Stretch marks (striae) are line-shaped marks that form when collagen fibers in the middle layer of the skin break down and elastin fibers are damaged. When skin stretches beyond its capacity in a short time, these fibers tear and lines appear. Stretch mark treatment aims to make these lines less visible.

Stretch marks most often appear in these situations:

• Pregnancy: common because of rapid stretching of the abdomen, breasts and hips.
• Puberty: rapid growth and hormonal changes can cause stretch marks.
• Weight changes: frequent and rapid weight gain and loss strain the skin’s elasticity.
• Cortisone use: long-term cortisone treatment can thin the skin and make stretch marks more likely.

Men can get them too, especially on the shoulders and arms during rapid muscle gain.

Because their exact causes are not fully understood, prevention is not always possible, and they usually do not fade away on their own. Cortisone-related marks may improve somewhat over time; pregnancy and puberty marks are less likely to.

New stretch marks are pink, red or purple, as there is still blood flow and inflammation in the area. Over time the color fades and the mark turns white and slightly sunken.

• Red (new) stretch marks: usually respond better to treatment. If noticed early, their effects can be partly reduced with topical products such as plant oils and creams.
• White (old) stretch marks: collagen loss in the tissue is more marked, and medical treatments that stimulate the skin’s renewal process are needed.

So it helps to show stretch marks to a doctor while they are still pink. Creams mostly act on the surface and may not be enough alone for established marks. White marks can still be treated, but the process may take longer.

At our clinic in Nişantaşı, Istanbul, the main method for stretch mark treatment is the carbon dioxide (CO2) fractional laser. The laser creates many microscopic channels in the surface of the skin (epidermis) and the middle layer (dermis). As the body repairs this controlled damage, it produces new collagen, and the appearance of the stretch mark tissue gradually improves.

The treatment follows these steps:

1. The type, color and depth of the marks and your skin type are assessed.
2. The area is cleansed, and a numbing cream may be applied for comfort.
3. The laser is applied to the stretch marks in controlled pulses.
4. A soothing skincare product is applied to the area afterward.

Discomfort with fractional laser is usually mild, and downtime is short. Sessions take 20–30 minutes and are repeated every 4–6 weeks, depending on your skin. Depending on your needs, laser treatment may be combined with golden needle treatment, GRP / PRP, radiofrequency, dermatherapy and carboxytherapy. Collagen injections may also be added to the plan to support collagen production.

The combination is chosen based on the color, width, depth and location of the marks, so that complementary treatments address different layers of the tissue together.

Stretch mark treatment takes patience: 3–5 sessions are usually done, depending on your skin and how quickly it heals.

The main factors that affect the number of sessions are:

• Age of the stretch marks: new, pink marks usually respond with fewer sessions.
• Width and depth: wide, sunken marks may need a longer process.
• Skin type: healing speed and elasticity differ from person to person.
• Area: large areas such as the abdomen and hips may need a longer plan.

Because collagen is produced over weeks, results appear gradually. After the first course the skin is left to rest, and a new course may be planned later if needed.

Many people search for stretch mark removal, but making stretch marks disappear completely is not always possible. Treatment aims to bring their color closer to your skin tone, reduce width and depth, and smooth the texture; results vary from person to person. A stable weight and well-moisturized skin also help.

Effects after fractional laser are usually mild and temporary. In the first hours you may feel sunburn-like warmth with redness and mild swelling, and light crusting and peeling within a few days is part of healing.

• Showering: do not take a cold shower right after treatment to cool down; use lukewarm water instead.
• Sun: protect the area from the sun for a few weeks and use sunscreen outdoors.
• Skincare: use the moisturizing and repairing creams your doctor recommends regularly.
• Scratching: if crusts form, do not scratch the area or pick them off.
• Saunas and pools: avoid saunas, Turkish baths and swimming pools in the first days.

Other marks such as burn, injury or surgical scars may be assessed in the same plan as part of burn, wound and laser scar treatment.