Striae gravidarum (SG), or stretch marks, are commonly seen among women during pregnancy. They may be experienced by nearly 90% of the women.1 Stretch marks are atrophic linear scars that are initially characterized by flat, pink-to-red bands called striae rubra or immature striae. These may become raised, longer, wider, and violet-red, and may eventually grow faint and become hypopigmented, known as striae alba or mature striae. Women may experience itching, burning, and discomfort along with SG. SG are usually present on the breasts, abdomen, hips, and thighs.2 SG are not associated with any medical issues, but they are associated with significant cosmetic concerns.3 They are disfiguring, and cause emotional and psychological distress to the woman.1Research has pointed out that several risk factors are associated with the development of SG. These may include higher prepregnancy maternal weight, higher pre-delivery 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 (higher prevalence in non-white women), 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.1-3 Neonatal factors have also been found to be associated with the development of SG. These include increased gestational age at delivery, increased birth weight, and increased height and head circumference.1 SG are more common among younger women.2,3 The more fragile structure of fibrillin in younger women could lead to striae development. Prepregnancy BMI and BMI at birth have been shown to be higher in women with SG than those without. Similarly, abdominal circumference of the pregnant women has been shown to be significantly higher in those with SG.3Prevention of SG is possible. Providing adequate information to women planning to conceive regarding the importance of factors that affect SG, such as prepregnancy body weight and the maternal age of conception, may help.3Exercise during pregnancy can control weight gain, and can possibly reduce the formation of SG. Exercise methods suited to pregnant women can help in increasing abdominal muscle strength, and reducing the stress and strain on the abdominal skin.3Some 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.3 Therefore, exercise and staying active seems to help. Daily massage therapy is also helpful in preventing SG.2 Some oils and/or creams have also been found to be effective in preventing the development of striae.3 Topical application of aloe vera prevents the progression of SG. Aloe vera has been shown to be effective in decreasing itching and erythema and in preventing the spread of striae on the surface of abdomen.4 Decreased occurrence risk of striae has also been reported in the women using sesame, sweet almond, or sesame and sweet almond oil, when compared with the control group.5 Vetiver (khus) grass is known for its skin soothing potential. Vetiver oil replenishes moisture in dehydrated skin and prevents stretch marks.6

References

1. Korgavkar K, Wang F. Stretch marks during pregnancy: a review of topical prevention. Br J Dermatol. 2015 Mar;172(3):606-15.
2. Farahnik B, Park K, Kroumpouzos G, Murase J. Striae gravidarum: Risk factors, prevention, and management. International Journal of Women’s Dermatology 2017;(2):77-85.
3. 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.
4. 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.
5. 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.
6. Burger P, Landreau A, Watson M, et al. Vetiver Essential Oil in Cosmetics: What Is New? Medicines (Basel). 2017 Jun; 4(2): 41