When Do Stretch Marks Start in Pregnancy and How to Treat Them

Stretch marks are very common during pregnancy, especially in the last few months. In fact, many women notice them as their skin stretches to support their growing baby. These marks can appear on areas like the belly, thighs, hips, breasts, and lower back. Studies show that stretch marks affect a large number of pregnant women around 50 – 90 %, making them a normal part of pregnancy for many people.(1) Stretch marks during pregnancy, also known as striae gravidarum, usually begin to appear around the sixth or seventh month as the skin stretches rapidly to support the growing baby. However, some women may notice them earlier in pregnancy as well. These marks are more commonly seen during a first pregnancy, but they can also develop for the first time in a second pregnancy.(2)

Some researchers believe that stretch marks are not caused only by skin stretching. Hormonal changes may also play an important role. Studies have found that the skin affected by stretch marks contains a higher number of hormone receptors in the outer skin layer. This suggests that areas exposed to greater stretching may become more sensitive to hormonal activity, which can contribute to the development of stretch marks.(3)

 How to treat:

Management strategies for stretch marks include cosmetic formulations and aesthetic procedures aimed at improving skin elasticity, hydration, and dermal repair. Moisturizers containing emollients and humectants such as glycerin, fatty acids, phospholipids, and hyaluronic acid help maintain skin hydration and flexibility. Bioactive ingredients including vitamin E, panthenol, collagen, elastin, and Centella asiatica support antioxidant protection, collagen synthesis, and skin regeneration. In addition, aesthetic treatments such as laser therapy, microneedling, carboxytherapy, and newer regenerative technologies may help reduce the appearance of established stretch marks by promoting collagen remodeling and epithelial restoration.(4)

Centella asiatica

Preventing stretch marks (striae gravidarum) remains challenging, and most topical approaches show only modest benefits. However, formulations containing Centella asiatica have demonstrated relatively better outcomes in clinical studies. This botanical extract is believed to support the synthesis of collagen and elastin, which are essential for maintaining skin structure and elasticity.

Clinical evidence suggests that regular application of Centella-based creams, starting early in pregnancy, may help reduce the occurrence and severity of stretch marks. Some studies also indicate that while stretch marks may worsen over time without treatment, their progression can be stabilized or minimized with consistent use of such formulations. (5)

Tretinoin

After delivery stretch marks removal cream mostly contain Vitamin A derivative - Tretinoin, is one of the most studied ingredients for improving stretch marks. It works by supporting collagen production, improving skin renewal, and enhancing overall skin texture. Research has shown that tretinoin creams, especially at 0.1% concentration, can help reduce the appearance of early red stretch marks (striae rubra) when used consistently for around 12 weeks or longer.

Studies reported visible improvement in the texture and width of stretch marks, although results were less noticeable in older white stretch marks. Mild side effects such as dryness, redness, peeling, or irritation were occasionally observed.

Some studies also compared tretinoin with treatments like platelet-rich plasma (PRP) and laser therapies, where combination or advanced treatments sometimes showed better results. However, tretinoin remains a commonly used topical option for improving the appearance of stretch marks over time.

Note: Tretinoin is generally not recommended during pregnancy and should only be used after consulting a healthcare professional. (6)

Bomb Bum Cream

Bomb Bum Cream is one of the best stretch mark cream for pregnant women which contains multiple bioactive ingredients that help improve skin elasticity, hydration, firmness, and overall appearance of stretch marks. Key active ingredients include Centella asiatica (Gotu Kola) extract, which supports collagen synthesis and dermal repair; Bakuchiol, a plant-derived retinol alternative known to stimulate skin renewal and improve skin texture; Palmitoyl Tripeptide-5 and collagen extract, which enhance collagen production and improve skin firmness and elasticity; and Hyaluronic acid, Panthenol, Shea butter, Cocoa butter, and Mango butter, which provide deep hydration and strengthen the skin barrier. Antioxidant-rich extracts such as Acai fruit extract, Fisetin, Vitamin E, Cucumber extract, and Dunaliella salina extract help protect against oxidative stress and support skin regeneration. Additionally, Caffeine, Raspberry ketone, and marine-derived actives like Siloxanetriol alginate and Codium tomentosum extract help improve skin smoothness, firmness, and texture, making the formulation beneficial for improving the appearance of stretch marks and uneven body skin texture.

Trofolastin cream:

Clinical studies on topical stretch mark prevention have shown promising results with creams containing Centella asiatica. In two studies involving 130 pregnant women, 56% of women in the placebo group developed stretch marks compared with 34% in the Trofolastin-treated group. Trofolastin Anti-Stretch Marks Cream contains active ingredients such as Centella asiatica extract, hydrolyzed collagen, hydrolyzed elastin, wheat germ oil, vitamin E, and triterpenes including asiaticoside, asiatic acid, and madecassic acid. These ingredients help stimulate fibroblast activity, enhance collagen synthesis, improve skin elasticity, hydration, and support dermal repair, thereby helping to reduce the development and severity of stretch marks.(7)

Current treatment options mainly focus on improving collagen production, skin texture, pigmentation, and elasticity. Treatments such as microneedling, radiofrequency, electromagnetic therapies, and laser treatments have shown visible improvement, especially in early stretch marks. Among laser therapies, pulsed dye lasers, Nd:YAG lasers, fractional CO2 lasers, and non-ablative fractional lasers demonstrated improvement in redness, collagen remodeling, and skin thickness. However, complete removal of stretch marks remains difficult, and early intervention provides the best outcomes(8)

Existing treatments such as microdermabrasion, microneedling, and laser therapies may provide partial improvement, but no single treatment has shown completely consistent results for all patients.

According to the study, a new treatment combining electromagnetic fields and negative pressure (V-EMF) demonstrated significant improvement in stretch marks and skin quality. The treatment promoted collagen and elastin production, improved blood circulation, increased epidermal thickness, and restored melanocyte activity, helping the skin regain a healthier and more even appearance. Patients experienced smoother, firmer skin with improved texture and pigmentation, while histological analysis confirmed tissue regeneration and collagen reorganization. Importantly, the treatment showed no major side effects or downtime.(9)

In conclusion, stretch marks are a very common part of pregnancy and develop due to skin stretching along with hormonal changes. Although complete removal remains difficult, early care with moisturizers, collagen-supporting ingredients, and treatments that improve skin repair and elasticity can help reduce their appearance and severity. Newer technologies such as laser therapies, microneedling, radiofrequency, and electromagnetic treatments have also shown promising results in improving skin texture, pigmentation, and collagen remodeling with minimal side effects.

Author: Dr. Swati Gajbhiye