Stretch marks are scars that appear in the skin when it is stretched rapidly, such as during pregnancy, puberty, weight gain or loss, or muscle building. They appear as indented lines or stripes on the skin’s surface that are usually pink, red, or purple in color. Over time, they typically fade to a white or silvery color.
“Stretch marks are a natural part of skin and the changes we go through during our lifetimes,” says Samantha Ellis, a board-certified dermatologist and a dermatology clinical instructor at the University of California, Davis.
You might be wondering why some of your stretch marks are white and silvery and some are red, almost purple. The only difference between these two kinds of stretch marks is the age of the mark. Newer stretch marks tend to be a little bit red and the older ones tend to be white.
Red Stretch Marks and Their Development
Stretch marks are basically tears on the skin, on the dermal layer specifically, caused by over-stretching of the skin due to weight gain/loss, hormonal changes, or pregnancy.
Red stretch marks are new stretch marks that have just begun to form on the skin. They appear as raised, inflamed lines that are bright red in color. The development of red stretch marks begins with the tearing of the dermis layer of skin due to rapid stretching. This causes damage to the collagen and elastin fibers that provide structure and elasticity.
Within the first few weeks after tearing occurs, the body’s natural wound healing process kicks in. Red blood cells rush to the injured dermis, causing the marks to appear red in color. Inflammation also occurs as the body tries to repair the damage. This causes the marks to feel warm, raised, and tender or itchy during the initial red phase.
At the onset, stretch marks tend to be reddish or purple and, as such, are referred to as Striae Rubra. As collagen production increases over the following weeks and months to rebuild the dermis, the marks will slowly fade from red to purple and then silvery in color. This is because as the skin fibers break, tiny tears develop, which allow the underlying blood vessels to show through.
Remedy for Striae Rubra
Natural Remedy for Striae Rubra
- Moisturize with Nutrient-rich Cream or Oil:
Daily application of a cream or oil containing vitamin E, vitamin C, coconut oil, or shea butter is essential. These nutrients play a crucial role in supporting collagen production and promoting skin healing. When selecting products, prioritize those with clinically-proven ingredients for optimal results.
- Gentle Massage with Moisturizer:
Incorporate gentle massages into your routine by applying moisturizer to the affected areas 2-3 times per day. Massage contributes to increased blood flow and lymphatic drainage, facilitating the healing process. This technique aids in the reduction of scars and promotes overall skin health.
- Nightly Application of Retinoid Cream:
Use a retinoid cream, such as one containing retinol, during your nighttime skincare routine. Retinoids are known to stimulate collagen and elastin regeneration, contributing to skin firmness and resilience. Begin with a low concentration to minimize potential irritation, and ensure thorough moisturization after application.
- Daytime Use of Silicone-Based Gel or Sheet:
Incorporate a silicone-based gel or sheet into your daytime routine. Silicone has demonstrated benefits for improving skin elasticity and hydration levels. Wear the gel or sheet for 4-8 hours daily to maximize its effectiveness in promoting skin healing and maintaining optimal moisture levels.
- Pulse-dye Laser Treatments:
Pulse-dye laser treatments will improve the color of your red stretch marks by up to 25-75%. These kinds of lasers deliver light into targeted areas of the skin, like blood vessels. The light then destroys the vessels by shrinking them; this will then remove the discoloration of your stretch marks. Pulse-dye laser treatments have been used since the ’80s to cure port wine stain birthmarks in babies and children. The treatment is relatively safe, but the patient may experience swelling and bruising for a couple of days. Nothing an ice pack can’t fix.
- Prescription Retinoid (Tretinoin):
Studies show that this vitamin A derivative can cause a 14% improvement in newly developed stretch marks. Tretinoin helps with wrinkles and stretch marks by stimulating collagen production, which is important in maintaining the skin’s elasticity. It does very little for older stretch marks, though, so it is best to use it for the red ones. A word of caution: although extremely effective, tretinoin is a known teratogenic and should not be used by pregnant or breastfeeding women.
