Stretch marks: what works on red ones, and what doesn’t on white
Extremely common. Permanent. And far more treatable while they're still red.
Medical review pending · 15 sources
Illustrative purposes only. Not a tool for self-diagnosis.
What this actually is
“Red means the window is open. White means the honest answer is modest.”
Stretch marks are lines that form where skin has been stretched faster than it can adapt: in pregnancy, through a growth spurt, with a change in weight, with rapid muscle gain, or under the influence of steroid medication. Underneath the surface, the collagen and elastin have been pulled apart and repaired. That repair is what a stretch mark is: a thin, settled scar sitting in the deeper layer of the skin.
They are extremely common. Most women who go through a pregnancy get them, and something like a quarter to a third of teenagers do. They are not a disease, not a sign you did anything wrong, and not something a cream failed to prevent.
The single most useful thing to know before you read further is the colour. Fresh marks are pink, red or purple. Older ones are white or silver. They look like the same problem and behave like two completely different ones: red marks respond meaningfully to treatment, white marks barely do. Everything below hangs off that distinction.
And the honest headline: nothing available today removes a stretch mark. Treatment fades and softens.
“Is this me?” self-check
One question does most of the work here, and it isn't "what caused them?" It's what colour are they now? The cause tells you where they came from. The colour tells you what's realistically achievable. Look at your marks in decent daylight, and sort them into one of the groups below. If you have a mix of red and white marks, that's normal: treat them as two separate questions.
Which kind are yours?
Red means the window is open. White means the honest answer is "modest", whatever the advert says.
Red, pink or purple: new marks
Striae rubrae · responsive
Recent, sometimes slightly raised, occasionally itchy, and often still spreading if the stretch is ongoing. Why it matters: this is the responsive stage and the only real treatment window. Prescription tretinoin, fractional laser, RF-microneedling and microneedling all work best here, and vascular lasers can target the redness specifically. If your marks are still red, the useful time to act is now, not because anyone should rush you, but because the biology genuinely changes.
Tell-tale signs
pink, red or violet
sometimes raised or itchy
roughly 60 to 70% improvement
White or silver: mature marks
Striae albae · resistant
Longstanding, flat or slightly sunken, with a faintly crinkled surface and no redness left. Why it matters: these are genuinely resistant. Improvement with the best available devices is typically under 30%, and no device changes that. It doesn't mean nothing helps: it means the realistic goal is a softer, less obvious line, over a course, at real cost. Anyone promising more than that is selling you the response rate of somebody else's red marks.
Tell-tale signs
white or silver
flat or slightly sunken
typically under 30%
Paler than the skin around them
Hypopigmented
In deeper skin tones, mature stretch marks often read as hypopigmented: lighter than the surrounding skin rather than white against pale skin, which can make them more visually obvious, not less. Why it matters: the contrast is a pigment problem as much as a texture one, and the treatments that tackle texture can worsen pigment if they're chosen or set badly.
Tell-tale signs
lighter than surrounding skin
pigment plus texture
device choice matters
Wide, deeply purple, with other changes
See a GP first
Marks over about a centimetre wide, strikingly violet, appearing with weight gain around the trunk, easy bruising, a rounder face or muscle weakness. Why it matters: this small minority is the one pattern that isn't cosmetic. It can point to an excess of cortisol (Cushing's syndrome) or to steroid medication, and it belongs with a GP before any clinic.
Tell-tale signs
wider than 1 cm
other changes too
not cosmetic
Illustrations of the four presentations, not before-and-after photographs. A mix of red and white marks is normal.
Which line sounds like you?
My marks are still pink, red or purple
Red · responsive
My marks are white or silver, and have been for a year or more
White · resistant
I have a mix of both, some newer, some old
Two questions
My marks look paler than the skin around them
See skin of colour
They appeared during pregnancy, a growth spurt, or a change in weight
Ordinary cause
They're wide, deep purple, and other things have changed too
See a GP first
What's bothering me is actually loose or crepey skin, not the lines themselves
A different concern
A self-orientation aid, not a diagnosis. Anything in the red-flag list goes to a GP first.
