Diagnostic Considerations

Although the diagnosis of striae is usually straightforward, the rare possibility of Cushing syndrome must be entertained. In the latter, striae are characterized by their inordinate breadth, depth, and intense color.

In linear focal elastosis (elastotic striae), asymptomatic, yellow linear bands arrange themselves horizontally over the lower back. These lesions may resemble striae distensae, but they are palpable rather than depressed and yellow rather than purplish or white.

Workup

Lin WC, Byers RA, Li W, Danby SG, Cork MJ, Matcher SJ. Imaging striae distensae: a comparison between PS-OCT and digital dermoscopy. Biomed Opt Express. 2021 Jun 1. 12 (6):3296-3311. [QxMD MEDLINE Link]. [Full Text].
Sheu HM, Yu HS, Chang CH. Mast cell degranulation and elastolysis in the early stage of striae distensae. J Cutan Pathol. 1991 Dec. 18(6):410-6. [QxMD MEDLINE Link].
Tung JY, Kiefer AK, Mullins M, Francke U, Eriksson N. Genome-wide association analysis implicates elastic microfibrils in the development of nonsyndromic striae distensae. J Invest Dermatol. 2013 Nov. 133(11):2628-31. [QxMD MEDLINE Link].
Oakley AM, Patel BC. Stretch Marks. 2022 Jan. [QxMD MEDLINE Link]. [Full Text].
Masood S, Jalil P, Naveed S, Kanwal S. Bullous Striae Distensae with Prolonged Steroid Use: An Unusual Clinical Presentation. Indian Dermatol Online J. 2020 Mar-Apr. 11 (2):280-281. [QxMD MEDLINE Link]. [Full Text].
Kang S, Kim KJ, Griffiths CE, Wong TY, Talwar HS, Fisher GJ, et al. Topical tretinoin (retinoic acid) improves early stretch marks. Arch Dermatol. May 1996. 132(5):519-26. [QxMD MEDLINE Link].
Goldfarb MT, Ellis CN, Weiss JS, Voorhees JJ. Topical tretinoin therapy: its use in photoaged skin. J Am Acad Dermatol. 1989 Sep. 21(3 Pt 2):645-50. [QxMD MEDLINE Link].
Kligman A. Topical tretinoin: indications, safety, and effectiveness. Cutis. 1987 Jun. 39(6):486-8. [QxMD MEDLINE Link].
Al-Himdani S, Ud-Din S, Gilmore S, Bayat A. Striae distensae: A comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol. 2013 Oct 11. [QxMD MEDLINE Link].
Goldberg DJ, Marmur ES, Schmults C, et al. Histologic and ultrastructural analysis of ultraviolet B laser and light source treatment of leukoderma in striae distensae. Dermatolog Surg. 2005. 31(4):385-7. [QxMD MEDLINE Link].
Fox JL. Pulse dye laser eliminates stretch marks. Cosmetic Dermatology. 1997. 10:51-2.
Jimenez GP, Flores F, Berman B, Gunja-Smith Z. Treatment of striae rubra with the 585-nm pulsed-dye laser. Dermatol Surg. 2003. 29(4):362-5. [QxMD MEDLINE Link].
McDaniel DH, Ash K, Zukowski M. Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser. Dermatol Surg. 1996 Apr. 22(4):332-7. [QxMD MEDLINE Link].
McDaniel DH. Laser therapy of stretch marks. Dermatol Clin. 2002. 20:67-76. [QxMD MEDLINE Link].
Suh DH, Chang KY, Son HC, Ryu JH, Lee SJ, Song KY. Radiofrequency and 585-nm pulsed dye laser treatment of striae distensae: a report of 37 Asian patients. Dermatol Surg. Jan 2007. 33(1):29-34. [QxMD MEDLINE Link].
Goldman A, Rossato F, Prati C. Stretch marks: treatment using the 1,064 nm Nd:YAG. laser. Dermatol Surg. May 2008. 34(5):686-91.
Hernandez-Perez E, Colombo-Charrier E, Valencia-Ibiett E. Intense pulsed light in the treatment of striae distensae. Dermatol Surg. 2002. 28(12):1124-30. [QxMD MEDLINE Link].
Shokeir H, El Bedewi A, Sayed S, El Khalafawy G. Efficacy of pulsed dye laser versus intense pulsed light in the treatment of striae distensae. Dermatol Surg. 2014 Jun. 40 (6):632-40. [QxMD MEDLINE Link].
Hexsel D, Soirefmann M, Porto MD, Schilling-Souza J, Siega C, Dal'Forno T. Superficial dermabrasion versus topical tretinoin on early striae distensae: a randomized, pilot study. Dermatol Surg. 2014 May. 40 (5):537-44. [QxMD MEDLINE Link].
Ferreira ACR, Guida ACP, Piccini AA, Parisi JR, Sousa L. Galvano-puncture and dermabrasion for striae distensae: a randomized controlled trial. J Cosmet Laser Ther. 2019. 21 (1):39-43. [QxMD MEDLINE Link].
Kim BJ, Lee DH, Kim MN, Song KY, Cho WI, Lee CK, et al. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol. 2008. 9(1):33-7.
Alexiades-Armenaka M, Sarnoff D, Gotkin R, Sadick N. Multi-center clinical study and review of fractional ablative CO2 laser resurfacing for the treatment of rhytides, photoaging, scars and striae. J Drugs Dermatol. 2011 Apr. 10(4):352-62. [QxMD MEDLINE Link].
Naein FF, Soghrati M. Fractional CO2 laser as an effective modality in treatment of striae alba in skin types III and IV. J Res Med Sci. 2012 Oct. 17(10):928-33. [QxMD MEDLINE Link].
Lee SE, Kim JH, Lee SJ, Lee JE, Kang JM, Kim YK. Treatment of striae distensae using an ablative 10,600-nm carbon dioxide fractional laser: a retrospective review of 27 participants. Dermatol Surg. 2010 Nov. 36(11):1683-90. [QxMD MEDLINE Link].
Yang YJ, Lee GY. Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO(2) Fractional Laser: A Randomized Controlled Trial. Ann Dermatol. 2011 Nov. 23(4):481-9. [QxMD MEDLINE Link].
Elmorsy EH, Elgarem YF, Sallam ES, Taha AAA. Fractional Carbon Dioxide Laser Versus Carboxytherapy in Treatment of Striae Distensae. Lasers Surg Med. 2021 Nov. 53 (9):1173-1179. [QxMD MEDLINE Link].
El-Domyati M, Hosam El-Din W, Medhat W, Ibrahim MR, Khaled Y. Carboxytherapy for striae distensae: A promising modality. J Cosmet Dermatol. 2021 Feb. 20 (2):546-553. [QxMD MEDLINE Link].
Ryu HW, Kim SA, Jung HR, Ryoo YW, Lee KS, Cho JW. Clinical improvement of striae distensae in Korean patients using a combination of fractionated microneedle radiofrequency and fractional carbon dioxide laser. Dermatol Surg. 2013 Oct. 39(10):1452-8. [QxMD MEDLINE Link].
Alster TS, Li MK. Microneedling Treatment of Striae Distensae in Light and Dark Skin With Long-Term Follow-Up. Dermatol Surg. 2020 Apr. 46 (4):459-464. [QxMD MEDLINE Link].
Obagi ZE, Obagi S, Alaiti S, Stevens MB. TCA-based blue peel: a standardized procedure with depth control. Dermatol Surg. 1999 Oct. 25(10):773-80. [QxMD MEDLINE Link].
Lu H, Guo J, Hong X, Chen A, Zhang X, Shen S. Comparative effectiveness of different therapies for treating striae distensae: A systematic review and network meta-analysis. Medicine (Baltimore). 2020 Sep 25. 99 (39):e22256. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

