Clinical Evaluation

Stretching the Truth by Patsy Champagne
For most new mothers, the thought of stretch marks are horrifying! For those that have had them for a while, they have become a fact of life. However, there seems to be some major mis-information out there regarding their prevention and elimination. Knowing that most women will experience these during their pregnancy, I thought that we should take a moment to explore this expanding problem.
Clinical Evaluation:
The first question you have to ask yourself when dealing with the human body is whether or not there is any clinical information on the subject.
The clinical community will refer to stretch marks that occur during pregnancy as Striae gravidarum. This is the the tearing of the dermis or middle (shape retaining) layer of the skin. While most stretch marks will appear to be purple or reddish in the beginning, this will normally fade over time. Here are the most commonly referred to treatments for this problem:
Topical Creams / Ointments
Laser Therapy
Tummy Tuck
Without going into too much detail, there appears to be some consensus on the success of at least two of the treatments; laser therapy, tummy tucks. While there is more research being done on the most non-invasive solution,Ugg Sheepskin Cuff, topical creams, there doesn't appear to be any standout solution here.
A direct reference to the U.S. National Library of Medicine states:
Creams and ointments that claim to prevent stretch marks during pregnancy are of little value3
Although this statement appears fairly conclusive, there are two clinical trials that we can look at. Unfortunately, only one used a placebo control and is therefore of any real value. In that trial women used Trofolastin, an ointment containing Centella asiatica extract, alpha tocopherol and collagen-elastin hydrolysates. With massage, this ointment was associated with less women developing stretch marks.1
As for laser therapy, there appears to be much more hope from a clinical standpoint. A recent study from the Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami looked at recent literature regarding the use of newer optical devices and laser therapy. Their conclusion:
"The therapeutic strategies are numerous,You may have an infection which is usually an odorless, and no single modality has been far more consistent than the rest. The long-term future of treatment strategies is encouraging with the advance in laser technologies."2
While laser technologies cannot prevent stretch marks, the results can be impressive according to many dermatologists,about three to four weeks. According to the Cleveland Clinic,
"Dermatologic surgeons can now use lasers to remove or improve stretch marks. The heat from the laser light triggers new elastin production in the deeper layers where the stretch marks are formed. As a result, your skin will have a tighter and smoother appearance."
Lastly, there is the tried and true tummy tuck. This procedure is where they surgically remove the skin where the stretch marks occur. I won't go into any detail on this procedure, just in case you are eating.
Conclusion:
What can I say; after reading as much as I could take on the subject, it is still a confusing topic. While there seems to be some hope on the topical ointment Trofolastin for prevention, the clinical data for removing existing marks is non-existent. Unfortunately, the alternative treatments are costly and often time consuming, not to mention they aren't normally covered by your insurance.
And of course, we've all heard about cocoa butter, but with all of the hype there is little to back it up. Even Tyra Banks had a show about a product called Trilastin SR, that showed impressive before and after photos; yet again, no clinical backing.
For those of us with existing marks, I guess we will have to save our money for lasers or continue to be guinea pigs for the late night info-mercials.
One thing is for sure, if this is a topic that concerns you, speak with your physician! If your OBGYN tells you to suck it up, then talk to a dermatologist. Their advice is the only one that I would take on something this important. At least this way, whatever you decide, you can decide to be informed!
References:
1.) Young GL, Jewell D. (2000). "Creams for preventing stretch marks in pregnancy". Cochrane Database Syst Rev (2): CD000066
2.) Dermatol Surg. 2009 Apr;35(4):563-73
3.)
4,No need to organize your purse.)