Stretch marks are a cosmetic blight most of us will encounter at some point in our lives. Here are some helpful hints on how to prevent and treat them

We have three layers of skin: the epidermis (outer layer), the dermis (middle layer), and the subcutaneous stratum (innermost layer). Stretch marks occur in the dermis, the resilient middle layer that helps the skin retain its shape. When the dermis is constantly stretched over time, the skin becomes less elastic and the small connective fibres within it break. The result is what we know as stretch marks.

Depending on your natural skin colouring, stretch marks begin as raised pink, reddish brown or dark brown lines that later turn a brighter violet or purple. Gradually these bright marks flatten and fade to a colour a few shades lighter than your natural skin tone. They usually become less noticeable over time.

Stretch marks can appear anywhere on the body where the skin has been stretched, and they often occur as a result of weight gain. They're most likely to appear in places where fat is stored, including the abdomen, breasts, upper arms, thighs and buttocks. They pose absolutely no health risk and don't compromise your body's ability to function healthily.

Prevention

Imagine a balloon that's been blown up and then deflated. No matter how much you blow it up again, it's already lost much of its original elasticity and will never look quite the same. Stretch marks are similar, in that they don't ever go away entirely. The key, however, is finding ways to reduce their appearance. The earlier you begin treating stretch marks - when they are red or reddish brown - the more likely you are to diminish their appearance. Once these marks begin to flatten and fade they become less obvious and are more difficult to treat.

Between 75 and 90 per cent of women develop stretch marks during pregnancy. The sustained stretching on the abdomen as a result of weight gain usually means stretch marks will appear during the sixth or seventh month. But pregnant women aren't alone in being susceptible. Adolescents experiencing growth spurts and athletes - especially bodybuilders who practise strenuous and repetitive exercise - are likely to get stretch marks, as is anyone who gains or loses a significant amount of weight in a short period of time.

If your weight doesn't tend to fluctuate, you are not likely to develop stretch marks. But those who carry children or tend to gain and lose weight frequently are likely candidates. Some say that since our skin structure is genetically determined, we are predisposed to developing stretch marks. Others believe that there are preventative measures we can take. Here are some general suggestions that may help: massage your skin with a glove or massage brush to increase circulation; apply moisturising cream to the affected area on a daily basis to keep the skin supple; and eat foods that contribute to the overall health of your skin, such as those high in vitamins C and E, zinc and silica.

Moisturisers and vitamin creams

If caught in the early stages, stretch marks can be minimised with over-the-counter moisturising creams. Vitamin E oil, which assists in general skin healing and condition, can reduce the appearance of stretch marks. Vitamin A is also a good emollient, but it's not as effective as prescription Tretinoin, or Retin-A, which attaches itself to receptors on the skin cells and helps exfoliate the skin and form healthy new cells. Though these creams are effective in moisturising the outer skin layer, they can't always penetrate deep into the dermis where stretch marks occur. They also can't completely change a pre-existing skin condition, which is why they work best on stretch marks that are just forming.

Alpha hydroxy acids (AHAs)

AHAs are derived from certain plants, many of which are fruits, and so are sometimes called 'fruit acids'. AHA creams are said to help with stretch marks because they moisturise the outer layer of skin, making it more pliable. These products increase cell regeneration by 'burning off' the outer layer of skin cells. By removing the top layer of cells, healthier ones rise to the surface, improving skin texture and colour, and allowing moisturisers to be absorbed so the skin remains supple. While penetrating the skin's surface, the water-binding properties of AHAs increase the skin's flexibility and assist in stretch mark reduction. Though your skin may feel dry and flaky at first from the dead cells being sloughed away, after a few weeks, AHAs may make your skin feel and appear smoother - and visibly reduce stretch marks. If you stop using AHAs, the skin will return to its normal state since cell regeneration is no longer taking place.

Prescription treatments

Tretinoin, or Retin-A, helps to loosen the keratin in the outer layer of skin and remove dead cells. Although derived from vitamin A, Tretinoin cream is much more effective than the naturally occurring vitamin because it thins the outer layer of skin in order to penetrate the dermis where stretch marks occur, and it increases collagen production. The result is a 'plumping up effect', which helps improve the appearance and texture of skin, and can diminish the appearance of stretch marks. Your doctor will advise you on the correct amount to use, but be aware that stronger dosages, although more effective, may cause stinging, swelling and redness, and potentially a sensitivity to sunlight. Skin thickening is another possible side effect of using this kind of cream, as collagen production is increased. Tretinoin is most effective in stretch mark treatment when used early.

Tretinoin is not recommended for use in pregnancy or while nursing. Also, those taking Retin-A are advised not to take any Vitamin A supplements at the same time, as this can increase adverse effects.

Laser surgery

Laser surgery is currently being developed for the treatment of stretch marks. This treatment doesn't remove stretch marks - it simply makes them fade. The laser responds to dark colours only, so in the early stages when stretch marks are dark red or brown, treatment will be most effective. Faded, flesh-coloured marks probably won't respond well to laser treatment because they are light in colour. A series of treatments might be required for visible results.

Endermologie

The Endermologie machine, developed in France over a decade ago, uses rollers and gentle suctioning to deeply massage stretch-marked areas, increasing the circulation by up to 200 per cent. At the same time, toxins and abnormal water build-up are expelled as connective fibres are stretched. The exfoliation in conjunction with the stretching of the fibres can be helpful in reducing the appearance of stretch marks. Expect to wear a body stocking as a technician runs the suctioning rollers over your body, concentrating on the affected areas. Each session lasts half an hour, but to see results, a series of treatments is recommended.