Stretch Marks & Scarring

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Why Stretch Marks & Scars Form

Stretch Marks (Striae Distensae)
- Triggered by rapid skin stretching → pregnancy, puberty, weight change, or muscle gain.
- Dermal collagen & elastin fibres rupture → leading to streaks that start red/purple (striae rubrae) and fade to white/silver (striae albae).
Scarring
- A by-product of wound healing → inflammation → collagen deposition → remodelling.
- The balance between collagen breakdown and deposition defines the scar type:
  - Atrophic (sunken) – acne scars, chickenpox pits → collagen loss.
  - Hypertrophic/Keloid (raised) – excess collagen build-up.
  - Post-surgical / traumatic – varied, often mixed.

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Why Treatment Is Complex

No current therapy can fully erase scars or stretch marks.
The goal is visible improvement in colour, texture, and blending with surrounding skin.
Outcome depends on scar age, depth, location, and skin type.

Evidence-Based Treatment Options

1. Tixel® 2 (Thermo-Mechanical Energy)

● Creates controlled thermal microchannels → stimulates fibroblasts + new collagen.

● Effective for acne scars, surgical scars, and early stretch marks.

● Safer than CO₂/Er:YAG for skin of colour.

2. RF Microneedling (Sylfirm X, Morpheus8)

● Combines mechanical microneedling with RF heat.

● Breaks down fibrotic scar tissue + triggers neocollagenesis.

● Evidence supports its use in acne scarring and striae rubrae.

3. Microneedling (ImedPen / Dermastamp)

● Induces micro-injuries → collagen and elastin production.

● RCTs show efficacy for acne scars and stretch marks.

● We use ImedPen (CE-certified) for precision + safety.

4. Biostimulators (Radiesse, Sculptra, Biofiller/PRF EZ Gel)

● PRF Biofiller / EZ Gel → improves atrophic scars with volume replacement + growth factor release.

● Sculptra / Hyperdilute Radiesse → biostimulatory effect for broad or fibrotic scars.

● Polynucleotides / Growth Factors → stimulate fibroblast activity, improve hydration and skin quality.

5. Dermal Fillers (Cross-Linked Hyaluronic Acid)

● Particularly useful for deep, tethered atrophic scars (e.g., rolling acne scars).

● Fillers release tethering, lift depressed scars, and improve light reflection.

● Results are immediate, often combined with microneedling or energy-based therapy for sustained collagen remodelling.

6. Adjuncts & Referrals

● Topicals – copper peptide / growth factor serums for aftercare.

● Dermatology referral – resistant keloids may need steroid injections, silicone sheets, or surgical revision.

What the Evidence Says

● Microneedling → consistently improves acne scarring and striae, especially when combined with PRP or polynucleotides.

● RF devices (Sylfirm X, Morpheus8) → high efficacy in mixed scars and early striae.

● Dermal fillers → immediate volume replacement + longer-term collagen stimulation (some fillers trigger neocollagenesis).

● PRF / biostimulators → promising adjuncts but require maintenance.

● Topicals alone → limited benefit in established scarring.

Patient Selection: Who Benefits Most?

● ✅ Atrophic acne scars, chickenpox scars, new stretch marks.

● ✅ Surgical or traumatic scars that are depressed or irregular.

● ❌ Very old white stretch marks → improvement possible, not erasure.

● ❌ Keloid-prone patients → must be managed carefully, sometimes referred elsewhere.

Our Honest Approach

● We do not promise miracles — only realistic, measurable improvements.

● Multimodal treatment (e.g., microneedling + PRP + filler) is often the gold standard.

● Every case starts with thorough analysis and transparent expectation-setting.

Honest Takeaway

Stretch marks and scars can’t be “deleted,” but with the right strategy they can be softened, lifted, and made less visible. From energy devices to fillers, we personalise treatment so biology — not marketing — drives results.

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