When does stretch marks start in pregnancy

Although stretch marks are relatively harmless and super common, many of us wish we could stop them from appearing during pregnancy.

Stretch marks, also known as striae gravidarum, are scars that appear when your skin stretches faster than usual.

While some wear their baby-making scars with pride, others feel self-conscious about them. Rapidly stretching skin can also be uncomfortable, adding one more thing to your growing list of pregnancy aches and pains.

If you do want to prevent stretch marks, keeping your skin hydrated so that it can stretch without breaking is your best defense. It may not be possible to completely eliminate them, but you can reduce stretch marks.

We reached out to two dermatologists to find out more about why stretch marks happen and what to do to minimize their appearance.

We get stretch marks when our body grows too fast for our skin to keep up. "This causes the elastic fibers just under the surface of the skin to break," explains Ailynne Marie Vergara-Wijangco, MD, a clinical dermatologist and researcher.

When the skin fibers break, new collagen forms to replace the damaged parts, which is less firm and elastic. "The new collagen may have a different texture, resulting in raised or indented scars," says Dendy Engelman, MD, FACMS, FAAD, a board-certified cosmetic dermatologist and Moh's surgeon at Shafer Clinic.

Dr. Vergara-Wijangco points out that stretch marks are very common in pregnancy, a time when you need to gain weight over a relatively short period. And as Dr. Engelman explains, stretch marks are scars, meaning that you can't make them disappear completely.

Stretch marks are quite common during pregnancy with about 90% of women seeing them sometime during pregnancy, according to Dr. Vergara-Wijangco. Genetics plays a role as well, so if your mom had them, you are more likely to get them too. Younger moms tend to get more stretch marks, presumably because their skin is firmer.

Most women begin to see stretch marks appear around the end of their second trimester, according to Dr. Engelman. "Some women start seeing stretch marks even earlier, and some may not get stretch marks at all. Stretch marks are dependent on each individual woman’s body and how it grows during pregnancy."

The color of your stretch marks may vary depending upon your skin tone. "If you have a lighter complexion, you will tend to develop pinkish stretch marks. [Those with deeper] skin tones tend to get stretch marks that are lighter than their skin tone," says Dr. Vegara Wijangco. 

Stretch marks can appear differently on the skin due to the age and severity of the mark. "Newer marks tend to be darker, while older marks may be more faded," notes Dr. Engelman.

Hydration is your skin's best friend if you want to try to prevent or keep stretch marks to a minimum because moistured skin is less likely to break when it stretches.

Drinking plenty of water to stay hydrated and using a humidifier while you sleep can help your skin stay supple, advises Dr. Engelman.

Frequently moisturizing the areas that are at risk of developing stretch marks, like the stomach, chest, and legs, will help, as well, Dr. Engelman adds.

Dr. Engelman recommends applying multiple products to the prone areas, which creates a layering effect. The result is more protection and hydration, according to the dermatologist. She recommends Bi- Oil and Palmer's Cocoa Butter as products to try.

Some ingredients found in stretch mark prevention products are not safe for use during pregnancy or while breastfeeding. Avoid products containing these ingredients:

• Retinol tightens skin and increases cell turnover, which is great for reducing stretch marks, but can harm a fetus or nursing infant.
• Formaldehyde and formaldehyde releasers "They have been linked to cancer as well as other nervous system issues including chest pain, difficulty breathing, and more," warns Dr. Engelman.
• Parabens, which are actually found in dietary sources more than topical products, have generally been found to be safe. There is a risk of irritation with sensitive skin types and they are being studied for any possible influence on the endocrine system.
• Phthalates help stabilize beauty product formulas but have been linked to pregnancy loss and gestational diabetes. "Avoid ingredients ending in –phthalate," Dr. Engelman advises.

Anecdotal evidence for stretch marks creams, oils, and ointments is easy to find, but there really is not a lot of scientific proof that they work. What we do know is that preventing stretch marks is much more plausible than treating them once they have already formed.

