Stretch marks cannot be completely erased, but they can be faded.

The realistic goal of stretch mark treatment is not to make them disappear completely, but to 'improve' them so that they are less noticeable. Stretch marks are atrophic scars caused by the tearing of collagen and elastin fibers in the dermal layer as the skin stretches rapidly. Once they occur, there is no guaranteed method for 100% restoration. However, it is entirely possible to make them much less prominent by gently smoothing out their color, texture, and depth.

And one more thing: timing is half the battle in stretch mark treatment. Fresh, red stretch marks respond well, while white stretch marks that have hardened over time take longer. Therefore, "when you start" heavily influences the results. In this article, we will unpack why stretch marks occur, how to approach them step-by-step, and how Onlif Clinic views stretch marks from a scar perspective.

🩹 What exactly kind of scar are stretch marks?

The medical term for stretch marks is **Striae Distensae**. When the skin stretches faster than it can handle, the elastic fibers in the dermis cannot withstand the tension and tear, leaving thin, long stripe-like scars.

The causes are more diverse than you might think. Representative examples include pregnancy, rapid growth during puberty, rapid weight gain or loss, fast muscle gain, and long-term use of steroids (corticosteroids). In particular, **Striae Gravidarum** (pregnancy stretch marks) are so common that they are reported to occur in about 50-90% of pregnant women (though research varies widely, making it difficult to pin down a single figure).

Stretch marks belong to the 'general scar' category among the scar types classified by Onlif—specifically, atrophic/depressed scars. Their characteristic feature is that their size barely changes over time, leaving only marks behind.

📌 Key Summary: Stretch marks are atrophic scars caused by torn dermal collagen and elastin, and 'improvement' rather than complete removal is a realistic goal.

🔴 Red stretch marks vs. White stretch marks: What is the difference?

The characteristics of stretch marks change completely over time. Understanding this difference is key to timing your treatment.

**Striae Rubra** refers to the red stretch marks in their early stage. Because the blood vessels are dilated in an inflammatory state, they appear red or purplish. This period is the so-called golden time for treatment. Since the tissue has not completely hardened yet, the response to improvement is generally good.

**Striae Alba** refers to mature white stretch marks. As the blood vessels contract and the atrophy settles, they remain as white, depigmented streaks. At this stage, the difficulty of treatment increases, and it takes more time.

A common misconception: Many people give up, thinking "it is too late for white stretch marks," but that is not true. Since the current state of the tissue is a more important criterion for scars than when they formed, even old white stretch marks can be addressed after a proper diagnosis.

📌 Key Summary: Red stretch marks represent the golden time; white stretch marks take longer, but being old does not mean it is time to give up.

💉 What methods are available for treating stretch marks?

Stretch mark treatments are broadly divided into 'topical applications' and 'stimulating the dermis through procedures.' A crucial premise here: No method can completely erase stretch marks; the goal is always the improvement of color, texture, and depth.

Approaches commonly mentioned for early red stretch marks

**Tretinoin**, a topical retinoid, is known to promote collagen synthesis in early striae rubra. Clinical studies have reported that applying 0.1% tretinoin reduced the length and width of early stretch marks. However, this applies only to early lesions, and its use is strictly contraindicated during pregnancy due to the risk of fetal malformation.

**Pulsed Dye Laser (PDL)**, which targets the vascular components of red stretch marks, also frequently appears in early-stage treatments.

Procedures used for white stretch marks and texture improvement

For mature white stretch marks, the approach is to directly stimulate the dermis to induce collagen regeneration.

• Fractional CO₂ Laser: This is the most frequently mentioned device for improving the texture and depth of white stretch marks.

• Radiofrequency Microneedling (RF Microneedling): This directly stimulates the dermis to induce collagen and is preferred for darker skin tones because the risk of post-inflammatory hyperpigmentation is lower than with lasers.

• Microneedling: A method that induces collagen through physical stimulation, widely applied across various skin tones.

• **Chemical Peels (Glycolic Acid, TCA, etc.)** or **PRP (Platelet-Rich Plasma)** are often mentioned as supportive or combination therapies rather than standalone treatments.

