Stretch Marks in Pregnancy: What Actually Works

Pregnancy bump at week 26 — when stretch marks most often first appear

Around 8 in 10 pregnant women get stretch marks, and estimates across studies put the range at 43% to 88%. That makes them one of the most common changes of pregnancy and one of the most heavily marketed — an entire shelf of butters and oils exists on the strength of a promise the evidence does not support.

This guide covers what actually causes them, why itching arrives before the marks do, what the research says about prevention, what to avoid while pregnant, and what genuinely helps after birth.

The short answer. Stretch marks are tears in the dermis caused by rapid stretching, and how prone you are is largely genetic. There is only limited evidence that creams or oils prevent them and no reliable evidence that anything removes them. They fade to pale, flat scars over the year after birth. Moisturise because it eases the itching, not because it is a guarantee — and skip anything containing retinol while pregnant.

What They Actually Are

Skin stretches, but the middle layer — the dermis — has a limit. When growth outpaces it, collagen and elastin fibres tear and the marks that appear are the visible line of that tear. They show up as narrow streaks that can be pink, red, purple or brown depending on your skin tone, most often on the tummy and sometimes on the upper thighs and breasts.

Pregnancy hormones contribute too, by softening connective tissue — the same relaxin-driven process behind back and pelvic pain. It is not only mechanical.

Itching Comes First

The earliest sign is often itching over an area where the skin is thinning, before there is anything to see. Mild itching over a growing bump is expected and moisturiser genuinely helps it.

One important exception. Intense itching, particularly on the palms of the hands and soles of the feet, and especially at night and without a rash, is not stretch marks. That pattern needs a blood test to rule out cholestasis of pregnancy — see our guide to itching in pregnancy and call your midwife the same day.

Who Gets Them

Mostly this is not something you control, and it is worth saying plainly because the marketing implies otherwise.

What the Evidence Says About Prevention

Honest version: reviews of the topical products recommended for striae conclude that they are frequently recommended despite minimal evidence supporting their effectiveness, and that no intervention has been definitively proven to prevent them. The NHS puts it the same way — limited evidence for prevention, no reliable evidence for removal.

That does not mean stop moisturising. It means moisturise for the right reason.

Worth doing

What Happens After Birth

The colour drains out of them. Red, pink and purple lines gradually turn into paler, flatter scars over the months after birth, and most of that improvement happens on its own during the first year. They probably will not disappear completely.

If you want to treat them once you have finished breastfeeding, dermatological options with actual evidence behind them include topical tretinoin, microneedling and laser. All of them work better on newer marks than on old white ones, and all of them improve colour and texture rather than remove anything. Our postpartum recovery guide covers the rest of the fourth-trimester timeline.

At a Glance

Stretch marks affect around eight in ten pregnancies, appear when the dermis tears under rapid growth, and are mostly decided by genetics. Creams have limited evidence for prevention and none for removal — moisturise for the itching, which is real and treatable. Skip retinol until after breastfeeding. Marks fade to pale scars over the year after birth, and treatments with evidence behind them all come after pregnancy. Intense itching on palms and soles is a different problem entirely and needs a same-day call.

Inside Baby Novum. The belly photo timeline tags every photo by week, puts any two weeks side by side and builds the whole pregnancy into one sequence — the record most people mean to keep and never quite do.

Next: Itching in Pregnancy → · Weight Gain Guide → · Postpartum Recovery →

Frequently Asked Questions

When do stretch marks appear in pregnancy?

Most often in the second half, as the bump grows fastest, though the timing varies widely and some women get them early or not at all. The first sign is frequently itching over an area where the skin is thinning, before any mark is visible.

How common are stretch marks in pregnancy?

Around 8 in 10 pregnant women get them, and estimates across studies range from 43% to 88%. They usually appear on the tummy and sometimes on the upper thighs and breasts.

Do creams and oils prevent stretch marks?

There is only limited evidence that oils or creams prevent them, and no reliable evidence that anything removes marks once they exist. Topical products are recommended almost everywhere despite that. Moisturising is pleasant and relieves itching, which is a good enough reason on its own — just not a guarantee.

Why did I get stretch marks when my friend did not?

Largely genetics. A family history is a recognised risk factor, and studies point to differences in collagen and fibronectin gene expression. Rapid or larger abdominal growth, a bigger baby and excess amniotic fluid also raise the odds, and younger women get them more often than older ones.

Do stretch marks go away after birth?

They fade but do not disappear. Over months the red, pink or purple lines turn into paler, flatter scars that are much less noticeable. Most of that change happens on its own in the first year after birth.

Can I use retinol creams for stretch marks while pregnant?

No. Topical retinoids are avoided in pregnancy, so any anti-ageing or stretch-mark product containing retinol, tretinoin or adapalene is out until after you have finished breastfeeding. Check the ingredient list rather than the marketing on the front.

Does staying within the recommended weight gain help?

It is associated with fewer stretch marks, because rapid stretching is the mechanism. That is not a reason to restrict eating in pregnancy. Steady gain within the range your midwife has given you is the goal, and our weight-gain guide sets out what that range is.

What treatments work after pregnancy?

Newer marks respond better than old white ones. Dermatologists use topical tretinoin, microneedling and laser, all of which come after breastfeeding rather than during pregnancy. Expect improvement in colour and texture rather than removal.

Sources

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