Stretch marks

Skin striae ("stretch marks" that are usually red or purple in appearance and greater than 1 cm) (50%)... 

Striae Linear, atrophic, pinkish or purplish, scar-like lesions that later become white (striae albicantes or lineae albicantes) may occur on the abdomen, breasts, buttocks, and thighs they are due to weakening of the elastic tissues commonly called stretch marks. 

The first step in recording and assessing the loaves is to record their weight then the loaves can be assessed for appearance. One factor to look for is the presence of some oven spring (see Figures 1-3). This is expansion of the loaf in the oven, which can be detected by stretch marks... 

The method of microdermabrasion was developed as a technique to cosmetically treat photoaging, hyperpigmentation, acne, scars, and stretch marks [51,52], The procedure... 

Stretch marks don t go away just because your belly deflates (or starts to). For some people, blackthorn oil (Dr. Hauschka makes one) can help heal this fact of life. So can some of the belly oils you may have been using prior to giving birth. Slather it on. And remember, stretch marks fade with time, too. 

Pimples, Bumps, and Splotchy Skin 153 Stretch Marks 153 Candles 154 Hair Dye 155 Manis/Pedis 157 Phthalates 157... 

Chapped. Nipples 242 Stretch Marks 243 Hair Dye, Nail Polish, and Everything Else You Gave Up for the Last Nine Months 243 Bathing Baby 243 Powder 244 Organic Cotton 244 Baby Nails 245 Wipes 245 Diaper Cream 245 Blocking the Sun s Rays 246... 

Stretch marks can only be treated definitively by applying aggressive treatments that can improve the epidermal and dermal atrophy that accompanies them. 

AHA peels have been used unsuccessfully in the treatment of stretch marks, both as monotherapy and in combination with corundum crystal microdermabrasion before the peel. Treating the stretch marks with microdermabrasion beforehand enhances AHA penetration, but does so linearly, in the form of claw marks (Figure 8.1). The results are poor, even on fine, white, superficial stretch marks. 

Technical error during the treatment of stretch marks using an abrasive procedure (see Chapter 21). Typically, a halo of hyperpigmentation surrounds the depigmented area, which in turn surround a scar response. Hyperpigmentation develops where the peel solution goes slightly deeper than it should, and scars form where the peel is much too deep. 

ETCA can be applied as a peel to the papillary dermis, when a sufficient number of coats are gradually applied to produce even pink-white frosting and epidermal sliding . The protocol developed to treat stretch marks has sometimes also been used successfully for facial rejuvenation. 

These include stretch marks, acne scars on the face and body, keratosis pilaris, and badly damaged d colletage. 

Post-acne pigmentation on the back does not respond readily to ETCA alone. The protocol developed for treating stretch marks produces excellent results, however - not only on the residual pigmentation but also on the depth of the acne scars. 

The Deprez-Adato classification is based on the clinical appearance of the stretch marks (Table 21.1). Stretch marks in stages 2B to 4 seem to respond best to this treatment. 

Table 21.1 Deprez-Adato classification of stretch marks ...

Stage 3A Ladder rungs (+) < 1 cm wide Atrophic stretch marks... 

Stage 4 Ladder rungs (++) >1 cm wide Atrophic pearly white stretch marks... 

The mechanism of action could be as follows the sandpaper abrasion and acid have a synergistic effect of physical and chemical resurfacing that improves the quality of the entire epidermis (Figure 21.1). When the post-peel cream penetrates the atrophic base of the stretch marks, it causes inflammation (controlled by the antioxidants) that stimulates fibroblast proliferation and metabolic production of the non-cellular components of the dermis (Figure 21.2). 

The abrasion and acid resurface the normal skin surrounding the atrophic base of the stretch marks both physically and chemically. 

With the help of pre-peel abrasion, the ETCA solution rapidly penetrates to the papillary dermis and provides chemical resurfacing on top of the physical resiufadng of the abrasion itself. The combined physical and chemical effect accelerates stimulation of keratinocyte growth on the edges of the stretch marks. The subsequent occlusion does not deepen the action of the ETCA. We have seen elsewhere in this book that occluding TCA tends instead to soften the effect of the TCA. 

Sequenced photographs of the treatment show that the post-peel mask cream penetrates more readily through the atrophic base of the stretch marks after abrasion and application of the ETCA acid solution. Here, it causes inflammation, which triggers regeneration, and it appears to be limited to this area. The large majority of signs of active inflammation disappear very quickly, in around 2-3 days, but a non-irritative edema can persist for around 15 days at the base of the stretch marks. 

In the deepest protocol, after abrasion and application of the ETCA solution, the post-peel mask cream is applied under occlusion. This is the protocol used to treat stretch marks and surgical scars, when the skin needs tightening. 

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