Applying products correctly can make a big difference in whether they work for you. Dr. Engelman offers the following tips for preventing or reducing stretch marks:

1. Begin moisturizing as soon as you find out you are pregnant.
2. If stretch marks have started to appear already, treat them immediately to give them less time to develop and darken.
3. Apply a few drops of oil or a few pumps of cream.
4. Moisturize your stomach, chest, legs, or anywhere else on your body that you know tends to grow when you gain weight. Apply product directly onto any existing stretch marks.
5. Gently massage the product into your skin with your fingers, using a circular motion, for about 30 seconds.
6. Repeat two or three times per day throughout your pregnancy and for the three months after you give birth.

You can't make stretch marks disappear completely, but you can reduce their appearance. Once you are no longer pregnant or breastfeeding, you can consult with a dermatologist to see which procedures that might work for you. Sometimes undergoing more than one treatment works best.

Chemical peels involve applying skin-safe acids to the skin to remove the top layer of skin cells and reveal newer skin cells. "Depending on the strength or level of chemical peel, there are different types of acids that are used," says Dr. Engelman. "Often chemicals like alpha-hydroxy acid (AHA), beta-hydroxy acid (BHA), glycolic acid, retinoic acid, salicylic acid, lactic acid, and more are used during peels."

The strength of the acids in the peel affects the amount of downtime you may experience. "If you receive a light chemical peel, you may experience little to no downtime, although it is advised to stay out of the sun for a couple of days after. If your chemical peel is stronger, it may leave you with up to one to two weeks of downtime," Dr. Engelman explains.

Chemical peels help to reduce the appearance of stretch marks, and are typically performed by a dermatologist. That said, they are not a final solution. “The treatment does not penetrate deeply enough to be very effective at removing stretch marks on its own," notes Dr. Engelman.

Laser therapy uses concentrated lasers to resurface the skin and stimulate collagen growth beneath the skin. "Because the lasers are so precise, they are able to treat problem areas without damaging the surrounding areas of skin," Dr. Engelman explains.

The lasers often used for stretch marks, ablative lasers CO2 and Erbium YAG, cause little to no downtime. "Recovery time might span from zero to a few days," says Dr. Engelman. Laser therapy is not painless, but you should feel no more than a light sting.

Microdermabrasion is a procedure that uses a tool with an abrasive surface to exfoliate the top layer of the skin. It is not painful, but it may feel slightly uncomfortable, like sandpaper rubbing against your skin.

Dr. Engelman says that the microdermabrasion is minimally invasive and can be done in the office with no downtime. "Your skin may be red for a few hours after the procedure, and it is best to stay out of the sun for a few days as your skin will be sensitive," she explains.

This in-office treatment can be performed quickly but is also not a significant or long-term solution to making stretch marks disappear, Dr. Engelman points out.

Ultrasounds aren't just for measuring your baby and finding out the gender. These machines can also aim sound waves at a targeted area to dilate blood vessels. "[It] improves circulation and drainage, and thus prompts the body to repair itself," explains Dr. Engelman.

This treatment has been successful in reducing the appearance of stretch marks without any major risks or safety concerns.

Radiofrequency treatments send radiofrequency waves deep into the skin to stimulate collagen production. Radiofrequency is a type of energy. Energy converts into heat when these waves are sent down into your skin, which encourages collagen production.

"This is a more effective method of stretch mark treatment compared to exfoliation, as it actively stimulates collagen to fill scars in from the inside out," says Dr. Engelman. "The procedure is painless but you may experience a warming sensation on the points of focus." There is no downtime. Radiofrequency is a relatively safe and effective treatment with minimal side effects.

The fact that your body can sustain a developing human being is an amazing feat. It can be easy to get caught up on pregnancy's undesirable side effects, but it can be helpful to try and honor and respect your body more than you mentally tear it down. Try to think of your stretch marks as symbolic of what your body is capable of.