Stretch Marks: Causes, Prevention and Treatment

Stretch marks, known medically as striae distensae, are line-like marks that appear on the skin when it is stretched faster than the collagen and elastin fibers can accommodate. As a result, the dermis is torn and damaged, and red, purple or white lines appear across the skin. Stretch marks are common among Thai people, especially pregnant women, people with a higher body weight, and teenagers who grow quickly. Although stretch marks are not harmful to health and do not cause serious illness, they affect the confidence and quality of life of many people. This article explains the causes, appearance and stages of stretch marks, ways to prevent them, and treatment approaches supported by medical evidence.

What causes stretch marks?

Stretch marks occur when the skin is stretched faster than collagen and elastin fibers can adapt, together with hormonal factors that weaken the skin's fibers. Common causes and risk factors include:

• Pregnancy: pregnancy causes the abdomen to expand rapidly.

• Rapid weight gain: especially during adolescence, when the body grows and gains weight quickly.

• Steroid medication: prolonged continuous use of steroids reduces collagen production.

• Genetics: genetic conditions such as Ehlers-Danlos Syndrome affect the strength of connective tissue fibers.

• High cortisol: high blood cortisol levels from stress weaken the skin's fibers.

Appearance and stages of stretch marks

Stretch marks fall into two main stages according to the color and age of the marks, which matters when choosing a treatment because newer marks usually respond better.

• Striae rubra (red/purple marks): early or new stretch marks, usually red or purple because small blood vessels are still present beneath the marks. At this stage the skin is still inflamed and responds best to treatment.

• Striae alba (white marks): long-standing stretch marks, which usually fade to white or silver. The skin in the area becomes thinner and slightly depressed. At this stage the marks are harder to improve.

How to prevent stretch marks

No method can prevent stretch marks 100%, especially in people with a genetic predisposition, but caring for the skin and controlling risk factors can reduce the chance and severity of marks.

• Moisturize the skin regularly, especially the abdomen, chest, thighs and hips, where stretch marks are common.

• Use creams containing Centella Asiatica or Vitamin E to help support skin elasticity.

• Keep your weight within an appropriate range and avoid rapid weight gain or loss.

• Drink enough water and exercise regularly to maintain skin hydration and health.

How to treat stretch marks

Treatment works best when started while the marks are still new (Striae rubra). A dermatologist will choose a method suited to the stage of the marks, your skin condition and the location. Evidence-supported options include:

• Tretinoin Cream: helps stimulate new collagen production and suits new marks (Striae rubra). It should be used under a doctor's guidance and avoided during pregnancy.

• Laser: Fractional Laser and Pulsed Dye Laser help make the marks less visible and stimulate new collagen and elastin fibers.

• Massage: massaging the marked area helps support collagen production.

• Skin polishing: Microdermabrasion can make the skin somewhat smoother.

Please note that no method can remove stretch marks completely, but appropriate treatment can make the marks fade and the skin look noticeably smoother. An assessment by a dermatologist is therefore important to choose a method that is safe and effective for each person's skin.

Frequently asked questions

Do stretch marks go away on their own? Stretch marks usually do not disappear completely on their own, but over time red or purple marks (Striae rubra) usually fade to white (Striae alba) and look somewhat lighter. Treating them while they are still new gives better results than leaving them until they become old marks.

Can stretch marks be completely cured? Currently no method can remove stretch marks completely, but treatment with Tretinoin Cream, lasers (Fractional Laser, Pulsed Dye Laser), massage and skin polishing (Microdermabrasion) can help the marks fade and the skin look smoother.

When should I start treating stretch marks? Treatment should start while the marks are still new, in the red or purple Striae rubra stage, because the skin responds best to treatment at this point. Once the marks have turned white (Striae alba), they are harder to improve.

How can I prevent stretch marks during pregnancy? Moisturize the abdomen, chest, thighs and hips regularly. You may use creams containing Centella Asiatica or Vitamin E, keep weight gain appropriate and drink enough water. However, prevention may not be 100% possible because genetic and hormonal factors are also involved.

If stretch marks affect your confidence, or you would like advice on care and treatment suited to your skin, consult a dermatologist at Siam Dermatology. Call +66 61 448 7000 or LINE @siamderm.

Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed July 16, 2026