Nov 22, 2008

Wrinkle Free New treatment for stretch marks

They are a natural skin condition, but nobody likes them: stretch marks. And in this segment of Wrinkle Free Friday, doctors give us advice about how to fix a very common complaint about the skin on the body. Sooner or later they will affect just about all of us.

"Ninety percent of us have stretch marks on us somewhere, so it's not even a disease, it's just a common marker of human beings," says Metairie dermatologic surgeon Dr. Bill Coleman.

Any fast growing skin is susceptible: hips, thighs, buttocks and breasts of maturing teenagers, the belly of an expectant mom, the chest and upper arms of a body builder and the body of anyone who gains weight. And something you have no control over, they tend to be hereditary.

"If when your mother was pregnant she got a lot of stretch marks, the chances are good you will have the same problem," says Dr. Mary Lupo, a dermatologist in New Orleans.

So what are these unattractive lines?

"A stretch mark is basically a rupture in the skin. Think of a fabric that's torn and the little elastic fibers pull back. That's what happens to your skin," adds Dr. Coleman.

The doctors agree. The only way to try to prevent them is by not gaining a lot of weight during pregnancy or puberty.

"You can rub all the cocoa butter in the world on your tummy and that's not going to stop you from getting stretch marks necessarily," says Metairie dermatologist Dr. Patricia Farris.

"All of this these myriad of creams that are being sold to treat stretch marks, they do not remove stretch marks and that's the bottom line on that and I don't care if they cost $10 or $100. It doesn't make any difference. It doesn't work," says LSU Health Sciences Center dermatologist Dr. Elizabeth McBurney, who practices in New Orleans and Slidell.

But there is something that makes stretch marks worse, taking steroids for legitimate medical reasons or illegally.

"A very common scenario we see is men who come in and tell us 'Look how great I look,' and they show us their big muscles and on top of them are these huge stretch marks and then they have acne too from taking the steroids and they are going bald and on balance they don't look very good," adds Dr. Coleman.

So how can you get rid of stretch marks?

Dermatologists say there's good news and bad. The good news is the prescription tretinoin cream, called Retin A, that is used for acne and wrinkles, can make a difference.

"If you come in while the stretch marks are still red you've got a very good chance, maybe as high as 70 percent with topical treatments alone getting results and that will save you a lot of money," says Dr. Lupo.

"I think the best time to treat a stretch mark is when it's early young stretch mark as we call them those are the red stretch marks. We like things that generate collagen alpha hydroxys and particularly tretinoin, Retin A, has been shown to improve stretch marks even when used alone," says Dr. Farris.

But doctors caution these creams should not be used during pregnancy.

The other good news is that doctors are starting to see some results with lights and lasers. One is that non-ablative Fraxel laser that's been used on the face that heats up but doesn't burn the skin.

"When they are in that early stage I do think that certain laser procedures help and I usually use a combination. I like the IPL (Intense Pulsed Light) because I think that does the best job in taking the red out and then you can generate new collagen with the non-ablative fractional lasers," adds Dr. Farris.

"If your stretch marks are red or slightly brown, they, and the reason they are because they are usually newly formed and they have an inflammatory reaction underneath the skins surface that causes them to be red, with those, those are probably the only situation in which I think the lasers make a significant difference," adds Dr. McBurney.

Most of the doctors agree treating them early will give best results, while the older ones are there to stay.

But dermatologist Dr. Mary Lupo says she is seeing some results treating the older ones.

"Once the stretch marks have that silvery or white color the only thing that I have found that has been successful is the Fraxel Restore Laser. This is a non-ablative laser. There's no down time to the procedure. It can be used on all skin types," says Dr. Lupo.

But five or six treatments are needed, which can get costly. So while there is help, doctors say the bad news is they have nothing in their arsenals to make them invisible.

"The Fraxel treatment shows promise but it still is not going to completely remove it. It is going to improve it maybe about 30 percent, 40 percent," says LSU Health Sciences Center plastic surgeon Dr. Kamran Khoobehi.

“All of the lasers that are out there now a days, including the Fraxel Restore, are all going to be good at getting the red out but not the white so you still have a white stretch mark, you still have a little valley there in the skin and that has not changed. We need a way to weld the skin back together. We just don't have it right now," says Dr. Coleman.

Doctors say it can be very embarrassing for teens to have stretch marks and they should be treated as soon as they get them.

Doctors also say one trick to covering up the older light stretch marks is to temporarily cover them with a bronzer.