Stretch Marks (Striae): What Actually Works and What Does Not

Stretch marks are a form of scarring in the deeper layer of the skin that appear when the skin stretches quickly, and while they usually fade over time, no cream, oil or procedure can reliably make them disappear completely. Treatment works best on early red or purple marks, and options such as topical retinoids, microneedling and lasers can make them softer and less noticeable, with results that vary from person to person.

Stretch marks are extremely common in India, in pregnant women, teenagers going through growth spurts, gym goers building muscle quickly, and people who have gained or lost weight. They are also a common side effect of steroid creams misused for fairness or fungal infections.

What are stretch marks and why do they form?

Stretch marks, called striae distensae by doctors, form when the dermis, the supportive middle layer of the skin, is stretched faster than it can adapt. The collagen and elastic fibres that give skin its strength and bounce get damaged, and the skin heals with thin, scar like lines.

Common triggers include:

• Pregnancy, especially in the last months, on the belly, breasts, hips and thighs
• Puberty and growth spurts, on the thighs, hips, buttocks, breasts and back
• Rapid weight gain or loss
• Bodybuilding with fast muscle growth, often on the shoulders and upper arms
• Steroid creams applied for long periods, especially in the groin, thighs and underarms
• Steroid tablets or injections and, less commonly, medical conditions that raise cortisol levels
• Family history, since some people are simply more prone

What do stretch marks look like?

Stretch marks change appearance over time:

Stage	Name	Appearance
Early	Striae rubrae	Raised, pink, red, purple or dark brown lines, may itch
Late	Striae albae	Flat or slightly sunken, pale, white or silvery lines, may feel wrinkled

On Indian skin, early marks may look dark brown or purplish rather than red, and late marks often look lighter than the surrounding skin, which can make them more noticeable.

Can creams and oils prevent stretch marks?

Many products are sold in India for stretch mark prevention, including coconut, almond and other oils, cocoa butter, and creams with plant extracts. Regular massage with a moisturiser is safe, keeps the skin comfortable and can ease itching during pregnancy. However, the evidence that any of these reliably prevents stretch marks is limited. Many people use them faithfully and still develop marks, because genetics and the speed of stretching play a large role.

Reasonable steps that are safe:

• Moisturise the skin daily, especially in pregnancy when the belly feels tight and itchy.
• Aim for gradual, steady weight changes where possible.
• Avoid using steroid creams on the skin without a prescription.

For safe skincare choices during pregnancy, see our guide on skin changes in pregnancy.

What treatments can make stretch marks less visible?

Treatments aim to stimulate new collagen, reduce redness or colour difference, and improve texture. Research reviews, including a network meta analysis of different therapies, suggest that several procedures can produce improvement, but study quality varies and no option works for everyone.

Topical treatments

• Topical retinoids may help early red marks when used consistently, under medical guidance. They are not used during pregnancy or breastfeeding.
• Products with ingredients such as hyaluronic acid or centella are sometimes used, with modest and variable evidence.

Topical treatments tend to do little for older white stretch marks.

In clinic procedures your dermatologist may consider

• Microneedling, which creates tiny controlled injuries to stimulate collagen. Our microneedling and PRP guide explains what to expect.
• Fractional lasers, which treat tiny columns of skin at a time to trigger remodelling
• Vascular lasers or light treatments to reduce redness in early marks, with caution on darker skin
• Radiofrequency microneedling, combining needles with heat
• Chemical peels in some cases, mainly for texture and colour
• PRP (platelet rich plasma), sometimes combined with microneedling or lasers

Most procedures need several sessions spaced weeks apart. Improvement is gradual and partial.

What should Indian skin types know before procedures?

Brown skin (Fitzpatrick types III to VI) has a higher risk of post inflammatory hyperpigmentation, meaning dark patches after heat, injury or inflammation. This matters for stretch mark procedures.

• Lasers and energy settings must be chosen carefully for darker skin.
• Sun protection before and after treatment helps reduce dark marks.
• Aggressive treatments in the summer months, or before travel in strong sun, may be best avoided.
• A test patch may be suggested before a full session.

Choose a qualified dermatologist who regularly treats Indian skin. Our article on dark spots and post inflammatory hyperpigmentation explains why this matters.

Can steroid creams cause stretch marks?

Yes. Long term use of potent steroid creams, often sold over the counter in India in combination with antifungals or as fairness creams, can thin the skin and cause stretch marks, especially in the groin, inner thighs, underarms and face. These steroid induced stretch marks are often permanent.

If you are using such a cream, do not keep applying it, but also speak to a doctor about stopping, as suddenly stopping after long use can cause a flare of the original problem. Read more in our article on topical steroid misuse and fairness creams and our guide to jock itch that keeps coming back.

When can stretch marks point to a medical condition?

Most stretch marks are completely harmless. However, see a doctor if:

• Wide, purple or dark stretch marks appear suddenly without pregnancy, growth or weight change.
• They come with weight gain around the belly, a rounder face, easy bruising, muscle weakness or high blood pressure.
• They appear in a child who is not going through a growth spurt.
• You have been taking steroid tablets or using steroid creams for a long time.

These can occasionally be signs of high cortisol or other hormonal problems that need investigation.

Do stretch marks in teenagers need treatment?

Stretch marks during puberty are very common in both boys and girls, on the thighs, hips, buttocks, breasts, back and knees. They are a normal result of rapid growth and usually fade a lot over the following years without any treatment. Reassurance is often all that is needed. Gentle moisturising is fine. A doctor should take a look if the marks are very wide and purple, appear without a growth spurt, or come with rapid weight gain, as described above. Teenagers should also avoid applying steroid or fairness creams, which can cause new stretch marks.

Setting realistic expectations

It helps to know:

• Stretch marks are a normal part of many people’s bodies, and many fade a great deal on their own.
• Treatment can make them softer, flatter and closer in colour to nearby skin.
• Complete removal is not a realistic expectation, and any clinic promising it should be approached with caution.
• Costs in India vary widely, and several sessions may be needed.

When to see a dermatologist

See a dermatologist if:

• Stretch marks appear suddenly or without a clear cause.
• You have used steroid creams or tablets.
• Early stretch marks are bothering you and you want to discuss treatment while they are still red or purple.
• You are pregnant or breastfeeding and want to know which products are safe.
• You are considering lasers or microneedling and want advice suited to Indian skin.

Dr. Maria offers online consultations to look at your stretch marks, discuss realistic options and help you decide whether in clinic treatment is worth it for you.