Best stretch mark removal cream?

Do any of the stretch mark creams on the market actually do what they claim to do? There's a lot of them out there and of course they all claim to be great. I'm a little skeptical about how well any of them work. Can you recommend one that you've used before on patients that produced worthwhile results? Or tell me which brands to definitely avoid?

mymegan

F, 31, Ohio

Stretch marks (or striae) are actually a type of scar that exists beneath the surface of the skin. These scars form when the skin is stretched beyond its elastic maximum. When stretched too far, it can tear beneath the surface. This tearing is typically visible above the skin as a red mark, eventually fading to a white color as the striae scar tissue forms.

Stretch marks commonly form during pregnancy, periods of rapid weight gain or loss, and during the growth spurts of puberty.

There are countless stretch mark removal creams marketed online, but to the best of my knowledge none have been clinically proven to work. Most contain natural ingredients like cocoa or shea butter and/or natural oils like olive, almond, and jojoba oil.

The only real benefit of these ingredients is that they moisturize the skin, providing a temporary supple tone to the epidermis. But even the best stretch mark removal cream can’t fade the stretch marks themselves as these scars exist on the dermis layer of the skin beneath the epidermis.

While it's tempting to believe over-the-counter creams and natural products could somehow remove stretch marks, my advice is to save your money. There are no home treatments that have been shown to have any positive effect.

Clinical treatments for stretch marks include microneedling and laser therapy. But even with these, it's important to set expectations realistically: there is no clinical treatment other than surgical excision that will completely remove a stretch mark. Even then, the most you can hope for is to partially reduce their visibility over time.

The only FDA-approved treatment for stretch mark removal is a non-ablative fractional resurfacing laser. Lasers like the Palomar Lux 1540 alter the internal structure of the skin and increase collagen after several sessions. In most cases, we’ll see visible improvements with non-ablative laser treatment after roughly four to six sessions. But even in with laser therapy, we can’t completely remove the stretch marks.

If your stretch marks are on your abdomen beneath the level of your belly button, it may be possible to remove them with a tummy tuck. Lower abdominal stretch marks are very common after pregnancy and quite possibly the most frequent reason why women seek tummy tuck surgery.

I can't offer you any specific medical advice or recommendations without an examination, but regardless of where your stretch marks are, if they’re bothering you I encourage you to consult with a board-certified dermatologist for an in-person consultation.

In the meantime, be very skeptical of any claims made by the makers of these alleged scar removal creams.

If you do a search on Amazon.com for “stretch mark removal cream” or “stretch mark prevention cream” you will find hundreds of products all promising the impossible.

The truth is that stretch marks cannot be removed by topical creams.

A stretch mark is a type of scar which forms when the skin is stretched beyond the natural limits of skin elasticity. Once the skin has stretched beyond its natural limit, the lower dermis layer tears, and the tear becomes visible through the top layer of skin.

When stretch marks first form, the capillaries in the dermis rupture, causing a bright red mark. As the capillaries heal the scars eventually turn white or silver. There are no topical creams or stretch mark products that have been shown to heal these subsurface scars. Nor are there any effective stretch mark defense creams to stop them from forming in the first place.

While there are some products, such as topical hyaluronic acid and topical retinoids, that increase the turnover of skin cells and improve the rate of collagen production, there are no skincare products that actually fade the marks themselves.

The only FDA-approved method for reducing the appearance of stretch marks are laser treatments, but they require multiple sessions and only reduce visibility to a certain extent. Nevertheless, we’ve seen good results, amounting to a 50% reduction in visibility, in as few as four or five sessions. While laser therapy doesn’t "remove" stretch marks, it's the best non-invasive approach we have at this point in time.

We've all seen the advertisements and heard about the supposed home remedies.

Unfortunately, no amount of palmer's cocoa, shea butter, rosehip seed oil will make your stretch marks fade away.

The reality is that there's only one way to repair stretch marks and it's to surgically remove them along with the surrounding skin.

Although in most locations surgically removing stretch marks just isn't an option. The one exception are those located on the lower abdomen. Pregnant women often develop these stretch marks during their third trimester. Fortunately, they are easily removed with a tummy tuck procedure that only leaves a small scar beneath the bikini line.

Aside from plastic surgery, however, unfortunately there are no other good options.

The US Food and Drug Administration does approve laser therapy for the treatment of stretch marks, but it's important to keep in mind that the therapy is only partially effective. In most cases the best results we can get amount to a roughly 60% reduction in visibility after multiple laser treatment sessions.

Depending on the location and visibility of your existing stretch marks, laser treatment could still be a good option -- even if it's only partially effective. I obviously can’t offer you a recommendation without an examination beforehand, but if you're interested in exploring clinical solutions for stretch mark removal, I advise you to contact a board-certified dermatologist or plastic surgeon in your area and discuss whether laser treatments actually make the most sense for you.

actually Megan none of them work. We use a combination of vascular laser as well as tattooing with camouflage to match your own skin type. It's highly effective

In my experience, I have never seen a topical skin cream that will improve a stretch mark beyond what your body would do without the cream

A stretch mark is actually a scar.  It is a tear in the dermis that can be seen through the epidermis.  NOTHING in the year 2016 is able to remove stretch marks except surgery.  During an abdominoplasty (tummy tuck) most of the stretch marks that lie at the level of the umbilicus (belly button) and below will be removed along with the skin and fat.  All topical products that claim to remove stretch marks are frauds.

Dear mymegan,

Longterm treatment with topical tretinoin produces the best results especially if the striae are treated early and are erythematous. Also if you add laser surgery or microneedling the results will produce more dramatic results.

Dear Mymegan,

Sorry. Stretch marks are forever. Despite the extravagant claims for many products, nothing on the market eliminates or even significantly removes stretch marks. That includes not only creams, salves, emollients, collagen products, and such but also lasers and various light devices of other types. I have the only laser that has been FDA approved to be marketed as a stretch mark reducing device and it has been a great disappointment. I have used it on numerous patients, very aggressively I  might add, and have yet to see any objective improvement in the marks. Most treatments recommend that they be started on fresh stretch marks. Some advertising shows impressive results with fresh stretch marks that look a very visible pink/red in the "before" photos and faint silvery marks in the "after" ones taken months later. The truth is that the same result would have been had six months later regardless; it is the nature of all stretch marks to fade with time. 

There is one way to remove stretch marks permanently: surgery. A tummy tuck will remove most, if not all, stretch marks from pregnancy and is part of what is popularly known as a "mommy makeover". Furthermore, tightening the abdominal skin will make the remaining stretch marks less conspicuous. 

Hope this helps. 

R. Bosshardt, MD, FACS