Stretch Marks: What Causes Them and Can They Actually Be Reduced?

Stretch marks form when skin is stretched faster than its collagen and elastin fibers can adapt, causing small tears in the deeper skin layer (the dermis). They’re extremely common, affect the majority of pregnant women and many people during growth spurts or weight changes, and are not a sign of anything wrong with your skin.

This guide explains what causes stretch marks, why the timing of treatment matters, what realistic improvement actually looks like, and how the experience differs across common causes like pregnancy, puberty, and weight change.

Quick answer: Stretch marks form when rapid skin stretching outpaces collagen and elastin’s ability to adapt, tearing the dermis. Newer, reddish stretch marks generally respond better to treatment than old, faded, white ones, though neither type can be completely erased with topical products alone.

What Causes Stretch Marks

Stretch marks occur when the skin is stretched more quickly than it can accommodate, most commonly during:

•             Pregnancy, as the abdomen (and often breasts, hips, and thighs) expands over a relatively short period

•             Puberty growth spurts, particularly rapid height or weight gain, common on the thighs, hips, lower back, and breasts

•             Significant weight gain or loss over a short timeframe

•             Rapid muscle growth, sometimes seen with intensive strength training, often appearing on the upper arms, shoulders, or thighs

•             Certain medical conditions or medications that affect skin elasticity or cortisol levels, in less common cases

Genetics also plays a meaningful role — some people develop stretch marks readily under mild stretching, while others rarely develop them even during significant changes, largely due to inherited differences in skin elasticity. A family history of stretch marks, particularly in a parent, is one of the more consistent predictors of an individual’s own likelihood.

The Two Stages of Stretch Marks

Striae rubrae (new stretch marks). These appear reddish, pink, or purple, since they are still relatively fresh tears with visible blood vessels close to the surface. This stage is generally the most responsive to treatment, and some people notice mild itching as the skin stretches, which is common and not a cause for concern on its own.

Striae albae (old stretch marks). Over months to years, stretch marks fade to a silvery-white or pale color as blood flow to the area decreases and the scar-like tissue matures. This stage is more resistant to topical treatment, though texture can still sometimes be softened.

Quick answer to a common question: if your stretch marks are still red or purple, that’s actually a better time to start treatment than after they’ve faded to white, since the tissue is more responsive to intervention while newer.

Stretch Marks by Cause: What’s Different

Pregnancy-related stretch marks typically appear in the second or third trimester as the abdomen expands, and most commonly affect the stomach, breasts, and hips. Because the timeline is relatively predictable, this is the scenario where preventive moisturizing is most commonly recommended, even though it cannot guarantee prevention.

Puberty-related stretch marks are extremely common and often appear during the growth-spurt years, frequently on the thighs, lower back, and breasts. Because they occur before the skin has finished developing, they sometimes fade more noticeably with time compared to marks that appear in adulthood.

Weight-change stretch marks can appear with either rapid gain or rapid loss, since both involve fast changes to the skin’s volume. Gradual changes, where achievable, place less sudden demand on the skin’s elasticity.

Muscle-growth stretch marks, sometimes seen with intensive strength training, occur because muscle can grow faster than the overlying skin can accommodate; these are a normal, common occurrence rather than a sign of overtraining or injury.

Can Stretch Marks Be Prevented?

Genetics is the dominant factor, and no product can fully prevent stretch marks in someone genetically prone to them. That said, a few habits may modestly support skin’s ability to stretch:

•             Gradual weight changes where possible, rather than very rapid gain or loss

•             Consistent moisturizing during pregnancy or periods of rapid growth, which supports overall skin flexibility even if it can’t guarantee prevention

•             Staying hydrated, which supports general skin elasticity, though it is not a stand-alone prevention method

It’s worth setting realistic expectations here: many people develop stretch marks despite doing everything “right,” simply due to genetics and the physical reality of how quickly their skin was stretched.

How to Treat Stretch Marks

For new (red/purple) stretch marks: Consistent moisturizing supports the skin as it heals, and topical retinoid products (used under guidance, and never during pregnancy or breastfeeding without medical advice) have some of the better-supported evidence for improving early-stage stretch marks.

