Stretch marks after weight loss: why they appear and whether they fade

What are stretch marks, and why do weight changes cause them?

Stretch marks are narrow lines of scar tissue that appear when the skin stretches or shrinks quickly. The sudden change tears the collagen and elastin that hold the middle layer of skin, the dermis, together. As those small tears heal, the line you can see is left behind.

Doctors call them striae distensae. They most often show up on the belly, breasts, buttocks, thighs and upper arms, in the places where the body stores fat or grows fastest.

Skin can cope with slow change. It struggles when a change is fast or large, and some people are more prone than others. Researchers point to a mix of physical stretch, hormones and differences in how each person’s skin is built.

The most common causes

The American Academy of Dermatology lists the times when people are most likely to get them:

• growth spurts during puberty;
• pregnancy, when the belly and breasts grow quickly;
• rapid weight gain or rapid weight loss;
• fast muscle growth from weight training, for example on the shoulders and upper arms;
• long-term use of a corticosteroid cream on the same patch of skin.

Some medical conditions, such as Cushing’s syndrome and Marfan syndrome, can also cause them. Family history matters too: if your parents or siblings have them, you are more likely to get them.

Obesity itself is linked to stretch marks. A dermatology review of skin changes in people living with obesity names them among the skin changes linked to a higher weight, next to skin tags and dark velvety patches.

The marks you notice now may have formed years ago, as a teenager, during a pregnancy or in a period of fast weight gain. Stretch marks from pregnancy have their own page: read about obesity and pregnancy.

Why stretch marks can look worse after weight loss

Many people feel their stretch marks look more obvious after weight loss. Studies have not measured this, but a likely reason is that the scar stays while the fat under it shrinks.

When the area was fuller, the skin was taut. With less volume underneath, older marks may look finely wrinkled. Dermatologists describe mature marks as sitting slightly below the skin, so a little sunken is their normal look, not a sign that anything is going wrong.

New marks can also appear while you lose weight, especially if the loss is quick. The skin changes shape again, and areas that were already stretched to the limit may tear a little more.

It helps to know that stretch marks and loose skin are two different things. They often turn up together after a large loss, but they behave differently and respond to different care.

Everything about folds, sagging and skin removal is on our page on loose skin after weight loss. This page sticks to the marks themselves.

Do stretch marks go away after losing weight?

Stretch marks usually do not go away completely after losing weight, but they do fade a lot over time. Dermatologists describe them as permanent, like any scar, while the colour and the raised feel slowly calm down.

Weight loss on its own does not remove them, because a scar is not fat. Losing more weight will not make a mark disappear, and gaining weight will not hide it for long either.

What changes is how they look. Early marks are coloured and may feel slightly raised; mature marks are pale, flat or a little sunken, and often hard to see from a distance. Many people find that, after enough time, they hardly notice them in daily life.

There is no fixed timeline. How fast a mark fades depends on your skin, your age, where the mark is and how much it was stretched. Patience is part of the honest answer.

Please do not slow down or give up on losing weight because you worry about stretch marks. Lower blood pressure, better blood sugar and less pain in your knees and back matter much more for your life than any mark on your skin.

Do white or purple stretch marks mean weight loss?

No, the colour of a stretch mark does not show whether you are losing fat. It tells you roughly how old the mark is: red, pink or purple marks are new, and white or silver marks are older.

This myth is common online, but it mixes two things up. A mark turns white because the scar has matured, which happens whether your weight goes up, down or stays the same.

New coloured marks during weight loss mean your skin is changing shape fast. They are not proof of fat loss, and white marks are not proof of anything either. The scale, your waist and how your clothes fit are far better signs.

The early colour depends on your skin tone. On darker skin, new marks often look dark brown rather than red, and mature marks can be lighter than the skin around them.

If you track progress with photos, our page on weight loss motivation has tips on fair before-and-after pictures that do not make you zoom in on your skin.

Why do stretch marks itch when you are losing weight?

