Stretch marks that develop on a woman’s skin during pregnancy are termed as striae gravidarum (SG). While SG do not cause any medical issues, they are associated with significant cosmetic problem.¹ SG are disfiguring, and cause emotional and psychological distress.² Striae that are red or purple in color at the outset become pale streaks with the passage of time. Severe cases may be associated with itchiness and restlessness in the pregnant woman and can on the abdomen, breasts, hips, and legs. The prevalence of SG ranges from 50% to 90%.¹

There are several risk factors for the development of SG. Some of these factors include prepregnancy maternal weight, weight gain during pregnancy, body mass index (BMI) >26, increased BMI at delivery, maternal age, skin structure, family history of striae, personal history of breast or thigh striae, race, and birth weight, alcohol intake, light skin color, increased abdominal and hip girth during pregnancy, and low serum vitamin C level, low serum relaxin level and low water intake during pregnancy.^1,2 Neonatal factors associated with the development of SG include increased gestational age at delivery, increased birthweight, and increased height and head circumference.²

Use of certain oils and/or creams has been found to be effective in preventing the development of striae. SG is more commonly seen in women at younger ages. It has been shown that the structure of fibrillin is more fragile in younger women, thus leading to striae development. Prepregnancy BMI and BMI at birth values are higher in women with SG than without. Likewise, abdominal circumference of the pregnant women has been shown to be significantly higher in those with SG.¹

Therefore, providing adequate information to women planning to conceive regarding the importance of factors influencing SG, such as prepregnancy body weight and the maternal age of conception may help.¹

Exercise during pregnancy can possibly reduce the formation of SG by controlling weight gain. Exercise methods that are suitable for pregnant women can help in increasing abdominal muscle strength, and will reduce the stress and strain on the abdominal skin. Some women are genetically predisposed to SG; however, it must also be noted that athletes and women who undertake heavy physical work get fewer or no stretch marks.¹

Herbal preparations have also been shown to have a role in the prevention of SG development. Aloe vera has been shown to prevent the progression of SG when applied topically. A study found aloe vera to be more effective than base cream in decreasing itching and erythema and in preventing the spread of striae on the surface of abdomen.³ Another study found decreased occurrence risk of striae in the women using sesame, sweet almond, or sesame and sweet almond oil, when compared with the control group.⁴ Vetiver (khus) grass is another potential herb known for its skin soothing potential. Vetiver oil has a balancing or regulatory activity on skin. Vetiver oil replenishes moisture in dehydrated skin and prevents stretch marks.⁵

References

1. Ersoy E, Ersoy AO, Celik EY, et al. Is it possible to prevent striae gravidarum? Journal of Chinese Medical Association 2016;79(5):272-5.
2. Korgavkar K, Wang F. Stretch marks during pregnancy: a review of topical prevention. Br J Dermatol. 2015 Mar;172(3):606-15.
3. Hajhashemi M, Rafieian M, Rouhi Boroujeni HA, et al. The effect of Aloe vera gel and sweet almond oil on striae gravidarum in nulliparous women. J Matern Fetal Neonatal Med. 2017 May 19:1-6.
4. Malakouti J, Khalili AF, Kamrani A. Sesame, Sweet Almond & Sesame and Sweet Almond Oil for the Prevention of Striae in Primiparous Females: A Triple-Blind Randomized Controlled Trial. Iran Red Crescent Med J. 2017 June;19(6):e33672.
5. Burger P, Landreau A, Watson M, et al. Vetiver Essential Oil in Cosmetics: What Is New? Medicines (Basel). 2017 Jun; 4(2): 41.