As spring turns to summer and bulky sweaters are shed in favor of bathing suits and spaghetti straps, many women find themselves confronting a familiar old enemy: stretch marks.

Also known as striae distensae, stretch marks are scar tissue that most often forms when skin is pulled taut by rapid growth or weight gain and can be found crisscrossing the breasts, belly, hips or buttocks - even the arms. Early on, the inflamed marks appear pink, red or purple in color. If left untreated, they turn whitish and the swollen patches of skin become flattened or even slightly depressed. Up to 70 percent of teenage girls have stretch marks, and the lucky few who survive adolescence unscathed may go on to become one of the 90 percent of pregnant women who suffer from the unsightly scars.

But don't reach for that beach cover-up just yet. Today, dermatologists have an increasing arsenal of tools at their disposal, including exciting new laser options for treating the scars once they've gone white. Keep reading to learn and understand the latest ways to prevent, minimize and - in some cases - virtually eradicate stretch marks.

Most doctors believe stretch marks are caused by rapid weight gain and loss as seen in normal teen growth spurts, pregnancy, obesity or weight lifting. Others hypothesize that internal factors are the culprits, and some point to increased levels of steroid hormones in the body, or certain diseases or medications.

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Avoiding rapid weight gain or loss is a good start. For those who are pregnant or experiencing the hormone changes of the teen years, it is crucial to moisturize. Skin becomes more pliant, more plasticized and better able to stretch when it's well hydrated - you should be moisturizing three or four times a day.

Look for products that have cocoa butter, shea butter or Centella Asiatica as a prime ingredient and massage them deep into breasts, belly, hips and buttocks. This seems to increase their efficacy, and it feels great, too. Belli Elasticity Belli Oil (www.skinstore.com), which contains healthy amounts of both cocoa butter and Centella asiatica, is a good one to try.

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Many of us may have heard that with a magical skin cream, time, diet or exercise alone, the stretch marks will simply disappear. But the truth is, only interfering with the proper treatment can minimize stretch marks.

Catching them early is the key. If at all possible, seek treatment when striae distensae is a relatively new skin condition – when its markings are still red or purple. It is then that the condition most readily responds to at-home products and in-office peels. Once the stretch marks are white, the treatment becomes more difficult and less successful.

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Red and purple stretch marks may respond to the glycolic acid in over-the-counter brands. Glycolic acid is a member of the alpha hydroxy acid (AHA) family. AHAs are widely lauded for their powers of rejuvenation, and when used in sufficient strength, they deserve the praise they receive. Though research isn’t yet definitive, they most likely work on stretch marks by increasing collagen production. I recommend brands with higher concentrations of glycolic acid such as MD Forté Glycare I and NeoStrata Ultra Smoothing Lotion. Mustela Stretch Marks Intensive Action also contains glycolic acid, but in a lower concentration, and is therefore less effective.

Vitamin C, if formulated properly, is also able to increase collagen production. You can use it on its own or to complement the work of glycolic acids. Among the vitamin C-based products I can recommend with confidence are SkinCeuticals C E Ferulic and La Roche-Posay Active C. Taking vitamin C supplements, 500mg twice a day, may be effective as well.

Relastin - This product, which is marketed as an eye cream and a face cream, is touted by its manufacturer for increasing elastic tissue, which may improve stretch marks. Studies are ongoing and the jury is still out. Please email me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it and let me know about your experience with Relastin and other stretch mark products.

Peptides - Many peptide-containing products such as StriVectin and HydroPeptide Full Body Anti-Aging Moisturizer with Stretch Mark Repair can be used during breastfeeding. However, I have not seen any convincing data that these peptide products improve stretch marks so don’t waste your time and money on these.

Relastin, the glycolic acid brands and vitamin C-containing products can be found at www.skinstore.com.

