Stretch marks: what are they?

Stretch marks are areas of skin where the deep dermis, located between the epidermis and the hypodermis, has spontaneously torn. When they appear, they have the shape of streaks resembling scars in length, of a purplish red color, and are inflammatory. They lighten over time to become white and pearly, almost the same color as the skin. Stretch marks are mainly found on the stomach, breasts, arms, buttocks and thighs. Very common, they can appear during pregnancy, during a significant and sudden gain or loss of weight as well as during adolescence.   

There are two kinds of stretch marks:

• Stretch marks revealing a health problem

Le Cushing syndrome, due to an excess of corticosteroids in the body, is the cause of significant stretch marks. They are typically wide, red, vertical, and are found on the abdomen, the roots of the thighs and arms, and the breasts. Other signs can be associated such as very thin, very fragile skin prone to bruising, as well as muscle wasting and weakness or weight gain in the stomach and face… These signs should alert and lead to a consultation fast. Cushing’s syndrome is caused by an excess of hormones such as cortisol, the stress hormone normally produced in adequate amounts by the adrenal glands. This Cushing syndrome is most often linked to the abuse of corticosteroid-type drugs. It can also appear in abnormal functioning of the adrenal glands which make too much cortisol.

• Classic stretch marks

These stretch marks are thinner and more discreet and are not accompanied by any particular health problem. Although they have no impact on health, they are often considered unsightly and cause significant discomfort. No treatment will be able to make them disappear completely.

Banal stretch marks also have, at least in part, a hormonal origin. They can thus appear at the time of puberty or pregnancy, moments of intense hormonal changes.

During pregnancy, from the second trimester, the amount of cortisol, a hormone produced by the adrenal glands, increases and varies the suppleness and elasticity of the skin. The higher the cortisol level, the lower the production of collagen is important. Since collagen is responsible, along with the elastic fibers, for the suppleness of the skin, the latter becomes less elastic. Therefore if the skin is stretched (weight gain, pregnancy, puberty), stretch marks can form.

The sudden and significant gain or loss of weight can also be responsible for the appearance of stretch marks. Weight gain may have relaxed the skin while weight loss may have stretched it.

The top athletes are quite often prone to stretch marks because their cortisol levels are high.

Prevalence

Stretch marks are very common: almost 80% of women³ has these type of small scars on certain areas of their body.

During the first pregnancy, 50 to 70% of women notice the appearance of stretch marks, often at the end of pregnancy.

At the time of puberty, 25% of girls against only 10% of boys observe the formation of stretch marks.

Diagnostic

Diagnosis is simply by observing the skin. When the stretch marks are significant and associated with other symptoms, the doctor will do a workup to detect Cushing’s syndrome.

Causes

• The appearance of stretch marks would be of hormonal origin. More precisely, it would be linked to an excessive production of cortisol.
• Stretching of the skin associated with increased production of cortisol. Rapid weight gain, puberty where the body’s morphology changes rapidly or pregnancy, can thus combine hormonal factors and stretching of the skin.
• The application of creams containing corticosteroids or prolonged use of corticosteroids Oral.

• Taking anabolic steroids in athletes for the purpose of increasing muscle mass, especially bodybuilders¹.
• Very skin end.