Stretch Marks

What It Is & Why It Happens

Stretch marks, or striae gravidarum, are a very common dermatological change during pregnancy. They appear as indentations or streaks on the skin, typically on the abdomen, breasts, hips, buttocks, and thighs. They can be pink, red, purple, or dark brown, depending on your skin tone.

The primary cause is the rapid stretching of the skin to accommodate fetal growth and maternal weight gain. When skin stretches quickly, the collagen and elastin fibers in the dermis (the middle layer of the skin) tear, allowing the blood vessels in the deeper layers to show through, which causes the initial color.

Genetics play a major role; if your mother or sisters had stretch marks, you are more likely to develop them. Additionally, elevated pregnancy hormones (specifically cortisol and estrogen) can temporarily reduce the skin’s elasticity, making it more prone to tearing.

Typical Timeline

Stretch marks typically develop during the second and third trimesters, usually starting around Week 20 to 24. This is when the baby undergoes rapid growth, causing the abdomen and breasts to expand quickly. The marks can continue to develop and darken up to your due date (Week 40). Postpartum, they gradually fade over several months.

Safe Comfort Measures

While you cannot prevent stretch marks, you can soothe your skin and manage related symptoms (like itching) safely:

• Moisturize Regularly: Apply a rich, unscented lotion, cocoa butter, shea butter, or coconut oil to your abdomen, breasts, and hips daily. This keeps the outer layer of skin hydrated, reducing dryness and itching.
• Stay Hydrated: Drink plenty of water (8-10 glasses daily) to support overall skin elasticity and health from the inside out.
• Manage Weight Gain: Work with your healthcare provider to achieve steady, gradual weight gain within clinical recommendations, avoiding sudden spikes.
• Gentle Skincare: Wash your skin with mild, unscented soap and warm (not hot) water, as hot water can dry out the skin and worsen itching.
• Avoid Unsafe Skincare Ingredients: Avoid retinoids, retinol, and high-strength salicylic acids during pregnancy, as these can be absorbed into the bloodstream and pose risks to the fetus.

When to Call the Doctor (Red Flags)

Mild itching is normal as skin stretches, but severe or widespread itching requires medical evaluation.

Contact your healthcare provider if you experience:

• PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy): A severe, intensely itchy rash consisting of red bumps or hives that start in the stretch marks on the abdomen and can spread to the thighs and buttocks.
• Cholestasis of Pregnancy: Intense, persistent itching primarily on the palms of your hands and the soles of your feet, without a rash, which is a sign of a serious liver condition that requires immediate clinical management.