Stretch Marks (Striae)

Who's At Risk?

• In children who are not yet teens (adolescents), most stretch marks occur in those who are overweight.
• In the United States, 70% of adolescent girls and 40% of adolescent boys have stretch marks. These are due to growth and stretching of the skin.
• Stretch marks are more common in females than males, and they occur equally in people of all races / ethnicities.
• Stretch marks are also seen with prolonged use of oral or topical corticosteroids, diseases of the adrenal gland, and rare genetic disorders.

Signs & Symptoms

In children who are overweight, stretch marks are usually seen on both sides of the body (symmetrically); they are most visible on the thighs, arms, and belly and are sometimes seen over the back, buttocks, and knee regions. Stretch marks can be itchy.

Stretch marks may be widespread, or they may appear in a specific location in people who use corticosteroids or have certain diseases.

Stretch marks change in appearance with time:

• In the early stage, they are faint pink or brown, parallel, band-like marks arranged in a line.
• They gradually enlarge and become red to purple, often with a wrinkled surface.
• Finally, they become white or lighter, slightly depressed, crepe-paper-like linear marks that may be 1-10 mm wide and many centimeters long.

Self-Care Guidelines

• Stretch marks appearing during adolescence often improve in appearance with time.
• If the stretch marks are occurring where topical corticosteroid creams have been used on the child’s skin, check with their medical professional about potentially stopping or changing the medication.
• Over-the-counter products that are marketed for fading or removing stretch marks are generally considered ineffective.

Treatments

If the stretch marks are cosmetically distressing to you or your child, early red areas can be medically treated, but treatments may not be covered by insurance. Treatments include:

• Tretinoin cream.
• Laser treatments.
• Chemical peels.

If the diagnosis or origin of the stretch marks is uncertain, a biopsy and blood tests might be done.

Visit Urgency

See your child’s medical professional if stretch marks appear without an obvious cause (ie, rapid weight gain or adolescent growth), if they develop on an area of topical steroid treatment, or if they are cosmetically bothersome to the child.

Trusted Links

• Clinical Information and Differential Diagnosis of Striae (Stretch Marks)

References

Bolognia J, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018.

James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.

Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.

Paller A, Mancini A. Paller and Mancini: Hurwitz Clinical Pediatric Dermatology. 6th ed. St. Louis, MO: Elsevier; 2022.