Does Cocoa Butter Prevent Pregnancy Stretch Marks?What Trials Found

Stretch marks affect around 8 in 10 pregnant women, usually on the tummy, thighs or breasts.¹ Rubbing in cocoa butter is the best-known way to try to stop them, so researchers tested it against look-alike creams.

Two trials of cocoa butter

	Lebanon trial	Jamaica trial
Women	210 in a first pregnancy, 175 finished2	3003
Started	First trimester2	16 weeks3
Stretch marks with cocoa butter	45%2	44%3
Stretch marks with placebo	49%2	55%3

Both trials were double-blind, so neither the women nor the researchers knew who had which cream.²³ In Lebanon, cocoa butter made no difference to how many women got stretch marks or how bad they were.² In Jamaica, the difference looked bigger on paper but wasn’t statistically significant, and the authors concluded cocoa butter doesn’t prevent them.³ The Jamaica trial may have been too small to pick up a modest effect.

The wider evidence

A Cochrane review of six trials with 800 women found no clear difference in stretch marks between women using creams with active ingredients and women using a placebo or nothing.⁴ It found no high-quality evidence for any of them.⁴ Its search ended in 2011.⁴

A 2015 review sorted the ingredients:⁵

• Cocoa butter and olive oil: not effective⁵
• Centella, and possibly bitter almond oil massage: limited evidence⁵
• Hyaluronic acid: weak evidence⁵

The authors concluded that reliable prevention methods are scarce.⁵ UK pregnancy advice says the same: the evidence on oils and creams is limited.¹

What does make them more likely

• Younger age and a larger baby went with more stretch marks in the Jamaica trial; body mass index didn’t.³
• Weight gain above average in pregnancy raises the odds.¹ But don’t try to eat less to lose weight while pregnant.¹

What this means for you

1. Moisturize if it feels good. Cocoa butter is a pleasant moisturizer. Just don’t blame yourself if marks appear anyway.
2. Itching can be the first sign of a new mark.¹ Tell your midwife about intense itching, especially on the hands and feet, since it can have other causes.
3. Leave retinoids for later. Tretinoin may help new marks, but it isn’t used in pregnancy.⁵
4. Expect fading. After birth, marks usually fade to paler lines, though they probably won’t vanish.¹ See old white stretch marks.

Try: “I’m 20 weeks pregnant and getting itchy, red lines on my belly. Is there anything worth using now, and what could I try for them after the baby’s born and I’ve finished breastfeeding?”

Skin, Head to Toe covers this in Chapter 8, “Marks That Stay,” in a section called “The Cocoa Butter Test.” Its four-box sort files prevention oils under Skip and new red marks after pregnancy under Try, so money and hope go where the trials point. See the book.