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The Treatment of Stretch Marks (Striae Distensae) by Joel Bain Herron, MD

A Difficult Problem

Stretch marks, or striae distensae, can be a difficult problem to address, as no treatment is likely to be 100% effective. However, we have made great strides in the 20 years or so that I have been involved in dermatology. When I first started in dermatology, topical retinoids were used with limited success. There are plenty of old wives tales circulating out there about cocoa butter, vitamin E, etc., but none of those have been shown to be of much help. There are some newer topical therapies designed specifically for stretch marks that can offer some improvement and may be used in combination with topical retinoids.

The Vascular Laser

The first truly effective treatment that came along was the use of the vascular laser.  This is most effective for new and still pink or red stretch marks, as the target of this laser is the blood vessels producing the pink or red color. However, the heating of the vessels and the surrounding tissue can stimulate the generation of collagen and elastin, thereby improving both the color as well as the texture of the stretch marks. Areas treated with vascular lasers are likely to be a little red or slightly darker in color with a small amount of swelling for a few days. Older, faded, or silvery stretch marks can still be treated, but may not notice as much improvement.

The Fractional CO2 Laser

The fractional CO2 laser was a great advancement in the early 2000s. The fractional CO2 laser can safely be used on stretch marks almost anywhere on the body. While the fractional CO2 laser may not address the pink or red color as well as the vascular lasers, it is a more aggressive and more effective treatment to target the generation of collagen and elastin. There is also no reason they cannot be used in combination with vascular lasers to accomplish a greater level of improvement. Generally, with the fractional CO2 laser, the treated area may be a little pink and flaky for about 5-7 days.

Secret RF: The New Solution

Fast forward to 2019. We are one of the first offices in the Columbus area to proudly offer Secret RF. Secret RF combines microneedling with radiofrequency, so you are able to benefit from the synergies of these two treatment modalities for stretch marks with one device. With Secret RF, there is little to no downtime. Most patients are only pink for one to a few hours. The discomfort from the Secret RF is much less than with fractional CO2 laser treatment. Typically, only about one hour of topical numbing cream is required. Due to the minimal downtime, Secret RF is a treatment that can be repeated as needed for incremental improvement with each session. With multiple sessions, results are better than the older modalities. Again, the Secret RF is a treatment that can be combined with any of our other treatments in order to achieve the greatest improvement.

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