For old (white/silver) stretch marks: Topical treatment alone tends to produce more modest results at this stage. Options like micro-needling or laser treatments, which a dermatologist can discuss, generally show more noticeable improvement for older marks than over-the-counter creams alone.

For everyone: Consistent, gentle massage while applying a moisturizing product may support skin texture, even if the visual evidence for massage alone is more limited than for other interventions.

Setting Realistic Expectations

No topical product completely removes stretch marks, regardless of what marketing claims might suggest. Realistic goals include:

•             Softening the texture of raised or indented stretch marks

•             Slightly reducing the color contrast between the mark and surrounding skin

•             Preventing new stretch marks from becoming more prominent through consistent skin support during periods of rapid change

Significant fading or texture change, if it occurs, typically takes several months of consistent use, and results vary widely between individuals.

Do Stretch Marks Itch?

Mild itching is common while skin is actively stretching, particularly during pregnancy or a growth spurt, and is generally considered a normal part of the process rather than a warning sign on its own. Persistent, severe itching, especially late in pregnancy and accompanied by symptoms elsewhere, is worth mentioning to a doctor, since it can occasionally point to an unrelated condition that needs separate attention.

Common Mistakes

Waiting until marks turn white to start treatment. Since new, reddish marks respond better to treatment, waiting until marks have already faded reduces the potential for improvement.

Expecting complete removal. This sets up disappointment; realistic improvement in texture and color contrast is a more accurate goal.

Using retinoid products during pregnancy without medical guidance. Some active ingredients used for stretch mark treatment are not recommended during pregnancy or breastfeeding; always check with a doctor first.

Stopping treatment too early. Visible change, when it happens, typically requires consistent use over several months, not days or weeks.

Assuming stretch marks only happen to women or only during pregnancy. Puberty growth spurts and muscle-building affect people of any gender, and stretch marks are common in both scenarios.

When to See a Dermatologist

Stretch marks themselves are a cosmetic, not medical, concern and don’t require a doctor’s visit on their own. Consider a dermatologist consultation if:

•             Stretch marks appear suddenly and are widespread without an obvious cause (rapid growth, pregnancy, weight change), which occasionally warrants ruling out a hormonal or medical cause

•             You’re interested in in-clinic treatments like micro-needling or laser therapy for older marks

•             You are pregnant or breastfeeding and want guidance on which topical ingredients are safe to use

Frequently Asked Questions

What causes stretch marks?

 Stretch marks form when skin is stretched faster than its collagen and elastin fibers can adapt, causing small tears in the deeper skin layer. Common triggers include pregnancy, growth spurts, and rapid weight or muscle changes.

Can stretch marks be prevented during pregnancy?

 Not completely, since genetics is the dominant factor. Consistent moisturizing and gradual weight changes where possible may modestly support skin’s ability to stretch, but many people develop stretch marks despite preventive care.

Do stretch mark creams really work?

Consistent use can help soften texture and reduce color contrast, especially on newer, reddish stretch marks. No topical product completely removes stretch marks, particularly once they’ve faded to white.

Why are new stretch marks easier to treat than old ones?

 New stretch marks (reddish or purple) still have active blood flow and are more responsive to topical treatment. Older, faded (white) stretch marks are more resistant to topical intervention and may need in-clinic treatments for noticeable change.

Are stretch marks permanent?

 They don’t disappear completely on their own or with treatment, though their appearance often fades naturally over time and can be further softened with consistent care or in-clinic procedures.

Does drinking more water help stretch marks?

Staying hydrated supports overall skin elasticity, but it is not a stand-alone method for preventing or treating stretch marks on its own.

Do stretch marks itch?

Mild itching is common while skin is actively stretching and is generally considered normal. Severe or persistent itching, especially late in pregnancy, is worth mentioning to a doctor.

Can teenagers get stretch marks from growth spurts?

 Yes. Puberty-related growth spurts are one of the most common causes of stretch marks, often appearing on the thighs, hips, lower back, and breasts.