The fundamental mechanism that creates stretch marks is damage to the collagen and elastin in the dermis. Therefore, these procedures ultimately aim for the same goal of 'regeneration.' Please also keep in mind that most require 3 to 10 or more sessions, repeated at intervals of 4 to 8 weeks.

📌 Key Summary: Regeneration-promoting approaches are used for red stretch marks, while dermal stimulation-based procedures are used for white stretch marks, typically requiring multiple repeated sessions.

🏥 How Onlif views stretch mark scars

Onlif Clinic classifies stretch marks as a branch of 'atrophic/depressed general scars.' Placing them in the same vein as acne scars, C-section, and surgical scars, our basic principle is to diagnose the condition first without generalization, and then design a customized approach.

The core of Onlif's general scar solution is the needle-free method. Using pneumatic energy, it breaks down tissue adhesions in the dermal layer while simultaneously delivering regenerative ingredients. It injects active substances to a depth of 250–300㎛ using strong wave energy, producing a so-called 'micro-subcision' effect in the lower dermis.

Since stretch marks are scars where the skin has torn due to expansion, the approach of filling the empty spaces and breaking down the tangled areas works very well. Because it does not use needles, the burden of bruising and swelling is minimized, and another advantage is that clients can generally return to their daily lives on the same day.

The process proceeds in four steps. ① 1:1 Diagnosis — Checking the scar type, tissue condition, and activity. ② Customized Design — Determining the treatment area and regenerative ingredients tailored to the location and depth. ③ Procedure — Relieving adhesions and injecting regenerative ingredients using a needle-free method. ④ Aftercare — Monitoring recovery and adjusting the next session.

The number of sessions varies depending on the scar condition and the substances used, but we usually recommend 3 to 5 or more sessions at 1 to 2-month intervals.

Onlif's philosophy is: "Because you are precious, we do not change you." Rather than reconstructing your appearance, we focus on removing the scars that overshadow your natural beauty. In stretch mark treatment as well, we aim to restore the skin's texture naturally, without going to extremes.

📌 Key Summary: Onlif diagnoses stretch marks as atrophic general scars and utilizes a needle-free method to simultaneously promote adhesion relief and deliver regenerative ingredients.

⚠️ For these types of stretch marks, seek medical consultation first

Not all stretch marks are simple cosmetic issues. If wide, dark purple stretch marks suddenly appear in multiple areas, do not ignore them.

This pattern can be a characteristic sign of endocrine disorders such as Cushing's syndrome. In this case, the stretch marks are merely a symptom, and the actual cause could be a hormonal abnormality, making a differential diagnosis necessary. This is especially true if there is a history of long-term corticosteroid use.

If you have a darker skin tone, the risk of post-inflammatory hyperpigmentation (PIH) after laser procedures is relatively high, so it is safer to prioritize methods that carry a lower pigmentary risk. Since such decisions are difficult to make on your own, getting a diagnosis first is essential.

📌 Key Summary: The sudden appearance of wide, dark purple stretch marks may be a sign that a differential medical diagnosis is needed, rather than just cosmetic treatment.

🛡️ How to prevent and manage stretch marks

While it is difficult to reverse stretch marks that have already formed, managing them to prevent new ones or maintain their current state is highly meaningful.

During periods of pregnancy or weight changes, keeping rapid skin expansion gradual can help. For reference, if your pre-pregnancy BMI is in the normal range (18.5–24.9), the recommended weight gain is about 11.5–16 kg (based on IOM guidelines).

Let us clarify some misconceptions about **stretch mark creams and oils (such as cocoa butter)**. While they are useful for relieving itching and dryness, clinical evidence regarding their effectiveness in removing already-formed stretch marks is limited. It is more realistic to set expectations around prevention and moisturizing.

A word of caution: Attempting to hide white stretch marks with tanning will backfire. Because the stretch marks lack pigment, they will remain white while the surrounding skin darkens, making them stand out even more. If you have undergone a treatment, be sure to practice UV protection and moisturizing during the recovery period to prevent hyperpigmentation.

