Stretch Marks – Pulling a disappearing act with laser’s help

By Linda Carroll

For the first time in more than 20 years, Marlene Dinken is going to have fun shopping for a bathing suit.

No longer will she have to spend hours scrutinizing each suit, searching for the one guaranteed to cover the ripples and ridges left by two pregnancies.

Now because of a new laser therapy, Dinken’s stretch marks are gone. In her case, the “cure” took only one treatment, followed by two months of recovery time, during which the reddish patches of laser-treated skin gradually healed and disappeared.

“Now I don’t see them at all,” said the 47-year-old resident of Bayside, Queens.

Until recently doctors could offer no hope to people with stretch marks. (Yes, some men get them, too.) Once the skin was damaged, there was no way to repair it. Now, with a special pulsed dye laser, a sprinkling of doctors around the country are saying that they can smooth out the unsightly scars.

But the therapy is controversial. Some dermatologists say they just can’t duplicate the successes of their colleagues and, so far, no study of the technique has been published in a scientific journal. Still, preliminary data, presented at a recent meeting of the American Society for Laser Medicine and Surgery, appears to show the technique can help.

Stretch marks aren’t just a problem for pregnant women according to Dr. Joshua Fox, the dermatologist who cleared up Dinken’s stretch marks. Growing teens and weight-lifters can also develop the unsightly dimples, said Fox, director of the Skin Laser Center of Queens and Long Island and an attending physician at North Shore University Hospital at Glen Cove.

Experts believe the marks are produced when bundles of elastin and collagen – fibers that give the skin its structure, firmness and elasticity – are stretched so far that they fray and break.

This can occur when the skin stretches to accommodate a growing fetus, or when a person grows fast or gains weight through muscle building.

The dimples form where the fibers rip. Picture a piece of clay being pulled apart. The sides stay thick as the center thins.

“If you look at a stretch mark under a microscope, you can see all the collagen fibers have pulled apart,” said Dr. D’Anne Kleinsmith, who is in private dermatology practice in West Bloomfield, Mich. “The elastic fibers have also pulled apart, and they are curled up in clumps like snapped rubber bands,”

Certain hormones – the glucocorticoids – may make matters worse by altering enzymes that break down collagen, according to Fox. ”Hormones can surge at certain times of life, either because of pregnancy or adolescence, for example.” Steroidal medications, such as those for asthma, can also be a problem, he said.

Doctors aren’t exactly sure how the laser repairs stretch marks, but they think that the device causes minor damage to the skin in the vicinity of the dimple. This then stimulates the skin to repair itself by manufacturing more collagen and elastin, Fox said.

Although one treatment was enough for Dinken, some people need two to three treatments, according to Fox, who doesn’t guarantee improvement. “I promise nothing, because it may or may not work,” Fox said. “But so far, there hasn’t been anyone who hasn’t had at least some improvement.”

Fox tries out the laser on a test area first, at a cost of $200. If it looks as if there’s improvement, he starts treatments at $300 per session, he said.

But with no published data on the effectiveness of laser therapy for stretch marks, dermatologists who haven’t been able to duplicate Fox’s results are disturbed.

“It may be a very nice treatment, but right now, today, it’s totally experimental and unproven,” said Dr. Mitchell Goldman, an assistant clinical professor of dermatology at the University of California at San Diego. “The fortunate thing is that there’s very little harm that can be done. If a patient wants to spend a few thousand dollars, that’s their choice. As far as I’m concerned, it’s a crap shoot.”

Goldman is still willing to use the technique, though. “Stretch marks can he devastating” he said. ‘I really feel for people with stretch marks. When women come to me, I tell them, yes, we will try to make their stretch marks go away, But they have to understand that the procedure is totally experimental,”

Other Options
Before Laser therapy came along, creams and lotions were the only option for treating stretch marks.

Generally the success rate was low, according to Dr. D’Anne Kleinsmith, a dermatologist in private practice in West Bloomfield, Mich. “The age-old treatment is cocoa butter,’ she said. “People also used vitamin E creams and oils. But I think, basically, these moisturizers just make the woman feel more comfortable. Stretch marks can be sensitive and tender.”

Another therapy used on stretch-dimpled skin is the acne drug Retin-A.

“Retin-A does seem to thicken skin and increase collagen,” Kleinsmith said. “I’ve prescribed myself, but I can’t say that I’ve seen a great response. You need to use it early, but we don’t like to prescribe it to pregnant women. So the earliest a woman can start is right after she gives birth.”

Of course, the cure for stretch marks is never to develop them in the first place. Pregnant women can lessen the chances of developing marks if they take care to gain no more than 25 pounds, Kleinsmith said.

They can also try to support their skin, Kleinsmith suggested, by wearing a loose girdle or extra large support hose with a control top. “You want to make sure they’re loose enough that you’re not compressing the baby.” she said. “For example, if you’re normally a size B, you might want a queen size when you’re pregnant.


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