What’s causing it
Skin stretches fast
Pregnancy, growth, weight, muscle, steroids
Dermal tearing
The dermis tears microscopically
Scar repair
It repairs as a thin, settled scar
It matures
Red matures to white over months
Skin has a certain amount of give. Stretch it slowly and it adapts; stretch it faster than the collagen and elastin can reorganise, and the dermis tears at a microscopic level and repairs as a scar. That's the whole mechanism, and it explains why stretch marks cluster around the moments when bodies change quickly.
Pregnancy is the commonest trigger, usually in the third trimester, usually on the abdomen, breasts and hips, driven by hormonal changes as well as mechanical stretch. Puberty and growth spurts account for a large share of the rest, on hips, thighs, back and breasts, in both boys and girls. Rapid weight gain or loss, and rapid muscle gain from serious training, do the same thing. So do corticosteroids: potent topical steroids used heavily, under occlusion or in skin folds, and systemic steroids, which thin the skin and make it more likely to give way.
Susceptibility is largely inherited. Stretch marks run in families and are documented in identical twins. Two people can go through the same pregnancy with the same care and the same creams and get completely different results, and that difference is mostly genetic and hormonal. Nothing you did or didn't do caused them.
And this is the error the whole category makes: the cause doesn't set the expectation, the colour does. "They're from pregnancy, so a laser will fix them" is a reasonable-sounding sentence and a false one. What predicts response is whether the mark is still red or has gone white, regardless of what put it there.
When to see a GP or dermatologist first
The overwhelming majority of stretch marks are entirely benign and need no medical attention at all. The marks themselves are never dangerous. But a small minority are a sign rather than a cosmetic feature, and the risk worth naming is treating a medical condition cosmetically and missing what's underneath. If any of the following applies, the right first appointment is with a GP, not a clinic.
Wide (often over 1 cm), deeply purple or violet marks appearing alongside weight gain around the trunk.
A rounder "moon" face, a fat pad at the upper back or neck, or easy bruising, developing with new striae.
Muscle weakness in the thighs or shoulders: difficulty rising from a chair or climbing stairs.
New or worsening high blood pressure or diabetes, or menstrual changes, alongside new stretch marks.
You're using potent or prolonged topical steroids, or systemic steroids, and marks are appearing.
Widespread striae in a child or young teenager with no obvious growth spurt, or in unusual places.
Any mole or lesion inside the area you're considering treating that is changing, itching or bleeding.
Cosmetic treatment of stretch marks is not funded by the NHS, and the NHS position is straightforward: they're common, harmless and usually fade over time, and no treatment reliably removes them. What the NHS does treat is a cause: investigating suspected cortisol excess, or reviewing steroid medication that's thinning your skin. That's a real medical pathway and it's free; the marks themselves are a private, optional, cosmetic question. Separately, any suspicious skin lesion within a proposed treatment area must be assessed before a laser or needling device is fired over it.
Read our safety guidance
Treatment options
Read this first. Every row below carries two tiers, one for red marks and one for white, because that is where the honest information lives. The same machine, on the same body, does substantially different things depending on the colour of what it's treating. Combination approaches (a device plus tretinoin, or two devices in sequence) outperform any single treatment on red marks. Nothing here is a one-session proposition; everything worthwhile is a course of roughly three to six.
Prescription topical tretinoin
The best-evidenced topical
Well Established
Red marks · White: Limited
Sep 2026
Prescription only · Red marks: Well Established · White marks: Limited · no price shown
What it can doThe best-evidenced topical for fresh marks. Randomised trial evidence going back to 1996 shows meaningful improvement in early striae, and network meta-analysis puts tretinoin combined with radiofrequency at the top of the effectiveness rankings. Cheap relative to devices, and quietly underrated.
What it can’t doWork on mature white marks: the same trial found little effect there. It also cannot be used in pregnancy or while breastfeeding, which is exactly when many people most want it. If that's you, the red window and the best drug don't overlap, and waiting is the answer.
View the evidence rationale
Well Established for red striae on independent randomised and meta-analytic evidence; Limited for white striae because the same evidence shows little effect once marks mature.
Key studies
Kang S, Kim KJ, Griffiths CE, et al. Topical tretinoin (retinoic acid) improves early stretch marks. Arch Dermatol 1996;132(5):519–526. Improves striae rubrae; little effect on striae albae.
Editorial only. Tretinoin is a prescription medicine: obtained from a prescriber after a face-to-face assessment, not bought or compared on price. See retinoids and retinol.