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Retinoids (vitamin A) are a family of products that include retinol and the prescription medications Retin A, Renova, Tazorac and Differin. Retinoids increase collagen and elastin production, and - when massaged nightly into red or purplish areas - can substantially improve the look and feel of stretch marks.

They are less effective once the stretch marks are white. Retinoids cannot be used when pregnant or breastfeeding.

Retinol can be found in over-the-counter products such as Philosophy Help Me and Neutrogena Healthy Skin. Prescription retinoids such as Retin A, Tazorac and Differin are stronger and therefore may be more effective than retinol.

Retinoic acid peels are also available in spas and salons and by your dermatologist. Ask your spa or dermatologist if they perform the Ultra Peel Exfoliating Treatment or the Esthetique Peel from www.pcaskin.com.

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For those looking for a speedier solution, glycolic acid can be administered in-office at higher doses. After three or four visits, our clients usually notice a slight change in the length, width and intensity of red/purple stretch marks. In-office glycolic peels are safe for all skin types, although lower concentrations of the acid should be used for those with darker skin tones. On average, a treatment of glycolic acid in the US will cost around $100.

Using glycolic acid and a retinoid together may provide the best of both worlds. Various prescription-strength retinoids (Retin-A, Tazorac, Differin or the generic retinoid tretinoin) are often applied as a preparation to rev up the skin before a glycolic acid peel is applied. It’s best to see a dermatologist as soon as you notice stretch marks starting to appear. Remember that the earlier in the process this treatment is applied, the better its effects are likely to be. In other words, you need to treat the stretch marks while they still have a reddish purple hue to achieve the best results.

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Vascular lasers can offer outstanding results. In fact, I’d like everyone whose stretch marks are still in the red/purple stage to know about vascular lasers.

Stretch marks, especially early stage striae distensae, indicate the presence of swollen and inflamed blood vessels. Because vascular lasers are designed to work with dilated blood vessels, they present a powerful treatment option. They are associated with epidermal turnover as well as increased collagen production and elastic remodeling. Most often, three to six sessions are required at a rate of approximately $450 a session. My favorite vascular laser for the treatment of stretch marks is the Dornier 940 nm laser but some physicians use the 585 nm or 595 nm laser, which are also effective.

So far, you’ve talked about treating stretch marks in the early stages, when they are still red/purple. Is there anything that can be done about stretch marks that have already turned white?

We may have very good news for those distressed by white stretch marks. Until very recently, there was nothing I could recommend to improve older white stretch marks. Now I can! Fractional lasers such as the Fraxel laser by Reliant! Fractional lasers have been approved by the FDA for acne, rejuvenation and facial hyperpigmentation known as “pregnancy’s mask” or melasma. Now, early clinical tests suggest that fractional lasers can substantially improve even the most severe of whitened stretch marks. Many physicians are beginning to use the Fraxel laser for the treatment of white stretch marks with good results. It is doubtful that stretch marks will ever completely disappear but any improvement is welcome.

Fractional laser treatments cost about $1000 per stretch mark treatment and usually 3 treatments are required.

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1. Treat stretch marks as soon as you begin to notice them.
2. Limit weight fluctuations.
3. Use a topical glycolic acid product in the morning and a prescription retinoid such as Tazorac 0.1% at night. (This is likely stronger than the retinoids you will be able to use on your face.)
4. Get the vascular laser while stretch marks are purple.
5. Get the Fraxel laser once stretch marks are white.
6. Know in advance that you will probably not be able to completely erase them but can reduce the severity.

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1. Apply a glycolic acid containing moisturizer twice a day.
2. Apply a moisturizer with cocoa butter or shea butter when possible and when skin feels dry.
3. Do not use a retinoid.
4. A vascular laser is ok as long as a topical anesthetic is not used.

As a last note, remember, 90% of us have them! They are our badges of honor for having kids. I am sure that I have more than you do if that makes you feel any better. Fraxel laser, here I come!

Wishing you great skin!

Dr. Leslie Baumann