Treating stretch marks: laser, RF microneedling and what really helps
Stretch marks (striae) develop during pregnancy, in puberty, with weight fluctuations and when building muscle. Here you will find out why red and white stretch marks are treated differently, what creams and oils can do, how RF microneedling and fractional lasers compare and which results are realistic on the abdomen, breasts, hips and thighs.
It also covers the number of sessions, intervals, pain, downtime and the treatment of dark skin types. The matching SIACSKIN devices: the TULIX as a non-ablative laser with 1550 nm, the EUPHEUS V and the EUPHEUS M8 for RF microneedling on the body, and the FRACO CO2 XL as an ablative fractional CO2 laser.
How do stretch marks (striae) develop and why doesn't everyone get them?
Stretch marks develop when the dermis is stretched faster than its fibre network can yield: collagen and elastin tear, while the epidermis above remains intact. In addition to stretching there is almost always a hormonal factor. Cortisol slows down the cells that produce collagen, which is why striae occur more frequently in pregnancy, puberty and during cortisone therapy. Whether you get them is largely a matter of predisposition: connective tissue, family tendency and the speed of the change count for more than any skincare.
Because the damage lies in the dermis, treatment must also act there. The TULIX reaches this layer with 1550 nm erbium glass, and the EUPHEUS V and the EUPHEUS M8 deliver radiofrequency directly into it via needles.
Red or white stretch marks: why does the colour determine the treatment?
The colour shows how old a stretch mark is, and that determines what can still be achieved. Red to violet marks (striae rubrae) are recent: the tissue is inflamed, well perfused and undergoing remodelling. In this phase healing can be guided, and the marks become narrower and fade more quickly. White marks (striae albae) are mature scars, poorly vascularised, slightly depressed and with a thin epidermis. Here the aim is to build collagen and even out the texture. This takes longer, and the pale colour often remains in part.
For recent marks, the non-ablative TULIX, which lists stretch marks as an application, is suitable. For old white marks, RF microneedling with the EUPHEUS V brings more remodelling at depth, and in stubborn cases the FRACO CO2 XL, which is designed for scar treatment, does so.
How soon after giving birth can pregnancy stretch marks be treated?
You can usually have pregnancy stretch marks treated from about 3 months after the birth, once the body has stabilised. Many wait until the end of breastfeeding. Putting it off for years is not worthwhile: as long as the marks are still reddish, they respond best. Your weight should be reasonably stable, and a caesarean scar must be firmly healed before any work is done on the abdomen. If you are breastfeeding, clarify the use of numbing cream on large areas with a doctor beforehand. New marks may appear with a further pregnancy.
The TULIX is suitable for an early start because it works non-ablatively and requires hardly any downtime. In addition to stretch marks, the EUPHEUS V also lists body tightening as an application, which suits abdominal skin after pregnancy.
Do stretch marks from puberty go away on their own or should they be treated?
Stretch marks from puberty fade on their own, but they do not disappear completely. They develop during the growth spurt, typically running horizontally across the lower back and on the hips, thighs, knees and chest. At first they are a strong red or violet; after 1 to 2 years they turn pale and are far less noticeable. For many people that is enough. Treatment makes sense once growth is complete and the marks continue to bother you, and in adolescents only after medical advice. A very large number of broad marks with no apparent cause should be investigated by a doctor.
For young adults with pale residual marks, the TULIX, which works non-ablatively, and RF microneedling with the EUPHEUS M8 are suitable.
What helps men with stretch marks from muscle building on the shoulders and upper arms?
What helps with stretch marks from muscle building is the same as for all striae: collagen formation in the dermis through RF microneedling or fractional laser. The marks develop when muscles grow faster than the skin can keep up, usually on the front of the shoulders, the biceps, the chest and the back. Your training also affects the result: anyone who continues to build mass very quickly will get new marks. Anabolic steroids further increase the risk. After a session, a 2 to 3 day break from training is usually enough; for that long the area should not be subjected to friction.
With needle depths of up to 7 mm, the EUPHEUS M8 also reaches the thicker skin on the shoulders and back. The TULIX is the laser alternative with little downtime.
Do stretch marks disappear after weight loss or does it make them more visible?
Stretch marks do not disappear after weight loss; often they even become more noticeable. The tears in the dermis remain. When the volume underneath shrinks, the skin lies more loosely, and the marks look more wrinkled and deeper. By this point they are usually already white and mature. It therefore makes sense to reach your target weight first, maintain it for a few months and then have treatment. Marked fluctuations afterwards undo part of the result.
Here it pays off that RF microneedling addresses two things at once: the EUPHEUS V and the EUPHEUS M8 list stretch marks and body tightening as applications, so they treat the marks and the lax skin around them in the same session.
Do creams and oils really help against stretch marks?
Creams and oils keep the skin supple, but they do not remove existing stretch marks. The tear lies in the dermis, and skincare products barely reach it. The evidence for prevention during pregnancy is also thin: no benefit has been demonstrated for cocoa butter or olive oil. For recent, red marks tretinoin can bring some improvement, but it belongs in medical hands and is off limits during pregnancy and breastfeeding. Good skincare is worthwhile all the same: well-moisturised skin itches less, looks smoother and recovers better after treatment.
Striae can only be visibly changed with energy in the dermis: with the TULIX as a non-ablative laser or with RF microneedling using the EUPHEUS V.
RF microneedling or fractional laser: which works better for stretch marks?