Fractional CO₂ laser
Ablative resurfacing
Well Established
Red marks · White: Emerging
Sep 2026
Red marks: Well Established · White marks: Emerging · +SAFETY-CAUTION (deeper skin)
What it can doThe strongest single laser in the network meta-analysis for striae, with effectiveness and satisfaction figures around 72% and 58%. On red marks it softens colour and surface texture meaningfully over a course, and works better still combined with tretinoin or RF-microneedling.
What it can’t doRemove anything. And it carries the highest pigmentation and burn risk of any option on this page in Fitzpatrick IV to VI: for deeper skin this is generally the wrong first choice, not the strongest one.
View the evidence rationale
Well Established for red striae on independent comparative and meta-analytic evidence; Emerging for white striae, where improvement is genuinely modest.
Explore the treatment
Non-ablative fractional laser
1540 to 1550 nm
Well Established
Red marks · White: Emerging
Sep 2026
Red marks: Well Established · White marks: Emerging
What it can doThe same collagen-remodelling job with less epidermal disruption, less downtime and a lower pigment risk. For most people with red marks, and for most people with deeper skin tones, this is the more sensible starting point of the two lasers.
What it can’t doMatch ablative CO₂ session-for-session on the strongest results. You are trading a degree of intensity for a safer margin, which is often exactly the right trade.
View the evidence rationale
Well Established for red striae on independent evidence alongside CO₂ and radiofrequency; Emerging for white striae for the same reason as every device here.
Explore the treatment
RF-microneedling
A genuine equal to CO₂
Well Established
Red marks · White: Emerging
Sep 2026
Red marks: Well Established · White marks: Emerging · +SAFETY-CAUTION
What it can doA 2024 systematic review and meta-analysis comparing fractional microneedle radiofrequency with fractional CO₂ found no clear superiority between them, meaning RF-microneedling is a genuine equal, not a lesser substitute. It combines particularly well with tretinoin.
What it can’t doBe treated as a spa add-on. This is a medical procedure with real consequences when done badly, and it does not remove marks either.
Safety note: on 15 October 2025 the US Food and Drug Administration issued a Safety Communication about certain uses of radiofrequency-microneedling devices, describing reports of burns, scarring, fat loss, disfigurement and nerve damage, some requiring surgical repair. The American Academy of Dermatology responded on 16 October 2025. This is a note about practitioner experience, device settings and informed consent, not a reason to rule the treatment out. Read the FDA communication ↗
View the evidence rationale
Well Established for red striae on independent head-to-head meta-analysis; Emerging for white striae.
Key studies
Aktoz F, Yilmaz N, 2024. Comparing fractional microneedle radiofrequency and fractional CO₂ laser for striae distensae: a systematic review and meta-analysis. Lasers Med Sci 2024;39:271. No clear superiority; around 60 to 70% improvement in early red striae, under 30% in mature white striae.
Explore the treatment
Microneedling (standalone)
Lowest pigment risk
Emerging
Red marks · White: Emerging
Sep 2026
Red marks: Emerging · White marks: Emerging
What it can doA 2024 systematic review and meta-analysis found statistically significant improvement, alone and in combination. It is the gentlest of the needle-and-energy options, the lowest-cost, and the lowest-pigmentation-risk choice for deeper skin tones, which makes it a genuinely reasonable first step where the lasers aren't.
What it can’t doMatch a fractional laser or radiofrequency on the strongest red-mark results. It's a real option with a modest ceiling, not a soft-focus version of the same outcome.
View the evidence rationale
Emerging: positive independent meta-analysis, but a smaller and more heterogeneous evidence base than the fractional and radiofrequency options.
Key studies
Sun X, Jia X, Huang L, 2024. Microneedling therapy for striae distensae: systematic review and meta-analysis. Aesthetic Plast Surg 2024;48(15):2915–2926.
Explore the treatment
Pulsed-dye / vascular laser
Targets colour, not texture
Emerging
Red marks only · White: n/a
Sep 2026
Red marks: Emerging · White marks: not applicable
What it can doTarget the redness specifically, by treating the dilated vessels that make a fresh mark look violet. Where colour rather than texture is the thing bothering you, and the marks are new, this is a targeted tool.
What it can’t doDo anything at all for a white mark: there is no redness left to treat. It also doesn't address texture, so it's usually a partner to another approach rather than a plan on its own.