Stretch marks often itch while they are new, because the skin is healing and is still inflamed. Researchers who reviewed creams for stretch marks note that itch is a common complaint in early marks; it usually settles as the mark matures.

Dry skin can make the itch worse. Weight loss, hot showers, cold weather and rough clothing all play a part.

Simple ways to soothe the itch

• Apply a plain, fragrance-free moisturiser after a lukewarm shower, while the skin is still slightly damp.
• Pat yourself dry instead of rubbing hard with the towel.
• Choose soft, breathable fabrics over the itchy area.
• Keep nails short and try not to scratch, which can break the skin.
• Press or gently pat the spot when the urge comes, or use a cool, damp cloth.

Please do not put a steroid cream on stretch marks without advice. Long-term use of these creams on the same spot can itself cause thin skin and new marks.

See your doctor if the itch keeps you awake, the skin weeps or cracks, a rash spreads, or the itch is all over your body rather than on the marks. These can point to another skin or health problem that needs a proper check.

Can you prevent new stretch marks while losing weight?

You cannot fully prevent stretch marks, but a steady pace gives your skin the most time to adjust. No trial has tested slow versus fast weight loss for stretch marks, so treat this as sensible care rather than a promise.

Fast change is the shared factor in almost every cause on the list above. That makes slow, steady change the most logical thing you can control. Our page on safe weight loss per week explains what a healthy pace looks like.

What about prevention creams and oils?

The evidence for prevention creams is weak. A Cochrane review of six trials with 800 pregnant women found no clear difference in new stretch marks between women who used a cream with active ingredients and those who used a placebo or nothing.

Single ingredients did no better. In trials, cocoa butter, olive oil, almond oil and vitamin E did not prevent stretch marks.

A few studies of creams with centella (a herb) or hyaluronic acid looked more promising. They are small, mostly in pregnancy, and some were run with products from one maker, so they are far from proof. A plain moisturiser keeps your skin comfortable, and that is a fair reason to use one.

Building muscle: go steadily

Strength training is good for you while you lose weight, and it protects your muscle. Very fast gains in muscle size, mostly in people who train hard for size, can bring new marks on the shoulders, chest and thighs.

For most readers, the normal pace of a beginner programme is no problem at all. Our page on how to lose fat and gain muscle explains realistic rates, and our strength training plan for beginners builds up gently.

Habits that help both your weight and your skin

• Aim for a steady loss rather than a fast one, and avoid crash diets.
• Eat a protein food at each meal to protect your muscle.
• Keep your weight stable once you reach a goal: each new cycle of gaining stretches the skin again.
• Remember that older marks do not tan, so sunbathing makes them stand out more, not less.

Cutting back on the biggest calorie sources in your day is one of the simplest ways to keep a steady pace. Our guide to foods to avoid for weight loss shows where to start.

What helps stretch marks fade: creams, retinoids, lasers and microneedling compared

Some treatments can make stretch marks less visible, but none removes them. Reviews of the research agree that most studies are small and short, and that early, coloured marks respond better than old, white ones.

Talk to your doctor or a dermatologist first before you start any treatment, and always if you are pregnant, trying to get pregnant or breastfeeding. Obesity Foundation does not sell or recommend any cream, brand or clinic.

Tretinoin and other retinoids

Tretinoin is a prescription vitamin A cream. In a small, double-blind trial, 8 of 10 people who applied it daily for six months to early marks saw clear improvement, against 1 of 12 who used a cream without the active ingredient.

Other studies were less positive, especially on older marks, and a large comparison of trials ranked tretinoin on its own below procedures. In two of the studies, about half of users had redness or flaking in the first one to two months.

Retinoids are not for pregnancy or breastfeeding. A review of pregnancies with accidental early exposure to retinoid creams found no clear rise in harm, but the authors stress that this is no reason to use them while pregnant. Dermatologists advise checking with your doctor before treating stretch marks at all during this time.

