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Pregnancy is a transformative experience, both emotionally and physically. Among the many bodily changes that women undergo during this time, stretch marks—known medically as striae gravidarum—are among the most common and often the most distressing. While they pose no health risk, stretch marks can have a significant impact on body image and self-esteem, especially in the postnatal period.
Understanding what causes stretch marks and the available treatments can help new mothers feel more empowered and confident in their skin. In this article, we’ll explore the science behind stretch marks after pregnancy, the different types of stretch marks, why they form, and the clinically proven treatments available today—from topical creams to in-clinic laser and injectable treatments.
Stretch marks are linear scars that develop in the dermis—the middle layer of the skin—when the skin is stretched beyond its capacity to adapt. During pregnancy, as the abdomen, breasts, thighs, and hips expand rapidly to accommodate the growing baby, the skin’s collagen and elastin fibres can tear, resulting in visible lines or streaks on the skin’s surface.
Striae gravidarum specifically refers to stretch marks that develop during pregnancy, typically appearing in the second or third trimester. They are most common on the abdomen, but can also affect the breasts, buttocks, hips, and thighs.
Stretch marks can vary in appearance depending on the individual's age, skin type and tone.
There are two primary types:
These are the early-stage stretch marks and appear red, pink, purple, or even dark brown. The redness is due to the inflammation and the visibility of blood vessels under the skin. At this stage, the stretch marks may feel slightly raised or itchy.
With time, red stretch marks fade and become white or silvery, indicating that the inflammation has resolved and the blood vessels have constricted. These stretch marks are usually flattened, depressed, and more difficult to treat. They represent permanent dermal scarring and collagen loss.
Stretch marks often co-exist with other post-pregnancy concerns, such as loose abdominal skin, stubborn fat and caesarean scars.
While mechanical stretching of the skin plays a major role, the development of stretch marks is influenced by multiple factors:
Pregnancy hormones can weaken collagen and elastin in the dermis, making skin more prone to tearing.
If your mother or sister had stretch marks during pregnancy, you're more likely to develop them as well. Genetics can influence your skin's elasticity and collagen quality.
Rapid or excessive weight gain during pregnancy increases skin stretching, contributing to the formation of striae.
Teenage or young mothers may be more susceptible, possibly due to hormonal factors and skin immaturity.
Lighter-skinned women may notice red or pink marks more easily, whereas women with darker skin tones may develop deeper pigmented marks.
There is no "miracle cure" for stretch marks, especially once they become white and mature. However, various treatments can enhance their appearance, texture, and pigmentation. The earlier you intervene—ideally while the stretch marks are still red—the better the potential outcome.
Topical treatments for stretch marks are common, with many over-the-counter creams promising dramatic results. Most women have tried some form of stretch mark cream or oil after pregnancy. Stretch mark creams usually contain the following ingredients:
Centella Asiatica, aka gotu kola or tiger grass, is a herbaceous plant native to wetlands in Asia. It's used in traditional medicine for wound healing and skin conditions, and is increasingly popular in skincare for its soothing and antioxidant properties. It's known to help with skin irritation, blemishes, and potentially improve the appearance of scars
Multiple studies suggest that creams containing Centella Asiatica may reduce the incidence and severity of stretch marks in pregnant women. A randomised controlled trial found that a cream containing Centella Asiatica, vitamin E, and collagen-elastin hydrolysates significantly reduced the development of stretch marks compared to a placebo. (Mallol J et al., Int J Cosmet Sci. 1991)
Hyaluronic acid is a naturally occurring substance in the body, primarily known for its ability to retain moisture. In skincare, it's a popular ingredient in serums, moisturisers, and other products due to its humectant properties, meaning it attracts and holds onto water, helping to hydrate and plump the skin. Daily application of a hyaluronic acid-containing cream reduced the likelihood of developing stretch marks. Hyaluronic acid improves skin hydration and elasticity. In a 2016 systematic review of stretch mark treatments, hyaluronic acid was one of the few ingredients with moderate evidence of benefit. (Ud-Din S et al., Clin Exp Dermatol. 2016)
Do topical treatments for stretch marks really work? Well, if they really did, there wouldn’t be any women with stretch marks after pregnancy A 2012 Cochrane review concluded that there is limited and poor-quality evidence for the effectiveness of topical treatments in preventing stretch marks.
(Brennan M et al., Cochrane Database Syst Rev. 2012). A 2016 review in Clinical and Experimental Dermatology noted that some ingredients (like hyaluronic acid and Centella Asiatica) show promise, but emphasised the need for more robust clinical trials. (Ud-Din S et al., Clin Exp Dermatol. 2016)
For significant improvements in stretch marks, in-clinic procedures like fractional CO₂ lasers, RF microneedling, or biostimulatory injectables like Sculptra are typically recommended.
Fractional CO2 laser is a potent resurfacing treatment that uses laser energy to create controlled micro-injuries in the skin, stimulating the body's natural wound-healing process and collagen production. Most commonly used on the face to treat acne scars, fractional CO2 laser can be used on the body to resurface stretch marks.
The fractional CO2 laser beams penetrate the dermis where stretch marks reside, breaking down scar tissue and promoting new collagen remodelling. Laser treatment improves the texture, colour, and depth of both red and white stretch marks. In addition, the Fractional CO2 laser can treat caesarean scars. 4-6 treatments a month apart are required, with downtime of 3-7 days after treatment (redness, swelling and skin flaking).
Radiofrequency (RF) microneedling involves performing microneedling with specialised gold-tipped needles that emit radiofrequency energy to boost collagen production in deeper layers of the skin. Using the SecretDUO platform (RF microneedling + fractional erbium glass laser), fine needles create microchannels in the skin, and RF energy is delivered into the dermis, heating tissue and promoting collagen and elastin synthesis. RF microneedling is effective for both red and white stretch marks, has minimal downtime (1–2 days of redness) and improves skin texture and tightness. RF microneedling is often recommended for postpartum women due to its safety profile, low downtime and ability to treat multiple skin concerns simultaneously (abdominal stretch marks and loose skin). 3-4 treatments a month apart are recommended.
Sculptra is an injectable collagen biostimulator made from poly-L-lactic acid (PLLA). It’s typically used for facial rejuvenation but is gaining popularity as a treatment for stretch marks due to its ability to stimulate collagen production. Sculptra is injected into the dermis beneath the stretch mark, where it gradually triggers the body to produce collagen. Over 2-3 months, skin quality and firmness improves and stretch marks become less visible. Sculptra injections are able to address abdominal stretch marks and loose skin simultaneously and can be combined with RF microneedling treatments. The effects of Sculptra are long-lasting, and Sculptra injections are minimally invasive with no downtime. 2-3 sessions of Sculptra injection is required, with 2-3 vials of Sculptra injected per session.
Stretch marks after pregnancy are incredibly common—affecting up to 90% of pregnant women—and while they are a natural part of the body’s transformation, many women seek treatments to improve their appearance. From topical creams to in clinic procedures like Fractional CO2 lasers, RF microneedling and Sculptra, there are now more options than ever to help address post pregnancy stretch marks.
At Bay Aesthetics Clinic, Medical Director Dr Hoe Ying Min has helped hundreds of women with their post partum issues. As a working mother herself, she deeply understands her patients and provides dedicated and personalised care.
Contact us to begin your post partum journey of restoration and healing.
