Stretch Marks Argh!

Stretch marks are another topic that I addressed in a Weekly Forum roundup in 2012 that likely deserves its own dedicated post, and so yet again I have extracted some of the original post and expanded upon it further this time around.

Right up front I can reassure you that stretch marks almost always post-date the actual weight gain. Stretch marks also fade.

Julie Gever:
Julie Gever:

Straie Distensae Explained

As an aside before I get into this explanation, I was searching for images of stretch marks and here was this tree in and amongst all the anatomical human versions of stretch marks and I simply fell in love. Stretch marks as growth and strength— what a suitable reflection when it comes to recovery from an eating disorder!

When stretch marks initially appear they are purple or red angry lines and can be painful as well. They are caused by tears in the dermis, the deeper layer of the skin.

Somewhere between 70-90% of all women will develop stretch marks during pregnancy. What is interesting is that causes of stretch marks are not merely the stretching of skin due to growth, but also that the skin itself is more sensitive to the presence of estrogen, androgen and glucocorticoids. Under certain conditions (hormone fluctuations, puberty, pregnancy, use of cortisol creams and weight gain) it appears that there is an increase in hormonal receptor expression “suggesting that regions that undergo greater mechanical stretching of the skin may express greater hormonal receptor activity.” 1

What I find fascinating/disappointing in the clinical literature is that the drive to eradicate the onset of striae distensae or straie gravidarum (stretch marks that appear during pregnancy) combined with the drive to minimize the appearance of the lines, have resulted in no study of the possible biological or adaptive value the entire process might have.

In other words, because our culture dictates an innate desire to be without blemish or scar, we can lead our scientific community around by the nose ring and insist that they find a way to stop them from occurring, or at the very list eradicate their existence after the fact, rather than identify what, if any, adaptive aspect may be at work in the onset of these dermal shifts in response to physiological changes. 

Expending research dollars on randomized controlled trials that assess the relative value of Vitamins C, E and/or A, laser treatment, topical tretinoin, cocoa or shea butters, alpha hydroxyl acids, BioOil®, etc. etc. in more rapidly fading or minimizing the appearance of stretch marks is perhaps not a lost cause.

However, we should first understand the mechanisms that are involved in the onset and presentation of stretch marks before we jump to the efforts associated with prevention. It might be that the onset of stretch marks is an important, adaptive and resilient facet of how our skin continues to be able to act as the amazing intercessor to the external world that it is. Clearly we don’t know and we should.

Pollyanna Principle

Pollyanna was a character in a 1913 book by Eleanor H. Porter and the term “Pollyannaism” became synonymous with an optimistic outlook thanks to the book.

I am unabashedly walking around with strange rose-tinted spectacles when it comes to stretch marks, scars and imperfections and so it is only fair that you know I do not see these things as bad or needing erasure.

I also do not pass any judgment on anyone who decides that stretch marks, scars and visible imperfections must be erased or fixed in some way. I reiterate that stretch marks fade and that even clinical trial data suggest that once they do, individuals are far less bothered by them as a result.

Donald Symons 2 posits that women will specifically manipulate age and parity (number of pregnancies) cues in order to enhance their sexual attractiveness (e.g. through makeup, clothing, cosmetic surgery, diets and exercise) and that phenotypic features such as skin texture, muscle tone, stretch marks, breast shape and facial configuration are reliably indexed to identify female age and parity and hence sexual attractiveness.

I don’t necessarily disagree with Symons, but I am not convinced that sexual attractiveness is the lone determinant in human behavior either.

For those who might be interested in an alternate view of these things, I offer up the following personal observations:

Scars seem interesting to me, not marring or some mark of being something "less than perfect". I have one on the outside corner of my left eye. I did that when I was 8 years old doing a back flip off of my grandmother's wrought iron bed. Lucky I didn't lose an eye actually!

I have another on my lip— that was in a gym class in Grade 3 where the mats had absolutely no rubber backing and as I did the assigned jump across the mat I caught it with my foot, it slid out from under me and I chipped my tooth to boot. That tooth eventually died when I was in my teens.

The coolest one is a pencil graphite 'tattoo' almost in the centre of my chest because I was holding a pencil with the sharp end pointed towards me and pierced myself with it while doing I don't know what (ah, the old adage "don't run with scissors" right?). It looks like a blue mole basically.

I have two scars on my shins from a strange reaction in my teens to turkey (likely the tryptophan in it) that involved huge blisters that subsequently scarred. It was a passing allergic response thankfully.

I could go on here of course! The point I hope to make is scars fade, but the stories that are connected to them don't.

I actually know lots of guys who have stretch marks— usually to do with the rapid growth spurt they experienced in their teens. I think it's rather nice to see a 6'2" guy and realize he was somebody's little boy who shot up so fast that both his mother and he himself found it strange to adjust to a new hulking frame.

I don't know if I want my scars and marks to fade to the point where I cannot see them anymore.

And maybe years from now if your stretch marks remain after years of living a full life in a complete remission you will feel almost appreciative that those marks are still there to remind you of what you achieved all those years ago—a defying run towards life.

1. Cordeiro, Raquel Cristina Tancsik, Karina Gotardello Zecchin, and Aparecida Machado De Moraes. "Expression of estrogen, androgen, and glucocorticoid receptors in recent striae distensae." International journal of dermatology 49, no. 1 (2010): 30-32.

2. PR Ambramson, SD Pinkerton (ed.) Sexual Nature, Sexual Culture, University Chicago Press, USA, 1995, p. 91