📌 Key Summary: Creams are for prevention and moisturizing, tanning backfires, and UV protection plus moisturizing after procedures are essential for recovery.

❓ Frequently Asked Questions (FAQ)

Can stretch marks be completely removed?

No existing method guarantees 100% removal. The goal is to make them less noticeable by improving their color, texture, and depth. However, starting treatment in the early stages yields a greater degree of improvement.

When is the best time to start treatment for red and white stretch marks?

The red stretch mark (striae rubra) stage is the golden time for treatment. Since they are still in the inflammatory phase, they respond well. White stretch marks take longer, but the current state of the tissue is more important than when they formed, so they can still be addressed after a proper diagnosis.

Do stretch mark creams or oils actually work?

While useful for soothing itching and dryness, clinical evidence supporting their ability to remove established stretch marks is limited. It is realistic to view them as tools for prevention and moisturizing.

Is it safe to treat stretch marks during pregnancy?

Retinoids like tretinoin are contraindicated during pregnancy. Active cosmetic procedures are generally postponed until after childbirth, and it is safer to focus on moisturizing and gentle care during pregnancy.

How many sessions are required, and is it painful?

It depends on the condition of the stretch marks, but multiple repeated sessions are standard. Onlif's general scar treatment recommends 3 to 5 or more sessions at 1 to 2-month intervals. Because it is a needle-free method, the pain is minimal, and you can generally return to your daily routine on the same day.

I suddenly developed wide, dark purple stretch marks. Should I go to the hospital?

Yes, we highly recommend it. Wide, dark purple stretch marks can be a sign of endocrine disorders like Cushing's syndrome, making a differential diagnosis necessary. Do not dismiss it as a simple cosmetic concern.

I have a dark skin tone. Is there a safe method for me?

Since darker skin tones have a higher risk of hyperpigmentation after lasers, it is advisable to prioritize methods that carry a relatively lower pigmentary risk. An accurate decision can be made after examining your tissue condition.

What to check before choosing a clinic for stretch mark treatment

Even for the same procedure, the results and recovery process can vary depending on where, by whom, and how it is performed. Asking these questions during your consultation can help you make an informed decision.

• Do they perform this procedure frequently? — Different clinics specialize in different treatments. Check if they regularly carry out stretch mark treatments.

• Can you verify the products and equipment used? — Ask during the consultation if you can confirm the product names and authenticity (whether they are officially imported and if there is an unboxing verification process).

• Do they explain the breakdown of costs? — Instead of just hearing the total sum, you should receive an explanation of what product is used, how much is used, and over what area to make a proper judgment.

• Do they design the treatment looking at the entire face? — Even for the same procedure, the placement and volume vary depending on facial shape, skin condition, and asymmetry.

• Do they explain adverse events and the recovery process beforehand? — It is better to choose a place that explains potential adverse events and how to handle them, rather than a consultation that only highlights expected positive changes.

• Is there a follow-up process after the procedure? — Check if there is a designated timeline to review progress, a way to contact them if issues arise, and set criteria for follow-up visits.

This is how Onlif Clinic approaches stretch mark treatment

• We divide responsibilities — Operating under the belief that a single doctor cannot master every single procedure, Onlif assigns dedicated doctors to each specialized field.

• We verify products and equipment together during consultations — We guide you through the products used and the unboxing verification process during your consultation.

• We provide cost breakdowns after diagnosis — Since the treated area, volume, and scope differ for everyone, we explain what costs what and why.

• We design treatments looking at the balance of the entire face — We look at the face through three axes: texture, balance, and signs of youth. Instead of changing your structure, we plan to refine the areas that mask your natural impression.

• We discuss adverse events and the recovery process first — Along with the changes you can expect, we guide you through individual differences, potential adverse events, and how to address them before the procedure begins.

• We monitor progress together after the procedure — If verification is needed during the recovery period, we provide guidance on follow-up visits and contact channels.

If you are considering stretch mark treatment, it is best to first find out what is possible and what is difficult in your current condition. An accurate diagnosis and treatment plan can only be determined through an in-person consultation. Come and find out through a consultation at Onlif Clinic in Gangnam.