View the evidence rationale
Emerging: a plausible mechanism with supportive but smaller studies specific to striae. Not applicable to white marks, because the target has gone.
Explore the treatment
Chemical peels, and PRP as an add-on
Peels, and PRP as an add-on
Emerging
Adjuncts · Not a primary plan
Sep 2026
Red marks: Emerging · White marks: Emerging
What it can doGlycolic and TCA peels show variable improvement in striae. PRP has some evidence for improving results when added to microneedling or laser rather than used alone.
What it can’t doStand up as a primary plan. These are adjuncts with variable data, and peels carry their own pigment risk in deeper skin. Be wary of PRP sold as the expensive upgrade that makes the difference: the honest description is "may add a little".
View the evidence rationale
Emerging: positive but heterogeneous independent studies; the benefit signal is mostly in combination, not monotherapy.
Explore chemical peels
Two things not on the list. Excimer laser and targeted phototherapy can temporarily repigment white striae: it re-colours the line without restoring the texture, and it needs ongoing maintenance to hold. The evidence is limited and it is not widely offered in the UK, so we don't route to it. Creams and oils belong in you may not need treatment, not here: they have a real but small role, and no role at all in prevention.
The honest ceiling
Said plainly, because this is the section that matters most on this page.
Stretch marks are scars, and scars are permanent.
No cream, laser, needle, radiofrequency device or injectable removes one. The realistic outcome, at best and after a course, is faded and softened: a line that is less obvious in ordinary light. If a treatment name contains the word "removal", the name is wrong.
White marks are the hard ceiling.
Once a mark has matured, improvement across every device studied sits typically under 30%. That is not a reason to do nothing; it is a reason to know the number before you spend, so that a modest improvement feels like the result you were promised rather than a disappointment you paid for.
Surgery is not a stretch-mark treatment.
Abdominoplasty removes lower-abdominal skin, and with it any marks that happen to be on the excised skin, as an operation for loose or excess skin, leaving a permanent scar of its own. It does nothing for marks anywhere else and is not indicated for striae. There is no surgical route to "getting rid of stretch marks".
And the ceiling on prevention is lower still.
There is no reliable way to stop stretch marks forming. Steady rather than rapid weight change helps a little; avoiding unnecessary potent steroids helps. Genetics decide most of it.
Commonly oversold / myths
The claim
"Stretch-mark removal": laser, RF or microneedling packages sold under that name.
Reality: These treatments genuinely work on red marks, and they genuinely do not remove anything. "Removal" is baked into the booking-page names of real, useful procedures, which is what makes it so effective and so misleading. Improvement, softening and fading are the accurate words. If a clinic uses "removal" and doesn't correct it in consultation, the expectation gap is already built into your visit.
The claim · most oversold
"This cream, oil or butter prevents stretch marks in pregnancy."
Reality: This is the most oversold claim in the category and it is marketed hardest at pregnant women. A Cochrane review of six trials and 800 women found no high-quality evidence that any topical preparation prevents stretch marks (average risk ratio 0.74, 95% CI 0.53 to 1.03, not statistically significant). Cocoa butter and olive oil have not been shown to work. Where a faint signal appears, it is confounded by the massage involved in applying the product.
The claim
"One session and they're gone."
Reality: Every worthwhile option here is a course, typically three to six sessions, spaced three to six weeks apart, with change accruing over months as collagen remodels. A single session produces very little. Quotes that look cheap are often priced for session one only, so ask what the whole course costs before you compare anything.
The claim
Old white marks quoted on new-mark results.
Reality: The biggest expectation trap on this page, and the easiest to fall into honestly. The "60 to 70% improvement" figures in the literature come from studies of red striae. Applying them to mature white marks, which typically improve under 30%, isn't a lie exactly, which is why it happens so often. Ask directly: "what improvement do you expect for marks at my stage?"
The claim · unlawful
Exosome "boosters" added to needling or laser sessions.
Reality: injectable exosomes are unlawful in the UK. The MHRA treats injected exosome products as unauthorised medicinal products with no UK marketing authorisation; they are lawful only within an MHRA-authorised trial. Topical exosome products are legal if correctly CE-marked, but independent evidence for their effect on stretch marks is essentially absent. An offer to inject exosomes tells you something important about the clinic making it.
