Assoc. Prof. Dr. Ebru Karagün
Stretch Marks
Accepting her patients in her own clinic, Dermatology Assoc. Dr. Ebru Karagün, by addressing the formation of skin cracks, sheds light on treatment methods and ways to minimize the formation of cracks.
Can you start by telling a little about yourself? What have you done so far, what are your trainings and areas of expertise?
I am from Samsun. I completed my education life in Samsun, including university. I received my assistant training in Ankara, Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital. After my assistantship, I finished my compulsory service in Ağrı State Hospital. I worked as an assistant professor at Istanbul Medipol University and Düzce University Faculty of Medicine. The most enjoyable periods of my professional life were training both medical faculty students and assistant physicians and fulfilling both the duty of medicine and teaching. I am continuing my academic life as a visiting professor staff at Istinye University Faculty of Medicine by getting the title of associate professor in 2021. Since April 2022, I have been performing my duty as a physician in my own clinic in Moment Beştepe Plaza.
Which treatments do you apply in your clinic?
In our clinic, cosmetic applications such as botox-filling mesotherapy applications, thread lifting methods, device procedures (Scarlet X laser), ozone-glutathione treatment, as well as diagnosis and treatment of all dermatological diseases are performed.
How and why do stretch marks occur on the skin?
Striae or skin cracks can also be described as streak-like tearing that occurs as a result of weakening of the supporting tissues in the lower layer of the skin and stretching of the skin above its expansion capacity. Names such as “striae distensae (SD)”, “stretch marks” and “stria rubra” or “alba” are given. It is also defined as “pregnancy stretch marks” because it often occurs during pregnancy. Although skin cracks are not a serious problem in terms of health, they are one of the most important cosmetic problems today as it was in the past. It is frequently seen between the ages of five and fifty and its incidence varies between eleven and eighty-eight percent. It is observed two and a half times more in women due to the pregnancy process. The exact cause of skin cracks is not known. However, many hypotheses are mentioned. These are: Mechanical effects (Mechanical stretching of the tissues and reduction of the subcutaneous support tissue. For example, pregnancy, weight gain, weight lifting -especially pull-ups – rapid height increase.), cortisone treatments, genetic factors. It is often seen after the growth of armpit and genital hair during adolescence. It usually occurs on the upper thighs, hips and breasts in women, while it is seen on the outer thighs, middle of the back and waist in men.
We can list the risk factors for skin cracks observed during pregnancy as follows: It often starts in the last third month of pregnancy in pregnant women and continues until the pregnancy ends. It is associated with familial predisposition, being pregnant at a young age, excessive weight gain during pregnancy, and abdominal size (overweight baby, excess amniotic water or multiple pregnancies). In women, post-pregnancy stretch marks are most common in the abdomen, breasts and upper thighs.
There are two clinical forms of skin cracks:
- Striae rubra (early stage)
- Striae alba (early stage)
Skin cracks are defined as “striae rubrae-SR” which means “red”, because they initially appear red and purplish. Later, this color fades and looks like a wrinkle or even a scar on the skin and is defined as “striae albae-SA” which means “white”. Treatment options for skin cracks vary depending on whether the skin cracks are clinically in the early or late stages.
Is it possible to completely cure these cracks?
Although skin cracks are not a medical problem, they are perceived as a serious problem, especially in women, in terms of aesthetics.
In order to prevent it, it is extremely important to first determine the risks in skin cracks and to make the patient aware of these risk factors. During pregnancy, creams should be started from the twelfth week of pregnancy. In particular, it has been determined by studies that creams containing centella asiatica (tropholastin), vitamin C, vitamin E and rosehip oil are effective.
Scientific studies on the effectiveness of widely used almond oil, cocoa butter and olive oil have not yielded sufficient positive results. It is known that the application of creams by massaging, especially during pregnancy, reduces the formation of skin cracks. For treatment, Scarlet X (gold needle), dermapen laser treatments, chemical peeling, PRP, mesotherapies are applied. Especially in the early stage, if the treatment is done in the pink-purple stage, the effectiveness of the treatment increases.
There are treatment options for all age groups and breastfeeding periods. There are treatment options for skin cracks in both the pink-purple stage and the white stage, but it should be known that if treatment is applied in the early period, in the pink-purple stage, the effectiveness of the treatment will increase.
It has been determined by studies that
creams containing Centella asiatica
(tropholastin), vitamin C, vitamin E and
rosehip oilare effective on stretch marks.
In our clinic, we first evaluate the cause of the skin cracks of the person and whether the cracks are in the early-late stages. Afterwards, a treatment plan is created for at least three or four sessions in the form of monthly treatment sessions. We combine planning with Scarlet X, dermapen, and treatments with PRP-mesotherapy applications. Depending on the treatment response, options may vary. Since the aim of the treatment is to increase the restructuring process under the skin, we see the effectiveness of the treatment from the second month. With patient-doctor cooperation, we can reduce skin cracks by forty to eighty percent.
So, will it repeat? What kind of path should be followed after the treatment?
Unfortunately, if the person gains and loses weight quickly, there is a possibility of recurrence. After the treatment, attention should be especially paid to the weight balance. When there are situations that you cannot control, when cortisone is used for any disease, during the periods of weight gain or rapid height growth, it may be necessary to get expert opinion to minimize the formation of skin cracks.
