Ways to remove stretch marks

Zapping stretch marks: can lasers help lighten stretch marks? … and more of your questions answered here – Beauty Q+A Shape, Oct, 2002

Q: I've tried plenty of creams to get rid of stretch marks, and none has worked. Is there anything else I can do?

A: While the cause of unsightly red or white “streaks” is poorly understood, most experts agree that when the skin stretches too much (which happens during pregnancy and rapid weight gain), tightly woven collagen and elastin in the skin's dermal (middle) layer become thin or break apart. (Think of pulling a rubber band until it eventually snaps or loses its elasticity.) Fibroblasts, cells that initiate the production of collagen, also cease that function, so a dermal “scar” remains. Generally, creams don't work. One exception is prescription retinoic acid (found in Renova and Retin-A), which has been shown to improve the appearance of newer, red stretch marks. But it isn't necessarily your best option. “I've seen fair to poor results with Renova,” says New York City dermatologist Dennis Gross, M.D. “It works best to regenerate sun-damaged skin; stretch marks are different.”

Gross has seen impressive results with the Nd:YAG laser, however, which is typically used to stimulate collagen production to smooth wrinkles. “The laser turns on the fibroblasts to produce collagen, which helps lighten the mark,” he says. While there have been no studies on the effectiveness of this laser in treating stretch marks, there have been several showing that a series of treatments with the pulsed dye laser (another type of laser) can improve both newer and more mature (white) marks. “The studies can be extrapolated to the Nd:YAG, because they're similar lasers,” Gross says. “But I've seen a better response with the Nd:YAG, and it's gentler [than the pulsed dye laser].”

Though Gross has seen “good to excellent” results in many of the 300-500 patients he's treated, lasers don't work for everyone. That's why he tests a one-inch area of stretch-marked skin first. Those whose skin responds usually require about three treatments spaced one month apart, each of which lasts 10-30 minutes and costs about $400. But this treatment isn't without its side effects: it can cause skin to become reddish purple for up to two weeks and cannot be used on dark or tan skin because of risk of long-term discoloration.

To find a board-certified doctor in your area who performs this treatment, contact the American Academy of Dermatology at (888) 462-DERM. — Beth Janes

Q I've heard that pH is important to healthy skin. What is it — and what does it do for the skin?

A Skin functions and looks best when its surface pH (measure of acidity) is between 4.5 and 5.5, says Audrey Kunin, M.D., a Kansas City, Mo., dermatologist and founder of DERMAdoctor.com, a skin-care Web site. The skin maintains this slightly acidic pH (on the scale, 1 is most acidic and 14 is most alkaline) with sebum, sweat and acid byproducts secreted by healthy bacteria, Kunin explains. This pH helps form a barrier, which protects skin from irritation and infection.

While the skin is able to maintain optimal pH on its own, external factors can throw it off balance: some soaps and body washes that are heavily scented and/or colored with artificial ingredients, and unprotected sun exposure.

If skin does become unbalanced, it usually returns to normal pH in a few hours, but pH-balancing toners can restore the balance immediately, helping you avoid possible irritation. You can also prevent skin from becoming unbalanced in the first place by using gentle cleansers. For healthier-looking skin, try these pH-balanced and -balancing products: Calvin Klein Balancing Milk Cleanser ($20; sephora.com), Clarins One-Step Facial Cleanser ($26; gloss.com), Prescriptives Immediate Glow Skin Conditioning Tonic ($18.50; gloss.com) and Nu Skin pH Balance Toner ($10; nuskin.com). – B.J.

Q My scalp is dry and itchy. What should I do about it?

A Because the scalp is out of sight, it's often out of mind. But your scalp needs to be cared for just like the skin on the rest of your body. Salon treatments that use a combination of heat and essential oils can ease minor dryness and leave hair looking shinier and healthier for several days. (These treatments typically last 30-45 minutes and cost about $50.) You can also soothe and moisturize a parched scalp at home with products like ThermaSilk Intensive Conditioning Thermal Wrap ($7.50; at drugstores), Paul Mitchell Tea Tree Hair and Scalp Treatment with salicylic acid to help exfoliate ($13; 800-321-JPMS) or Aveda Scalp Remedy ($11; aveda.com).

But if your dryness is accompanied by flakes, you may be suffering from dandruff and need to look beyond conditioning treatments for relief. New York City dermatologist Amy B. Lewis, M.D., explains that while the exact cause of dandruff is unknown, most experts agree that the buildup of naturally occurring scalp fungi (P. ovale) is probably to blame. Anti-dandruff shampoos reduce the amount of fungi — and flaking. Try Nizoral A-D ($15; at drugstores), Head & Shoulders Refresh Shampoo and Conditioner with scalpsoothing mint ($4 each; at drugstores), Redken Solve Dandruff and Purifying Shampoos ($10 each; 800-REDKEN-8 or prescription-strength Capex Shampoo (capexshampoo.com).

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