Both procedures deliver comparable improvements in stretch marks; the difference lies in how they get there. RF microneedling releases the heat via needles directly in the dermis and largely spares the epidermis. This makes it less sensitive to tanned and dark skin, and the surrounding skin is tightened as well. The fractional laser acts from the surface and improves texture and colour differences more strongly, but it demands consistent sun protection. For broad, depressed white marks on the abdomen, RF microneedling is often the first step; for fine or still red marks, the laser.
At SIACSKIN, the EUPHEUS V with vacuum, the EUPHEUS M8 with needle depths of up to 7 mm and the TULIX with 1550 nm are available for this.
Why don't white stretch marks tan in the sun, and does tanning help against them?
White stretch marks barely tan in the sun because the mature scar tissue produces only a little pigment, and tanning therefore tends to make them more visible. The surrounding skin darkens, the mark stays pale, and the contrast grows. UV light also breaks down collagen, which is exactly what is lacking in the mark. For concealing them, self-tanner is better than the sun or a sunbed. Consistent sun protection keeps the colour difference small.
For treatment this means: the target is the structure, not the colour, and laser treatment is performed on untanned skin. The TULIX works non-ablatively and lists stretch marks as an application. If the skin is already tanned, RF microneedling with the EUPHEUS V is the more forgiving choice, because its insulated needles release the heat only beneath the epidermis.
On which parts of the body can stretch marks be treated well, and where is caution needed?
Stretch marks on the abdomen, hips, buttocks and thighs can be treated well, whereas the breasts and the inner upper arms call for more caution. The reason is skin thickness. On the abdomen and thighs the dermis is robust, so deeper treatment with more energy is permissible here. On the breasts and the inner arms the skin is thin and reacts more sensitively. There the rule is: shallower needle depth, lower density and a distance from the areola. On the back the skin is tough, so more sessions tend to be needed there.
On the EUPHEUS M8 and the EUPHEUS V you set the needle depth in 0.1 mm increments and adjust it area by area. On the TULIX the energy ranges from 0.5 to 300 mJ, which leaves scope for thin as well as thick skin.
How many sessions do red and white stretch marks need, and when do results show?
Red stretch marks usually need 3 to 4 sessions, white ones more like 4 to 6, each at intervals of 4 to 6 weeks. Skin on the body builds collagen slowly. You will see the first changes after 4 to 8 weeks: the marks feel less depressed and the edges become softer. The actual result matures until about 6 months after the last appointment. So wait after the course and only then decide on further sessions. Top-up sessions are generally not necessary, although new marks can develop with marked changes in weight.
With the TULIX, 3 to 5 sessions are usual; with RF microneedling using the EUPHEUS V or the EUPHEUS M8, more like 4 to 6.
Can stretch marks be removed completely or only improved?
Stretch marks can be improved considerably, but they cannot be removed completely. They are scars in the dermis, and scar tissue never becomes original skin again. What can be achieved is that the marks become narrower and flatter, feel smoother and move closer in colour to the surrounding skin. From a normal distance they are then less noticeable; close up and in raking light they remain recognisable. Recent marks gain the most, very broad white ones on heavily stretched skin the least.
Take photographs before each session under the same lighting, and you will see the progress honestly. Treatment is carried out with the TULIX, the EUPHEUS V or the EUPHEUS M8, each of which lists stretch marks as an application.
Can stretch marks on dark skin be treated without causing pigment spots?
Yes, stretch marks can also be treated on dark skin, most safely with RF microneedling and a carefully adjusted non-ablative laser. Dark skin responds to heat and inflammation more readily with dark spots, and on the body these last longer than on the face. Then there is the contrast: white striae are more noticeable on dark skin, and no procedure reliably restores the pigment. The treatment smooths and densifies, and the colour difference usually only becomes smaller. A test patch, low density, longer intervals and sun protection are part of it.
The EUPHEUS V works with gold-plated, insulated needles, so the energy is released below the epidermis. The TULIX is specified for all skin types and leaves the surface closed.
How painful is stretch mark treatment and how long does healing take?
With numbing cream the treatment is well tolerated, and healing takes from a few days to 3 weeks depending on the procedure. The abdomen and inner thighs are more sensitive than the hips and buttocks. After RF microneedling the area is red and slightly swollen for 1 to 3 days, and small bruises are possible. After non-ablative laser the skin feels warm and rough for a few days. After ablative CO2 laser, small crusts form, which can take 2 to 3 weeks on the body. Wear loose clothing and avoid exercise, sauna and swimming pools for a few days.
The EUPHEUS M8 comes with a Cold Hammer for cooling. The KYROMASTER cools the skin with cold air down to minus 50 °C before, during and after the session and is suitable for RF microneedling and CO2 laser. The aftercare guide describes the skincare afterwards.
Can stretch mark treatment be combined with skin tightening on the abdomen?
Yes, and the combination often makes more sense than treating the marks alone. Stretch marks are usually found in skin that has lost elasticity overall. If only the mark is smoothed, the surrounding area remains lax and the overall appearance uneven. RF microneedling treats the entire area: the heat in the dermis stimulates collagen in the marks and in between. Between sessions, needle-free tightening can be performed on the same area at an interval of 1 to 2 weeks. This does not eliminate pronounced excess skin, which remains a matter for surgery.
The EUPHEUS V combines RF microneedling with vacuum and needle-free RF tightening in one device. For large-area tightening and cellulite, the JORDISHAPE complements this with vacuum, rotating massage heads and radiofrequency.
