Striae Distensae (Stretch Marks) Medication

Updated: Feb 22, 2022
  • Author: Samer Alaiti, MD, RVT, RPVI, FACP; Chief Editor: William D James, MD  more...
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Medication Summary

Drugs of choice should have the ability to improve the skin texture and color, to remodel the collagen in the dermis, and to promote elastin synthesis.


Retinoid-like Agents

Class Summary

Topical retinoids have been shown to be beneficial in remodeling hypertrophic scars and in improving the clinical appearance, including improvement of the surface texture, fine and coarse wrinkling, skin color, and laxity, of photoaged skin after 3-6 months of therapy.

Tretinoin topical (Avita, Retin-A, Atralin, Renova)

Trans-retinoic acid is a derivative of vitamin A (retinol), effectively used to treat acne vulgaris and other disorders of keratinization for the past 3 decades. Exhibits a certain degree of vitamin A growth-promoting activity; however, it is not stored in the body as retinol and its esters. Rather, it is metabolized rapidly and mostly excreted in bile. When administered topically, a minute amount passes through dermis but has not been detected systemically.

In epithelial cells, affects differentiation, neoplastic transformation, tumor promotion, collagen synthesis, wound healing, stimulation and modulation of immune response, inflammation, cell membranes, and many other processes.

0.05% strength has been shown to improve hypertrophic scars. Postulated that this is due to effect on fibroblasts (ie, decreased fibroblast proliferation and decreased fibroblast collagen synthesis). Effect on fibroblasts is mediated through specific binding receptor proteins. Topical application significantly improves clinical appearance of early, active stretch marks. Processes responsible for clinical improvement remain unknown.

Patients are instructed to gradually increase amount of tretinoin until mild erythema and exfoliation develops; may also apply a bland emollient if excessive irritation develops.