You may not need treatment
Steady weight
+
Daily SPF
+
Time
For a lot of people reading this, the honest answer is that no treatment is needed, and we'd rather say so here than bury it.
Stretch marks from puberty and growth spurts usually fade substantially on their own, becoming much less noticeable over the years without anything being done. Marks from pregnancy soften too. The red fades to white, the raised settles flat, and the thing that felt enormous at nineteen is frequently barely a consideration at twenty-five. If you're young, if your marks are faint, or if what's driving you is a comparison with bodies online, remember that those bodies are posed, lit and edited, and that stretch marks are close to universal. Waiting is a real, evidence-based plan, not a failure to act.
If you'd like to do something, here's what's honest about doing it at home: skincare will not remove or prevent stretch marks. Its genuine roles are comfort, a modest effect on appearance, and supporting any clinical work you do later. Nothing more, and anyone selling more is selling the thing the Cochrane review found no evidence for.
The one thing with real leverage costs nothing: steady weight change rather than rapid swings, which reduces new mechanical stretch and helps whatever you do next hold up. The framing throughout is what to look for, not what to buy. No product on this page is a treatment.
Worth doing anyway
SPF / sunscreen
Doesn't treat the scar, but stretch marks are often paler than surrounding skin and can become more conspicuous with sun exposure. Also protects any device work you have done.
Active ingredient
Retinoids / retinol
Cosmetic retinol and retinaldehyde are gentler and weaker than prescription tretinoin; a reasonable at-home step if the prescription route isn't open to you. Not in pregnancy or breastfeeding.
Active ingredient
Centella asiatica
Among the few topicals with any signal at all in the striae literature, and that signal is weak and inconsistent. Fine to use; don't expect much.
Active ingredient
Hyaluronic acid (topical)
Same story: modest appearance and comfort benefit, weak prevention evidence, no ability to change a scar.
Deeper skin belongs at the centre
This is not a caveat at the end of the treatment plan. For Fitzpatrick IV to VI it is the treatment plan, because the option ranking changes.
Two things are different in deeper skin. First, stretch marks often present as hypopigmented, paler than the skin around them, which can make them more visually prominent than they are on lighter skin, and adds a pigment problem on top of a texture one. Second, and more importantly, laser and energy treatments carry a materially higher risk of post-inflammatory hyperpigmentation and burns, and the risk is not evenly spread across the options. Ablative fractional CO₂ carries the highest pigmentation and burn risk of anything on this page. The most-recommended treatment in the general literature is, for you, often the wrong one.
What safer practice actually looks like:
Prefer non-ablative fractional wavelengths over ablative resurfacing, and conservative fluences and depths over aggressive settings.
Where RF-microneedling is used, insulated needle tips reduce thermal injury to the epidermis and are the appropriate choice.
Standard microneedling is a legitimate option, not a consolation prize: it is the lowest-pigmentation-risk device route here and has independent evidence behind it.
Test-patch every time, and stage sessions cautiously. Ask for it; don't wait to be offered it.
Choose a practitioner with specific, demonstrable experience treating skin like yours, not a clinic that treats your skin tone as a variation on a standard protocol. A generic "stretch-mark laser" package booked without a skin-tone-aware assessment and a test patch is a red flag, not a bargain.
Safest route for deeper skin: non-ablative fractional or standard microneedling, conservative settings, insulated tips, a test patch every time, and avoid ablative CO₂ as a first choice.
Costs and what to expect
Two things to hold in mind before the numbers. Everything effective here is a course, typically three to six sessions three to six weeks apart, with change accruing over months, so the number that matters is the course total, not the session price. And body areas cost more than faces, because they're larger. All private; none NHS-funded. Most plans run to 3 to 6 sessions, 3 to 6 weeks apart.
Option
Indicative 2026 price
Notes
At-home skincare (SPF, cosmetic retinol, centella or HA formulations)
~£0–£150
Comfort and modest appearance support only. Not a treatment, and not prevention.
Prescription topical tretinoin
Prescription only, price not publicly advertised
Obtained from a prescriber after a face-to-face assessment, not compared on price. Not in pregnancy or breastfeeding.
Microneedling
~£100–£250 per session
A course of three commonly runs around £250–£600. The lowest-cost device route, and the lowest-pigmentation-risk one.
