Stretch marks, also called striae, are one of the most frustrating problems I have encountered in my 25 years of plastic surgery practice. They are such a common problem that they affect most women who have had children, no matter how carefully they have managed their weight during pregnancy and no matter how hard they have worked to regain their shape and fitness after childbirth. In recent years, steroid use has caused stretch marks in many young men who have worked very hard at bodybuilding and fitness. What has frustrated me the most is that I have had very little to offer my patients that effectively removes stretch marks.
Time and time again I have read articles or seen presentations at meetings claiming that lasers can remove stretch marks and stretch marks, but looking closely at the results of good clinical studies has been too disappointing to try these therapies on my patients. Until now, I could only offer a tummy tuck or abdominoplasty, which only partially removes the problem in the lower abdomen, and I have had no solution for other areas of the body.
Recently, however, I have been very impressed with the significant removal and improvement I am seeing in laser stretch mark removal using a combined technique with the Starlux 1540 nonablative fractionated erbium laser resurfacing technique combined with the stretch mark tightening technique. Starlux LuxIR deep infrared skin. This technique was developed by an Italian doctor named Dr. DeAngelis and a man from the Palomar Medical laser company named Richard Benkowski. The results of this new laser technique are the first I have seen showing almost complete removal of even mature stretch marks.
What causes stretch marks and stretch marks?
The skin that covers our body consists of the outer surface that we see called the epidermis and a deep pink layer called the dermis. The dermis is the pink tissue that we see after scraping the epidermis, for example when we scrape our knee. The dermis supports our skin, fills it, gives substance and elasticity to the skin. Elasticity is the component of the skin that allows our skin to stretch, move and return to its normal shape after being stretched.
During pregnancy, the skin on the abdomen stretches many times its normal size as the baby grows. After the baby is born, the elasticity of the skin in the dermis contracts to return the abdominal skin to its normal shape.
During skin tightening, if the dermis expands too much or too quickly, the dermis can rupture, split, or rupture. These breaks in the dermis of the skin cause a wide depressed scar called a striae or striae.
If you look at a stretch mark under the microscope, you will see a defect or gap in the dermis where the dermis has broken or split. The use of steroid medications also causes stretch marks even without tension or pulling on the skin. The mechanism of steroid-induced stretch marks is direct damage or dissolution of collagen in the dermis by steroid medication. Very rapid growth spurts during adolescence or even in adults who lift weights and have rapid muscle expansion can also cause dermal breakdown and stretch marks.
The basic component of the dermis is collagen. Collagen is the main ingredient in the dermis and the collagen fibers break down and damage in the dermis below the stretch marks.
How do we remove stretch marks and stretch marks?
Stretch mark and stretch mark removal requires the building of new collagen in the dermis of the skin to replace lost collagen and the tightening of the skin to reattach stretched skin. To date, the only available mechanism for producing new collagen in the dermis and tightening the skin has been heat produced by lasers, infrared energy, and other forms of thermal energy.
When the collagen in the dermis is heated to 66 degrees Celsius, the collagen contracts and tightens, and the collagen is stimulated to remodel and produce new collagen.
This principle is used in all forms of laser and light energy skin resurfacing, skin tightening and wrinkle removal treatments. Some examples are Starlux 1540 and 2940, Fraxel, Fraxel repair, ActiveFX, DeepFX, Refirm, Affirm, Thermage, Titan and LuxIR Deep technologies.
How does Starlux 1540 laser treatment and LuxIR deep stretch mark removal therapy work?
The Starlux 1540 nonablative fractional erbium laser penetrates deep into the dermis to heat collagen to 66 degrees Celsius and promotes the growth and production of new collagen to replace collagen lost in the dermis in the stretch mark. The Starlux 1540 also causes the shortening of the collagen that tightens the skin. The Starlux 1540 works up to approximately 1000 microns deep in the dermis. That’s about half the depth of the skin.
The LuxIR Deep is a fractional infrared device that delivers heat to the deeper layers of the dermis, deeper than the 1000 microns affected by the Starlux 1540. These deeper layers are where the elasticity of the dermis lies. Thus, LuxIR Deep adds not only new dermal collagen production, but also adds significant skin tightening.
Both devices are called fractionated because the heat is delivered to small partial areas of the skin rather than the entire skin surface. Because areas of skin are left untreated, the skin is not shed or peeled, so no skin is removed or excised. Therefore, non-ablative laser and light treatment.
These non-ablative treatments leave the skin intact so there is no surface healing required, no downtime, unlike the old laser resurfacing that required 2-3 weeks for skin to heal.
How is the Starlux 1540 Laser Treatment and the Starlux LuxIR Deep Treatment for Stretch Marks?
A topical anesthetic or anesthetic cream is applied to the skin before the Starlux 1540 treatment to make you feel more comfortable. Cold compresses are also very helpful. The LuxIR Deep has its own skin cooling device and is painless.
These combination treatments take time. A lower abdomen can take an hour and a half for the combined treatment. Larger areas may take longer.
Once your treatment is over, your skin will be pink but otherwise normal. There are usually no blisters, peeling, or lesions on the skin that require bandages and wound care. She applies a soothing ointment after her treatment and goes home.
How long until I see results?
You will see an improvement about a month after treatment. The production of new collagen reaches a peak during 3 months. It will take 6 months from your last treatment to see a final result. Usually 5 to 6 treatments are required.
Remember, we are stimulating the dermis of your skin to repair and heal the dermis with new collagen that plumps the skin and firms the skin. It took 9 months for the stretch marks to form, so expect at least 6 months after your last treatment to see a good result and at least a year to see a full result.
Depending on the severity of your stretch marks, you may need more treatments for continued improvements, and when it’s over, you may need annual touch-up treatments for the first year or two.
Who should do my Starlux 1540 laser and LuxIR deep infrared treatments?
Board-certified plastic surgeons and dermatologists are experts in laser skin treatments. Not all plastic surgeons and dermatologists use lasers, so you’ll have to do your homework to find an expert.
Ask your primary care doctor for a recommendation. Also visit the websites of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons for information on lasers and board-certified doctors in your area.