Striae distensae on the torso of a 13-year-old boy. One-day duration. Courtesy of Wikimedia Commons.
Female torso with striae distensae from pregnancy. Courtesy of Parenting Patch and Wikimedia Commons.
Striae distensae in pregnancy. Baby is due in less than 2 weeks. Courtesy of Patrick Fitzgerald and Wikimedia Commons.

of 3

Author

Samer Alaiti, MD, RVT, RPVI, FACP Medical Director, Miracle Mile Medical Center for Dermatology and Cosmetic Surgery, Inc

Samer Alaiti, MD, RVT, RPVI, FACP is a member of the following medical societies: American Academy of Dermatology, American College of Phlebology, American College of Physicians-American Society of Internal Medicine, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steven R Feldman, MD, PhD Professor, Departments of Dermatology, Pathology and Public Health Sciences, and Molecular Medicine and Translational Science, Wake Forest Baptist Health; Director, Center for Dermatology Research, Director of Industry Relations, Department of Dermatology, Wake Forest University School of Medicine

Steven R Feldman, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, North Carolina Medical Society, Society for Investigative Dermatology

Disclosure: Received honoraria from Amgen for consulting; Received honoraria from Abbvie for consulting; Received honoraria from Galderma for speaking and teaching; Received consulting fee from Lilly for consulting; Received ownership interest from www.DrScore.com for management position; Received ownership interest from Causa Reseasrch for management position; Received grant/research funds from Janssen for consulting; Received honoraria from Pfizer for speaking and teaching; Received consulting fee from No.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Arash Taheri, MD Research Fellow, Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine

Disclosure: Nothing to disclose.

Sections Striae Distensae (Stretch Marks)
Overview
Presentation
DDx
Workup
Treatment
Medication
Media Gallery
References

Striae Distensae (Stretch Marks) Differential Diagnoses

Diagnostic Considerations

References

Tables

Contributor Information and Disclosures

What would you like to print?