Woman in ivory loungewear with a hand on her abdomen, representing pregnancy stretch marks

Body Guide · Striae Gravidarum · Stretch Marks · Orchard Road

Pregnancy Stretch Marks: Prevention and Treatment After Delivery

Moisturise in pregnancy. Treat when the timing is right.

Most women develop some stretch marks in pregnancy. Dr Sin Yong at IN Eternity Clinic on Orchard Road explains what prevention can realistically do, and how treatment after delivery depends on whether the marks are red or white.

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Dermis

Where stretch marks form

Red first

Then fading to white

After weaning

Usual time to treat

Improve

Not erase

Key facts

What they are: striae gravidarum, linear scars in the dermis where collagen and elastic fibres have been disrupted by stretching.
When they appear: most often in the second half of pregnancy, on the abdomen, breasts, hips and thighs.
Risk factors: younger maternal age, family history, higher weight gain, a larger baby or twins, and stretch marks from earlier in life.
Hormones: pregnancy hormones and cortisol change how fibroblasts make collagen, so skin tears more easily under the same stretch.
Red stage: striae rubrae are newer marks with active blood vessels and inflammation; they respond more readily to treatment.
White stage: striae albae are mature, thin, pale scars; their texture can be improved, but they are harder to change.
Prevention evidence: a Cochrane review found no high-quality evidence that any topical cream prevents stretch marks in pregnancy.
Treatment timing: lasers, energy treatments and prescription retinoids are generally deferred until after pregnancy and breastfeeding.

Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Last updated 7 October 2026

Why they form

Why do stretch marks happen in pregnancy?

Stretch marks form in the dermis, the supporting layer of the skin, not on the surface. When skin is stretched faster than its collagen and elastic fibres can adapt, those fibres break and reorganise in parallel lines. Under the microscope the result looks like a scar: thinner dermis, fewer and straighter elastic fibres, and a flattened surface.

In pregnancy, stretch is only part of the story. Pregnancy hormones, including oestrogen, relaxin and cortisol, change how fibroblasts make and organise collagen, so the skin becomes more prone to tearing under the same strain. That helps explain why some women develop marks with modest weight gain while others do not, and why family history is one of the strongest predictors.

Reviews of the risk factors consistently find that younger mothers, women with a family history, those who gain more weight, and those carrying a larger baby or twins are more likely to develop striae. Many of these cannot be changed, which matters when thinking about what prevention can achieve.

Stretch marks are not unique to pregnancy. Growth spurts in adolescence, rapid weight change, bodybuilding and long-term use of steroid medicines cause the same scars, which is why some women already have marks before their first pregnancy and are more likely to develop new ones.

Prevention

Can you prevent stretch marks during pregnancy?

Not reliably. A Cochrane review of topical preparations used in pregnancy, including creams containing centella, hyaluronic acid, olive oil and cocoa butter, found no high-quality evidence that any of them prevents stretch marks. Some small studies of combination creams were encouraging, but they were small and difficult to compare, and cocoa butter and olive oil on their own performed no differently from placebo in the trials that tested them.

That does not make moisturising pointless. Well-moisturised skin is more comfortable, itches less as it stretches, and is less likely to be scratched, which can aggravate early marks. A plain, fragrance-free moisturiser, or one with hyaluronic acid, applied daily to the abdomen, breasts, hips and thighs, is a sensible habit. Steady weight gain within the range your obstetrician advises also helps, though it does not remove genetic risk. Oils are fine if you like them, but they are no more protective than a plain moisturiser.

What to avoid in pregnancy matters as much. Prescription retinoids, such as tretinoin, are not used in pregnancy, and lasers and energy treatments for stretch marks are deferred. The pregnancy and breastfeeding safety page sets out what is generally avoided and what is considered acceptable during pregnancy and breastfeeding.

