Stretch marks are among the most common skin concerns and the most widely misunderstood. They are not a surface problem, which is why they resist almost everything applied to them, and they are not caused by weight alone, which is why they appear in athletes, in teenagers who have simply grown, and in people who have never been overweight.
Sam Assassa, MD founded the American Association of Aesthetic Medicine and Surgery and has served as its President since 2006, He founded Beverly Hills Aesthetics in 1995 and is board certified in Internal Medicine. Dr. Assassa has directed hands-on training courses for physicians in more than 15 countries and performed more than 25,000 aesthetic procedures.
What a Stretch Mark Actually Is
A stretch mark, clinically a stria, is a scar in the dermis. When skin is stretched faster than it can adapt, the collagen and elastin network beneath the surface tears. The skin above heals over the damage, and what remains is a band of tissue with a different structure from the skin around it.
That is why they behave the way they do. They sit below the surface, so surface treatments reach past their depth. They have a different texture because the fibre arrangement is different. And they reflect light differently, which is why they catch the eye even when the colour has faded.
Common triggers are growth spurts in adolescence, pregnancy, rapid weight gain or loss, rapid muscle gain, and corticosteroid use. Genetics determines how readily you form them, which is why two people through identical circumstances get very different results.
Red Versus White Stretch Marks
This distinction affects what treatment can achieve more than any other factor, and it is worth knowing before you book anything.
Striae rubrae are new. They look red, pink, or purple because the tear is recent and blood vessels are visible through the thinned skin. They are often slightly raised and sometimes itchy. These respond considerably better to treatment, because the tissue is still remodelling and treatment can influence how it heals.
Striae albae are mature. Over months to years the redness fades and they become white or silvery, often slightly depressed, with a texture different from the surrounding skin. The remodelling has finished. These improve with treatment and improve less.
If yours are still red, that is the window. Waiting for them to fade before treating them is the most common missed opportunity here.
What Treatment Can Realistically Achieve
Improvement, not erasure. Stretch marks can be made substantially less noticeable in colour and texture, and in normal lighting many patients find them difficult to see afterward. They cannot be removed, because the dermal structure has changed and no current treatment restores the original architecture.
Anyone promising complete removal is overselling, and knowing that beforehand is the difference between a satisfied patient and a disappointed one.
One thing worth stating plainly: liposuction does not treat stretch marks. Removing fat beneath a stretch mark does not repair dermal scarring, and where skin retracts after fat removal the change is in tension rather than in the scar.
How Stretch Marks Are Treated
- Microneedling creates controlled micro-injuries that trigger collagen remodelling in the scarred dermis, usually across a series of sessions. Effective on both red and white marks and carries a lower pigmentary risk in deeper skin tones.
- Fractional CO2 laser resurfacing removes damaged tissue and prompts rebuilding, delivering the most change per session with recovery to plan around.
- Nanofat uses your own processed fat placed superficially to improve the quality of the scarred skin.
Treatment is usually a series rather than a single session, and combining approaches is common. Skin type affects the recommendation, since ablative treatment carries a higher risk of pigmentary change in deeper skin tones.
Have Your Stretch Marks Assessed in Beverly Hills
Dr. Assassa will assess whether yours are still remodelling, which affects how much improvement is achievable, and recommend a treatment depth appropriate to your skin. Request a consultation or schedule your appointment online.