What are stretch marks?
Stretch mark is a type of cicatrix. It is formed as a result of pregnancy, abrupt reducing of weight, long treatment with hormones, rapid growth during adulthood etc. There are a lot of reasons but the key point of the problem is rupture of collagen fibres or sharp decrease of collagen synthesis. Collagen fibres make up skin frame and take responsibility for skin strength and elasticity. So far 28 different types of collagen have been identified but only two of them are responsible for skin texture: Type 1 and Type 3 fibres. Those two types make up skin frame. Collagen fibres of Type 3 are able to stretch considerably and shrink accordingly. Collagen fibres of Type 1 are not able to stretch to that great extent and they are easily disrupted. Skin elasticity and its liability to stretch marks formation is characterized by predominance of Type1 collagen fibres. Percentage ratio of these two types is passed on from one generation to another.
In health there is a continual process of old collagen decay and new collagen synthesis inside skin layers. New collagen formation is conditioned by a number of factors such as healthy food (protein deficiency results in new collagen reduction), environmental factor (climate, radiation), harmful habits (alcohol, smoking) and vitamin C deficiency.
Fig.1. Relation of stretch mark formation to collagen types
Collagen fibres of Type 1 and 3
Skin sagging and stretch mark formation
The processes of old collagen degradation and the synthesis of new collagen are constantly taking place in the deeper layers of the skin. Multiple factors influence the formation of new collagen: balanced nutrition (lack of protein in nutrition causes decreased collagen synthesis), environmental influence (climate, UV radiation), social habits (alcohol, smoking), lack of vitamin C. These, among other numerous factors, lead to decreased collagen synthesis, with collagen degradation staying on the same level. Therefore, old collagen degrades while new collagen is not synthesized in the necessary amount which leads to decreased skin tone and stretch mark formation (Fig.2).
Fig.2. Stretch marks and atony of abdominal skin
Predisposition to stretch mark formation
People who tend to formation of stretch marks:
- fat people
- pregnant women
- people in their adulthood
- people on low-calories diet
- patients getting hormones
- people with frequent weight changing
- people who are liable genetically
- women in menopause period
Methods for stretch marks treatment
The animal collagen injections are used to treat the problem area. Such procedure is painful. It often causes allergic reaction and the effect is temporary (3-6 months).
Surgical excision with intradermal suture results in scarring. It is a costly surgery in view of subtle and meticulous work of the plastic surgeon. Plastic surgery of abdominal skin (abdominoplasty) is not the procedure of choice, as it does not solve the stretch mark issue (Fig.3).
Fig.3. Condition following abdominoplasty and TCA-peel in the stretch mark area
Mesotherapy does not give any visible effect. As a rule, patients refuse to continue their treatment after 3-4th procedure.
Microdermabrasion with aluminium microcrystals is long (each stretch mark is polished along the full length), moderately painful and needs 4-8 procedures through 3-4 weeks. Mechanical deep dermabrasion with Schumann and Shrews cutter causes bleeding, bad and long-lasting recovery alongside with deranged pigmentation.
Peelings with glycol acid (50-70%). After a month treatment by trethinoin and glycol acid cream the result is zero.
Laser treatment. Ablative laser systems include vaporizing of epidermis and partially derma in order to improve the outside of skin. Laser systems are not very effective for stretch marks treatment. Moreover, side effects exceed immensely the results expected. Non-ablative laser is successfully used for reducing redness. Though skin sagging is not curable.
We use a new combination of sandabrasion method, TSA-peeling and variable occlusion. This combined method is simple and fast (30-60 min. procedure) and painless. Number of procedures is not fixed as the effect is estimated after each procedure. When achieving positive effect the treatment is stopped. It usually takes 1-2 procedures through 2-3 months. Final results impress and the effect after such treatment is durable due to home collagen synthesis stimulated inside skin. This method is used for treatment of all kinds of stretch marks: new and old with hypotonic skin, located on abdomen, hips, buttocks or bust. It is known that the worse initial state is the better final result is.