Red and white

Red or white: why the colour of your stretch marks matters

Stretch marks change over time. In the first months they are red, pink or purple (striae rubrae), slightly raised and sometimes itchy. At this stage blood vessels and inflammation are active and the tissue is still remodelling. Over months to a couple of years they fade to pale, silvery, slightly depressed lines (striae albae), with thin skin, fewer pigment cells and fewer elastic fibres.

The two stages respond differently. Red marks have more scope for change: treatments that reduce redness and stimulate collagen can make them flatter, paler and less noticeable. White marks are mature scars; their texture can usually be improved, but colour is harder to restore, and they rarely blend in completely. The first year after delivery is therefore a useful window, even though most treatments wait until breastfeeding is over. The stretch marks condition page explains the stages in more detail.

Colour also depends on skin tone. In Asian skin, newer marks can look dark brown or purplish rather than red, and older ones may look lighter than the surrounding skin. Itching is common while marks are forming; scratching can inflame them further, so a cool moisturiser and loose clothing help.

Treatment

What treatments help stretch marks after pregnancy?

Treatment aims to remodel the dermis. The approach is chosen by the stage of the marks, your skin type and how much recovery time you have.

Approach	How it works	Often used for
Non-ablative fractional laser (1540 or 1927 nm)	Columns of heat under an intact surface	Red and white marks, shorter recovery
Fractional CO2 resurfacing	Microscopic columns of tissue removed	Established white marks, longer recovery
RF microneedling	Heat delivered through fine insulated needles	Texture with loose skin
Prescription retinoid cream	Stimulates collagen in early marks	Early red marks, after breastfeeding

Fractional lasers create a pattern of microscopic treatment zones in the dermis, surrounded by untreated skin that speeds healing. The skin responds by laying down new collagen and elastic fibres over the following months. Non-ablative wavelengths such as 1540 nm and 1927 nm leave the surface intact and need less recovery; fractional CO2 removes tiny columns of tissue and does more per session, with more downtime. Reviews of striae treatment report improvement in texture and appearance with fractional lasers in both stages, more so in red marks. In Asian skin the main risk is temporary darkening after treatment.

Radiofrequency microneedling heats the dermis through insulated needles and is useful where loose abdominal skin accompanies the marks. Topical retinoids, which are prescription medicines, have modest evidence in early red marks and are started only after breastfeeding. Moisturisers and over-the-counter creams can make the skin feel smoother and reduce itch, but they do not reach the depth needed to change established scars, so their effect on white marks is small. At IN Eternity Clinic the approach is set out on the stretch mark treatment page; it is usually a course of sessions several weeks apart, reviewed against baseline photographs.

Timing

When can you start stretch mark treatment after giving birth?

Most elective treatments wait until after your postnatal review, and treatment over the abdomen waits until any caesarean wound has fully healed. Lasers and energy treatments for stretch marks are usually planned once you have finished breastfeeding, and prescription retinoids are likewise deferred until weaning. A reasonably stable weight also helps, because further change in size can create new marks.

While you wait, daily moisturiser and sun protection on any exposed area are the useful steps; sun on fresh marks can deepen their colour, so covering them outdoors is worthwhile. If the marks are on the abdomen and the tummy also feels loose, or bulges along the midline when you sit up, the abdominal muscles may have separated (diastasis recti). That is checked first, because it changes the plan; see sagging tummy and the after-pregnancy hub.

Expectations

What can treatment realistically achieve?

Treatment makes stretch marks less noticeable: flatter, smoother, and closer to the surrounding skin in colour and texture. It does not erase them. Most people need several sessions, and collagen remodelling continues for months after each one, so change is judged over time with photographs taken in the same light and position.

Asian skin needs particular care. It is more prone to post-inflammatory hyperpigmentation after laser, so energy levels, cooling, the interval between sessions and sun protection are all adjusted, and a test area may be done first. Dr Sin Yong examines the marks, notes their stage and your skin type, and explains what is realistic before any plan is agreed.

