STRETCH MARKS

Any woman can get stretch marks-and many frequently do, because of a sudden increase in weight as happens in pregnancy. But do any preventive measures work?

Human skin is naturally elastic, and can normally stretch considerably to accommodate a change in weight or in the shape of the mass it covers. The tissue beneath the skin surface develops as we grow so that the skin area above it gradually increases. But if very rapid physical expansion takes place the elastic tissue may be put under intolerable strain so that it tears and stretches the skin above it. This will show as a stretch mark - a red line on the skin surface.

The redness fades in a matter of months, but the skin surface can never go back to its previous condition. A papery kind of scar tissue will remain, and the stretch marks will look like pale or silvery thread-like lines.

WHEN STRETCH MARKS OCCUR ?

Stretch marks can occur during puberty. As the hormonal balance changes, teenage girls may quickly put on weight in specific areas. The sites most likely to be affected are the breasts, hips, thighs and buttocks. Stretch marks are more likely to occur in girls who are already some what overweight, although they can affect girls who develop large breasts at the particularly fast rate during puberty.

Stretch marks which appear during pregnancy are also caused by hormonal changes which results in weight gain. Women with small breasts may be especially prone to stretch marks when they are pregnant, since the breasts will need to enlarge considerably in readiness for lactation (milk production). If the breasts are small, the skin may not be sufficiently elastic to cope with this change. Stretching of the abdominal wall is of course bound to happen in pregnancy, and there may be an increase in fat deposits around the hips and thighs.

These marks will stay a reddish colour throughout the pregnancy, but will gradually lose their colour after the baby has been born. Some may hardly show after a few months but others will be visible indefinitely. In some cases, they may be so severe that they resemble post-operative scars, like the abdominal scar left by an appendectomy.

CAN STRETCH MARKS BE PREVENTED ?

The changes in shape that accompany both puberty and pregnancy are clearly unavoidable, but some women put on far more weight than others at these times. Adolescent girls who are putting on excess weight may have to change their eating patterns if stretch marks are to be avoided. Exercise is also very important-it helps to burn up the extra calories needed for the increase in muscular activity.

Women who are careful about what they eat and how much weight they put on during pregnancy are also less likely to develop stretch marks. Even though stretch marks on the breasts and abdomen of the body-the legs, arms, hips and thighs-are almost always the result of overweight. There is no evidence that one type of skin is more prone to stretch marks than another.

If you find you are developing stretch marks during pregnancy you should immediately review your diet. Hormonal changes mean that calories are burnt up less efficiently than before the pregnancy, so to compensate for this you may have to eat less fat and carbohydrates. Your doctor or antenatal clinic will be able to advise you on what your weight should be during pregnancy, and help you to plan your diet accordingly. Some marks are unavoidable but if you take early preventive action you will minimize the possibility of getting more marks later in the pregnancy.

Some people maintain that oils or creams rubbed into the skin of the breasts and abdomen will prevent stretch marks, but most doctors will point out that no amount of lubrication of the skin surface will affect the changes beneath it. However, many women find that the skin becomes dry and flaky during pregnancy, and that an oil or cream helps considerably with this. There is certainly no harm in using these products, and if a pregnant woman takes care of herself in this way, she may become aware sooner of unnecessary weight gain and so be more careful about her diet.

Stretch marks are likely to be worse in women carrying twins since the abdomen will be stretched far more than in a single pregnancy. Extreme fluid retention or an excess of amniotic fluid can also result in particularly severe stretch marks. In these cases plastic surgery may be advised after pregnancy, but this is unusual for the majority of women.