Are there any nonsurgical treatments for stretch marks? Do topical retinoids help?
—Charles McLemore, CFNP, Lake Charles, La.

Stretch marks, also referred to as striae distensae, are atrophic dermal scars with overlying epidermal atrophy. They can appear red or white (hypopigmented). Topical retinoids (e.g., 0.05% or 0.1% tretinoin cream) may be helpful for the management of early striae, resulting in improvement of length and width of the striae (J Am Acad Dermatol. 1998;39:S90-92). Other topical agents that may be helpful include 20% glycolic acid with either 0.05% tretinoin emollient cream or 10% l-ascorbic acid. There are anecdotal reports of mild improvement after 6-10 or more treatments with vacuum-based aluminum oxide microdermabrasion (Dermatol Clin. 2002;20:67-76). Patients with lighter skin phenotypes are suitable candidates for pulsed dye laser therapy, which may result in hyperpigmentation in individuals with darker skin phenotypes. Increased pigmentation of mature hypopigmented striae has been reported after treatment using the 308-nm excimer laser (Dermatol Surg. 2003;29:596-599 and Arch Dermatol. 2004;140:955-960).
—Philip R. Cohen, MD (103-4)

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