Fractional laser
~£250–£300 per targeted area, per session
Larger areas such as the abdomen from around £500+ per session. Course of 3 to 6.
RF-microneedling
~£350–£800 per session
Course typically 3 to 4 or more. The most expensive route here.
The value message, honestly: for red marks, a course delivers real, visible softening and is a defensible spend. For white marks, budget for modest improvement, or decide the money is better kept. Watch for quotes covering session one only, and for "removal" packages that price erasure.
Why is no price shown for tretinoin?
Tretinoin is a prescription-only medicine. Dermystify does not show prices or promotion for prescription-only medicines. It is prescribed after a face-to-face assessment, not chosen by comparing prices, and it cannot be used in pregnancy or while breastfeeding.
Not NHS-funded. The NHS route exists only for investigating an underlying cause, such as suspected cortisol excess or a steroid effect. See when to see a GP.
Indicative 2026 prices · verify at booking.
The emotional side
Most people have them. Most people who have them have never mentioned it to anyone.
Stretch marks are a normal consequence of a body that grew, carried a pregnancy, gained muscle or changed weight. They are close to universal, and they are not a flaw, a failure of self-care or evidence of anything at all except that you have a body which did something.
Two things are worth naming without alarm. The first is comparison. If your sense that your marks are unusual has come from social feeds, that sense is measurably wrong: the bodies you're comparing against are posed, lit, filtered and often retouched, and stretch marks are one of the first things smoothed away. Knowing that is genuinely the whole intervention for a lot of people.
The second is postnatal body change, which deserves warmth rather than urgency. A body that has just done something enormous is not a project with a deadline. There is no window closing on your worth, whatever the marketing implies about the window closing on red marks. And distress here is real. If how you feel about your appearance is taking over your days, checking, covering, avoiding, or spending in pursuit of a result nobody can deliver, that's worth mentioning to a GP. Nobody needs to fix a stretch mark to be well.
If it is dominating your days
If thoughts about your stretch marks are dominating your mood, your clothing choices or your relationships, a GP is a reasonable and unembarrassing first step. Feeling this way about a visible body change is common, support exists, and it works. You don't need to justify the referral by having "something serious".
NHS: mental health support
If more treatment keeps disappointing
Where a minor or normal feature preoccupies you for hours, drives repeated checking or covering, and pushes you towards more treatment after each result disappoints, that pattern can point to body dysmorphic disorder. It's recognised and treatable, and another session is not the answer to it. A GP can start that conversation.
NHS: body dysmorphic disorder
If you are under 18
If you're under 18 with marks from a growth spurt, the honest position is that you almost certainly need nothing done. They are extremely common at your age and they fade a lot. If they're genuinely distressing you, a GP is the right first conversation, not a clinic, and not a course of laser sold to a teenager for a normal variation.
Frequently asked questions
Can stretch marks be removed completely?
No. Stretch marks are permanent scars in the deeper layer of the skin, and nothing currently available removes one: not creams, not lasers, not radiofrequency, not needling. What good treatment does is fade the colour and soften the texture, so the marks become less obvious. Any treatment named "stretch-mark removal" is describing something it can't do.
Do red stretch marks respond better than white ones?
Yes, substantially, and this is the most useful fact on the page. Fresh red or purple marks improve meaningfully with the best options, in the region of 60 to 70% in the published studies. Mature white marks typically improve by under 30%, whatever the device. If your marks are still red, the treatment window is open. If they're white, expect modest.
Do stretch marks fade on their own?
They usually become considerably less noticeable over time, especially marks from puberty and growth spurts. The red fades to white or silver, and any raised texture settles. They don't disappear, but for a lot of people, particularly younger people, the thing that felt enormous at the time simply stops being a consideration. Waiting is a legitimate plan.
Do prevention creams and oils work?
There's no good evidence that they do. A Cochrane review of six trials involving 800 women found no high-quality evidence that any topical preparation prevents stretch marks in pregnancy. Cocoa butter and olive oil have both been tested and neither was shown to work. Susceptibility is largely genetic. This is the most oversold claim in the category.
Is laser or microneedling safe for darker skin?
