Pregnancy

Epidemiology

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

Risk Factors

Younger age
Fetal Macrosomia
Obesity (higher prepregnancy BMI)
Family History
Non-caucasian

Physiology

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

Signs

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

Management
Antepartum

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

Management
Postpartum

Typical course is for striae to fade postpartum
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
Other dermatologic procedures
1. Pulsed dye laser at 585 nm
2. Microdermabrasion
3. Radiofrequency
4. Microneedling

References