An Overview on Striae Distensae

Abstract

Background: Striae distensae (SD), commonly known as stretch marks, are a frequent dermal disorder characterized by linear atrophic lesions resulting from disruption of the extracellular matrix. Although not medically harmful, SD can cause considerable cosmetic concerns and negatively affect quality of life. Their pathogenesis is multifactorial, involving genetic susceptibility, hormonal influences, mechanical stretching, inflammatory mediators, and alterations in collagen and elastin metabolism.
Objective: To provide a comprehensive overview of the current evidence regarding the definition, classification, epidemiology, histopathology, pathogenesis, prevention, and treatment of striae distensae.
Methods: A narrative review of the recent literature was conducted, emphasizing clinical, histopathological, and molecular aspects of SD, together with evidence supporting currently available preventive and therapeutic interventions.
Results: SD progress through an early inflammatory phase (striae rubrae) and a chronic atrophic phase (striae albae), each exhibiting distinct clinical and histopathological characteristics. Molecular studies demonstrate impaired extracellular matrix synthesis, increased matrix degradation, altered growth factor signaling, and dysregulated collagen and elastin organization. Management remains challenging because no treatment achieves complete resolution. Preventive strategies show limited but promising efficacy, particularly formulations containing Centella asiatica derivatives. Therapeutic modalities—including topical retinoids, lasers, radiofrequency, microneedling, platelet-rich plasma, carboxytherapy, and microdermabrasion—have demonstrated varying degrees of clinical and histological improvement, with combination therapies generally producing superior outcomes compared with monotherapy.
Conclusion: Striae distensae are a multifactorial dermatologic condition with complex pathogenesis and substantial cosmetic impact. Advances in understanding their molecular mechanisms have expanded available treatment options; however, current therapies provide only partial improvement. Future well-designed randomized controlled trials and standardized outcome measures are needed to establish optimal evidence-based management strategies and develop more effective therapeutic approaches.