Pregnancy stretch marks: when do they appear, and can you really avoid them?

By a Doctor of Pharmacy, founder of KOUAGA

It is one of the most common concerns during pregnancy. Between 50 and 90% of pregnant women develop stretch marks^1,2, so they are the rule rather than the exception. Two questions keep coming up: when are they likely to appear, and can they really be prevented? As a pharmacist, I will answer you honestly.

When do pregnancy stretch marks appear?

Stretch marks most often appear during the second trimester, generally between the 24th and 27th week of pregnancy, when the stretching of the skin speeds up¹. What is less well known is that the changes leading up to them begin much earlier. From the very first weeks, hormonal upheavals alter the structure and elasticity of your skin, even before your belly visibly rounds¹.

This time lag explains why it is better to act early: by the time stretch marks become visible, the process has already been under way for several weeks.

Who is most affected?

Certain factors increase the risk. One of the best documented is surprising: young age. In a French study, 84% of women under 20 developed stretch marks, compared with 24% of women aged 30 and over³. Heredity, rapid weight gain and a personal history of stretch marks, during puberty for example, also play a role^3,4. That said, and this is important, even with all these factors combined, science still cannot predict with certainty who will get them and who won't. Two women with identical profiles can react differently. It is one of the great unsolved mysteries of the subject.

Can you really avoid them? My honest answer

This is where I commit to telling you the truth, even if it is nuanced. The global reference in evidence-based medicine, the Cochrane review, analysed all the available clinical trials on the prevention of pregnancy stretch marks. Its conclusion is unambiguous: to date, no cream, oil or lotion has reliably demonstrated that it prevents stretch marks from appearing².

But that does not mean skincare is useless. Regular application of a moisturising treatment contributes to the skin's hydration and comfort and can soothe itching, the sometimes intense tightness of pregnancy^1,5. Some data even suggest a reduction in the severity of the marks with certain active ingredients⁵. That is not nothing: supporting your skin, soothing it and making it more comfortable for nine months is a real benefit.

What you can actually do

The best strategy is a set of good habits, started early: massage your skin daily with the treatment of your choice, morning and evening, on the most exposed areas (belly, breasts, hips, thighs); stay well hydrated by drinking enough; aim for gradual, steady weight gain rather than sudden jumps; and choose skincare whose formula is designed for pregnancy. Consistency is essential!

One criterion outweighs all the others during this period: ingredient safety. A treatment applied every day, for months, on the body of a pregnant or breastfeeding woman should never be a source of worry.

Our approach at KOUAGA

It is precisely this standard that guided the creation of our skincare: two creams formulated by a pharmacist, whose tolerance has been validated for all populations, including during pregnancy and breastfeeding. Our founder even tested her own creams during her pregnancy! We do not promise to erase or prevent stretch marks, because that would be lying to you. We offer to support your skin with seriousness, safety and honesty, when it needs it most.

KOUAGA, the stretch mark experts.

Sources

1. Farahnik B, Park K, Kroumpouzos G, Murase J. Striae gravidarum: risk factors, prevention, and management. Int J Womens Dermatol. 2017;3(2):77-85.
2. Brennan M, Young G, Devane D. Topical preparations for preventing stretch marks in pregnancy. Cochrane Database Syst Rev. 2012;(11):CD000066.
3. Incidence and risk factors for striae gravidarum (French study). J Am Acad Dermatol. 2015;73(4).
4. Chang AL, Agredano YZ, Kimball AB. Risk factors associated with striae gravidarum. J Am Acad Dermatol. 2004;51(6):881-885.
5. Ud-Din S, McGeorge D, Bayat A. Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae. J Eur Acad Dermatol Venereol. 2016;30(2):211-222.