It can be, with the right choices, but the options rank differently for you. Ablative fractional CO₂ carries the highest risk of burns and post-inflammatory pigmentation in Fitzpatrick IV to VI and is usually the wrong first choice. Non-ablative fractional laser, insulated-tip RF-microneedling, or standard microneedling with conservative settings are safer routes. Insist on a test patch and a practitioner experienced with your skin tone.
Can I treat stretch marks while pregnant or breastfeeding?
Tretinoin, the best-evidenced topical, is off the table entirely in pregnancy and breastfeeding. Device treatments are generally deferred too, and any decision belongs with a professional who knows your situation. It's an awkward overlap: the marks are at their most treatable when the safest options are unavailable. Waiting until afterwards is usually the sensible answer.
Citations & sources
15 sources
Citations & sources
15 sources
Medical review and reference verification are pending.
1. Kang S, Kim KJ, Griffiths CE, et al. Topical tretinoin (retinoic acid) improves early stretch marks. Arch Dermatol 1996;132(5):519–526. Improves striae rubrae; little effect on striae albae.
2. Ud-Din S, McGeorge D, Bayat A. Topical management of striae distensae: prevention and therapy of striae rubrae and albae. J Eur Acad Dermatol Venereol 2016;30(2):211–222.
3. 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 2014;170(3):527–547.
4. Aktoz F, Yilmaz N. Comparing fractional microneedle radiofrequency and fractional CO₂ laser for striae distensae: a systematic review and meta-analysis. Lasers Med Sci 2024;39:271. No clear superiority; around 60 to 70% improvement in early red striae; under 30% in mature white striae.
5. Sun X, Jia X, Huang L. Microneedling therapy for striae distensae: systematic review and meta-analysis. Aesthetic Plast Surg 2024;48(15):2915–2926.
6. Comparative meta-analysis, fractional CO₂ versus microneedling for striae distensae. Lasers Med Sci 2025 (6 randomised trials, 166 patients): comparative effectiveness, pigmentation incidence and satisfaction.
7. Lu Y et al. Network meta-analysis of treatments for striae distensae: bipolar radiofrequency plus topical tretinoin ranked highest for clinical effectiveness and satisfaction; fractional CO₂ superior among lasers.
8. Brennan M, Young G, Devane D. Topical preparations for preventing stretch marks in pregnancy. Cochrane Database Syst Rev 2012;11:CD000066 (6 trials, 800 women; no high-quality evidence of prevention; average risk ratio 0.74, 95% CI 0.53 to 1.03).
9. Epidemiology: Cochrane CD000066 (pregnancy 50 to 90%); Evaluation of various therapeutic measures in striae rubra, PMC4924406 (puberty incidence around 25 to 35%); Aktoz & Yilmaz 2024 (around 90% of pregnant women). No robust UK population-prevalence dataset exists; the figures above are international estimates.
10. Cushing's syndrome presentation: dermatology reference sources and case literature (wide, over 1 cm, purple striae with central obesity, easy bruising, proximal muscle weakness, moon facies, buffalo hump, hypertension or diabetes). BMJ Case Reports 2024: violaceous abdominal striae as a clue to Cushing's syndrome.
11. US Food and Drug Administration, Safety Communication: Potential risks with certain uses of radiofrequency (RF) microneedling, 15 October 2025 (burns, scarring, fat loss, disfigurement, nerve damage). American Academy of Dermatology statement, 16 October 2025.
12. Skin-of-colour device safety: higher pigmentation and burn risk in Fitzpatrick IV to VI; ablative fractional CO₂ carries the highest risk; insulated RF microneedle tips reduce epidermal thermal injury; test patching and conservative parameter selection essential.
13. Remote-prescribing rule: from 1 June 2025, a face-to-face consultation is required before prescribing prescription-only medicines for non-surgical cosmetic procedures (NMC position; GMC, GDC and GPhC aligned; GPhC guidance updated April 2025).
14. Injectable exosomes: unlawful in the UK. The MHRA treats injected exosome products as unauthorised medicinal products with no UK marketing authorisation; lawful only within an MHRA-authorised trial. Topical exosomes legal if correctly CE-marked.
15. NHS position on stretch marks (common, harmless, usually fade; no treatment reliably removes them; cosmetic treatment not NHS-funded). Indicative UK 2026 prices aggregated from current UK clinic price guides. Verify at publish.
Medical review pending
Reviewer and review date to be assigned. This concern sits under the dermatology reviewer group.