White Stretch Marks and Their Development
White stretch marks are old, fully matured stretch marks that have faded from their original red or purple color to a pale white or silvery tone.
White or silver-colored stretch marks are marks wherein the blood vessels have constricted and receded, leaving the underlying fat tissue visible. The white fat tissues give it that distinct silvery color. These kinds of stretch marks are clinically referred to as Striae alba.
It takes 6–18 months on average for stretch marks to progress from red to white as the skin heals and remodels itself. During this time, the collagen in the dermis layer regenerates. As new collagen is deposited, it causes the marks to gradually flatten and fade in color. The accumulation of red blood cells and inflammation subside.
By about 12 months, most stretch marks will have transitioned to a pale pink or purple phase as healing nears completion. Over time, they will continue to lighten. Between 18 and 24 months, fully white or silver stretch marks usually develop as the final stage. The collagen has rebuilt to the point where the marks are no longer raised.
Genetics influences how quickly marks fade; those with naturally fair skin tend to see faster whitening. Deeper marks may take longer to lighten fully.
Remedy for Striae Alba
Since they are older marks, it will take more than just a topical prescription to lighten them. In fact, most experts will argue that they do not completely go away unless surgically excised; even then, you cannot remove all of them because there are some sections of skin that are not amenable to excision. No need to worry, however, because although your options are limited, you at least have some viable ones.
- Fractional Non-Ablative Laser:
In photothermolysis, the laser creates micro-“wounds” through several layers of skin. The development of these micro-wounds will trigger a wound-healing response from the body, which, in time, will replace the wound and the tissue around it with healthier cells and tissue. This is ideal for stretch marks because these marks are technically scars that have not seemed to heal properly. Introducing micro-wounds through photothermolysis triggers the body to heal these scars.
In abdominoplasty, or “tummy tuck,” excess skin and fatty tissue in the abdomen are removed, along with the stretch marks that used to be there. A similar process may be done for stretch marks on the upper arms and thighs.
The appearance of stretch marks, whether red or white, still continues to bother men and women all over the world. It comes as great news, then, that even if we cannot completely eliminate them, we now have options to improve their appearance over time.
In summary, there are notable differences in the appearance and development stages of red versus white stretch marks. Red stretch marks that have newly formed appear raised, inflamed, and bright red in color. This is because they are in the initial, active healing phase, where the dermis layer is repairing itself through collagen regeneration and reduced inflammation.
Over many months, this healing process continues until the marks have fully transitioned to a flattened, pale white, or silvery appearance, indicating the skin has completed remodeling the damaged collagen fibers. By this white stage, the marks have been present for 6 months up to 2 years.
While both red and white stretch marks will gradually fade further over time, red marks are distinctly still in the process of actively healing and remodeling within the skin. With proper treatment, their eventual appearance can be improved. Both mark types may always retain some texture difference compared to the surrounding skin.
Nonetheless, the key distinction is that red marks are new and changing, while white marks have finished the natural healing process within the dermis. With patience, all stretch marks will continue to lighten.
We review published medical research in respected scientific journals to arrive at our conclusions about a product or health topic. This ensures the highest standard of scientific accuracy. Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796020/
 Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/
 Striae Distensae Treatment Review and Update: https://pubmed.ncbi.nlm.nih.gov/31334056/
 Advances in Dermatology and Allergology/Post?py Dermatologii i Alergologii: https://www.termedia.pl/Retinoids-active-molecules-influencing-skin-structure-formation-in-cosmetic-and-dermatological-treatments,7,37473,0,1.html
 Topical preparations for preventing stretch marks in pregnancy: https://pubmed.ncbi.nlm.nih.gov/23152199/
Other Treatment for Striae Rubta
As mentioned, red or purple stretch marks are newer compared to the white ones and will most likely be more responsive to treatment. The most effective treatment for striae rubra will probably be either pulse-dye laser treatments or prescription retinoid creams.