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2. DEFINITION
Striae are skin defects that look like bands, stripes, or lines. Striae are seen when a person grows or gains weight rapidly or has certain diseases or conditions. Another term for striae is stretch marks.

3. CONSIDERATIONS
Stretch marks can appear when there is rapid stretching of the skin. They are often associated with the abdominal enlargement of pregnancy. They can be found in children who have become rapidly obese. They may also occur during the rapid growth of puberty in males and females. Striae are most commonly located on the breasts, hips, thighs, buttocks, abdomen, and flank.

Stretch marks appear as parallel streaks of red, thinned, glossy skin that over time become whitish and scarlike in appearance. The stretch marks may be slightly depressed and have a different texture than normal skin.

Striae may also occur as a result of abnormal collagen formation, or a result of medications or chemicals that interfere with collagen formation. They may also be associated with longtime use of cortisone compounds, diabetes mellitus, Cushing disease, and post-pregnancy.

4. COMMON CAUSES

  • Pregnancy
  • Puberty
  • Obesity
  • Cushing’s syndrome
  • Iatrogenic Cushing syndrome
  • Topical corticosteroid overuse
  • Ehlers-Danlos syndrome

5. FREQUENCY:

  • In the US: Approximately 90% of pregnant women, 70% of adolescent females, and 40% of adolescent males (many of whom participate in sports) have stretch marks.
  • Internationally: International figures may reasonably mirror the numbers in the United States.
  • Mortality/Morbidity: Striae distensae are usually a cosmetic problem; however, if extensive, they may tear and ulcerate when an accident or excessive stretching occurs.
  • Race: Stretch marks affect persons of all races.
  • Sex: Striae affect women more commonly than men.
  • Age: Stretch marks affect adolescents, pregnant women, and patients with excessive adrenal cortical activity.

6. HOME CARE
There is no specific care for stretch marks. Advertised creams and salves to prevent stretch marks during pregnancy are of little value. However, the marks often will disappear after the cause of the skin stretching is gone. Avoiding rapid weight gain helps in the case of stretch marks caused by obesity.

7. TREATMENT
Medical Care:

  • Adolescents with striae can expect some improvement in their striae with time.
  • Topical application of tretinoin can significantly improve the clinical appearance of early striae distensae.

Surgical Care:

  • The authors have had good success using low concentrations (15-20%) of trichloroacetic acid (TCA) and performing repetitive papillary dermis-level chemexfoliation. The peels can be repeated at monthly intervals. Significant improvement in regard to skin texture, firmness, and color can be achieved.
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