Old Stretch Marks: What Creams, Lasers and Self-Tanner Can and Can't Do

A stretch mark is a scar that forms when skin stretches or shrinks quickly.¹ Most of the ones a woman notices after 50 are decades old: the color has faded, and the bands have sunk a little below the surface.¹ The American Academy of Dermatology (AAD)¹ is plain about them: “Like any scar, stretch marks are permanent, but treatment may make them less noticeable.”¹

Early marks and old marks respond differently

	Early stretch marks	Old (mature) stretch marks
What they look like	Red, purple, pink, reddish-brown or dark brown, depending on skin color; may feel raised and itchy1	Faded; you feel a slight dip when you run a finger over them1
Creams	Tretinoin or hyaluronic acid may make them less noticeable1	“Treatment seems to have little effect”1
Almond oil, cocoa butter, olive oil, vitamin E	None of the marks faded in studies1	None of the marks faded in studies1
Self-tanner	Camouflages them1	Camouflages them1
Sun tanning	Makes them more noticeable, because they don’t tan1	Makes them more noticeable1

The cream trial everyone cites

A University of Michigan trial gave 22 people with new, active stretch marks either 0.1% tretinoin cream or a look-alike cream every day for 6 months. Neither the patients nor the doctors knew who had which.²

• 8 of the 10 on tretinoin had definite or marked improvement, compared with 1 of the 12 on the plain cream.²
• The treated marks got 14% shorter and 8% narrower. The untreated marks grew 10% longer and 24% wider.²

The trial only included early marks.² It doesn’t tell you what tretinoin would do to a silver mark from 1985, and the AAD’s advice is to use creams on early marks.¹

What a dermatologist can offer

• The procedures: chemical peels, laser therapy, microdermabrasion, radiofrequency and ultrasound. The AAD says these have proven more effective than creams, lotions and gels, but none of them can get rid of stretch marks.¹
• The evidence is thin. A 2017 review of 74 studies found low-quality evidence, small studies and different methods in each one. Its verdict: “No treatment has proved to be completely effective.”³
• Pale marks are a different target. For white marks, much of the research aims to add color back, for example with ultraviolet light.³
• Ask about your marks specifically. The AAD says a dermatologist can tell you what suits your health, your age and how long you’ve had the marks.¹ In the UK, you pay for these treatments yourself.⁴ See our checks for at-home microneedling rollers and silicone scar products.

When new stretch marks after 50 are a clue

• Steroids: using a steroid cream on your skin for a long time can cause stretch marks, and so can some steroid tablets.¹⁴ Ask your prescriber before changing anything.
• Cushing’s syndrome is rare, but the NHS⁴ says to see a doctor if you have large stretch marks along with more fat on your chest and tummy but slim arms and legs, a build-up of fat on the back of your neck and shoulders, or a red, puffy, rounded face.⁴

Try: “My stretch marks are decades old, silver and slightly sunken. Would any procedure make them less noticeable on my skin, how many sessions would it take, and what results should I expect?”

Skin, Head to Toe sorts stretch marks in Chapter 8, “Marks That Stay”: early red marks go in the Try box, and pale, mature marks go in Normal, with self-tanner as camouflage. If you do start a treatment, its Skin Log has you photograph the area in the same window light every two to four weeks so you can compare the area against your first photo. See the book.