Marks on the breasts are usually treated more conservatively, and only after breastfeeding has finished, because the skin there is thinner and the tissue is still changing in size. Marks on the hips and thighs often behave like those on the abdomen. Where stretch marks come with loose skin, skin tightening and stretch mark treatment are usually planned together, so the sequence is agreed at the start rather than decided piecemeal.

Myths and facts

Common myths, answered

Myth: Cocoa butter prevents stretch marks.
Fact: Trials found cocoa butter no different from placebo. Moisturising helps comfort and itch, not prevention.
Myth: Only women who gain a lot of weight get stretch marks.
Fact: Genetics and pregnancy hormones play a large part; some women develop marks with modest weight gain.
Myth: Laser removes stretch marks completely.
Fact: Treatment improves their texture and colour. Established marks are scars and do not disappear.
Myth: White stretch marks cannot be improved.
Fact: They are harder to change than red marks, but their texture can often be improved.

Questions

Frequently asked questions

Can stretch marks be prevented in pregnancy?

Not reliably. A Cochrane review found no high-quality evidence that any cream prevents stretch marks in pregnancy. Moisturising daily is still reasonable because it reduces itch and dryness, and steady weight gain within your obstetrician’s advice helps, but genetics and pregnancy hormones play a large part that creams cannot change.

When do pregnancy stretch marks appear?

Most appear in the second half of pregnancy, often from around the sixth month, on the abdomen, breasts, hips and thighs. Some women first notice them after delivery as the skin settles. They start red or purple and fade over months to pale, silvery lines.

Do pregnancy stretch marks go away by themselves?

They fade but do not disappear. Red marks usually become paler and flatter over months to a couple of years, which can make them much less noticeable. The texture change remains because they are scars in the dermis. Treatment can improve their appearance further once the timing is right.

Can I have laser for stretch marks while breastfeeding?

Lasers and energy treatments for stretch marks are usually deferred until you have finished breastfeeding, because there is little research on them in breastfeeding women and the skin and weight are still changing after pregnancy. Dr Sin Yong reviews your timing at assessment, and moisturising and sun protection continue in the meantime.

Which treatment suits my stretch marks?

It depends on whether they are red or white, your skin type and how much recovery time you have. Non-ablative fractional laser suits many red and white marks with less downtime; fractional CO2 does more per session with a longer recovery; RF microneedling helps when loose skin is present too. Treatment improves appearance rather than erasing the marks.

How much does stretch mark treatment cost?

Cost depends on the size of the area, the stage of the marks, the approach used and how many sessions are needed. A small area of red marks is a very different plan from white marks across the whole abdomen. A written plan with costs is given after assessment. The consultation fee is waived with any medical treatment.

Is stretch mark laser suitable for Asian skin?

It can be done in Asian skin with care. The main risk is temporary darkening after treatment, so settings, cooling, the interval between sessions and sun protection are adjusted, and a test area may be done first. Your skin type and any history of pigmentation are assessed before a laser is planned.

References

Brennan M, Young G, Devane D. Topical preparations for preventing stretch marks in pregnancy. Cochrane Database Syst Rev 2012;(11):CD000066. doi:10.1002/14651858.CD000066.pub2
Farahnik B, Park K, Kroumpouzos G, Murase J. Striae gravidarum: Risk factors, prevention, and management. Int J Womens Dermatol 2017;3(2):77-85. doi:10.1016/j.ijwd.2016.11.001
Al-Himdani S, Ud-Din S, Gilmore S, Bayat A. Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol 2014;170(3):527-547. doi:10.1111/bjd.12681
Trivedi MK, Kroumpouzos G, Murase JE. A review of the safety of cosmetic procedures during pregnancy and lactation. Int J Womens Dermatol 2017;3(1):6-10. doi:10.1016/j.ijwd.2017.01.005
Singapore Medical Council. Guidelines on Aesthetic Practices for Doctors (2016 edition). healthprofessionals.gov.sg/smc

These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.