AN OVERVIEW highlights combination strategies that improve stretch marks through Fitzpatrick phototypes in practice for clinicians.
Striae distensae, commonly known as stretch marks, are frequent dermal scars that follow rapid skin stretching during puberty, pregnancy, or weight change. Although often viewed as cosmetic, stretch marks can affect quality of life and remain challenging to treat, particularly in patients with darker skin tones where postinflammatory hyperpigmentation is a key concern.
Stretch Marks Treatment Varies by Stage and Skin Type
In a comprehensive review of available and emerging therapies, investigators evaluated topical, procedural, laser based, and combination approaches for stretch marks across all Fitzpatrick skin types. Treatment selection depended on striae stage, with striae rubra tending to respond more readily than striae alba. Across modalities, reported outcomes reflected collagen remodeling and visible improvements in stretch mark appearance, alongside careful attention to tolerability in skin of color.
Procedures and Combination Approaches Lead Outcomes
Topical tretinoin showed modest benefit, with response influenced by concentration and duration of use. Laser based therapies, including ablative and nonablative fractional lasers, were associated with improvements in texture and tone, while nonablative devices appeared better tolerated in darker skin types. Microneedling and microneedling with radiofrequency emerged as effective, cost-efficient procedural options that can be used across skin types.
The review found the strongest results with combination therapies, particularly regimens pairing microneedling or fractional CO2 lasers with platelet rich plasma or radiofrequency. These multi-modality strategies outperformed monotherapy in several reports, especially for treatment resistant striae alba, and may offer a practical pathway to balance efficacy with pigment safety in patients at higher risk of dyspigmentation.
Interpreting the Evidence and Next Steps
The authors emphasized that direct comparison across treatments remains limited by study heterogeneity, small sample sizes, variable protocols, and inconsistent outcome measures. Limited long term follow up further restricts conclusions about durability. Standardized assessment tools, including consistent visual scoring and patient reported quality of life metrics, are needed to support individualized, stage specific stretch marks treatment decisions for diverse populations.
Reference: Chaudhury H et al. Advancements in treating stretch marks across all skin types: a comprehensive review of therapeutic modalities. Int J Womens Dermatol. 2026;12(1):e244.