Hyaluronic acid and centella

Hyaluronic acid is a substance your skin makes itself. Dermatologists report that in two larger studies, applying it to early marks made them less noticeable.

Creams with centella have mostly been studied for prevention in pregnancy. If you try one of these, the advice is to use it on new marks, massage it in gently and keep going daily for several weeks before you judge it.

Lasers

Lasers can improve the colour and texture of stretch marks a little. Different lasers are used for different stages: some target the redness of new marks, others aim to rebuild collagen in older ones.

A review in dermatologic surgery reported modest improvement with fractional lasers, based mainly on clinical experience, because controlled trials are few. A network analysis of 14 trials with 651 people ranked fractional CO2 laser best among the lasers it compared, but the authors called for larger studies.

The main side effect to know is darker patches after treatment. A recent review notes that this risk rises with higher laser energy and can last up to a year, and that it is harder to accept for people with darker skin.

Microneedling

Microneedling uses fine needles to make tiny wounds that prompt the skin to repair itself. Sometimes it is combined with radiofrequency, a form of heat.

A meta-analysis of 11 studies found microneedling roughly as effective as lasers, and better than non-laser treatments. Most studies were small, and results varied a lot between them.

Before you book a procedure

• See a qualified dermatologist, not only a beauty salon, and ask what result is realistic for your type of marks.
• Ask how many sessions you will need and the total cost, since most procedures need several.
• Mention your skin tone, any medicines and any history of scarring or cold sores.
• Wait until your weight is fairly stable, so new changes do not undo the work.

Ask beforehand whether any of the cost is covered, as treatments for appearance often are not. Our doctor visit checklist helps you prepare questions for the appointment.

Wraps, firming gels and slimming gadgets promise a lot for skin as well. Our look at weight loss gadgets shows what trials found about them.

When stretch marks need a doctor

Most stretch marks are harmless and need no medical care. A few patterns are worth a visit, because they can point to a hormone problem or a side effect of medicine.

See your doctor if:

• wide, reddish-purple marks (often more than 1 cm across) appear, together with weight gain around the belly, a rounder face, easy bruising, weak thighs or high blood pressure;
• marks appear where you have used a steroid cream for a long time;
• you take steroid tablets and notice new marks;
• marks appear without any clear reason, such as growth, pregnancy or a change in weight or muscle.

An Endocrine Society guideline lists such marks, easy bruising, a flushed face and weak upper legs or arms among the signs that best point to Cushing’s syndrome, when the body makes too much of the stress hormone cortisol. Our page on why you are not losing weight lists more of these warning signs.

Do not stop steroid tablets or other prescribed medicines on your own. Your doctor can look at the whole picture and decide what to check.

Living with stretch marks: comments, swimwear and the gym

Stretch marks are one of the most common skin features in the world, and many people find them easier to live with once they stop hiding them. Still, it is normal to feel self-conscious, especially in a changing room or on a beach.

A few practical ideas help many people:

• Choose clothes for comfort first. Leggings, a longer swimsuit or a T-shirt in the pool are fine choices if they help you keep going.
• Use a self-tanner if you want to. Sun tanning makes marks stand out more, because the scar tissue does not tan; a self-tanner can blend them in.
• Have a short answer ready for comments, such as “That is my skin, and I am proud of what my body is doing.”
• Look at what your body can do now: the extra walk, the stairs without stopping, the swim you could not do before.

Feeling at ease in water is covered on our page on swimming for weight loss. Nobody has the right to remark on your body; our page on weight stigma explains how to respond.

If worries about your skin take over your thoughts, keep you from going out or lead to comfort eating, please talk to someone. Our page on psychological support explains what help is available.

Free help to lose weight at a pace your body can keep up with

We help people lose weight and get healthier with good food, suitable exercise and walking. Everything is free, and none of it involves creams, wraps or supplements. Talk to your doctor first before you start any plan, especially if you have a health condition or take medicines.

• A free eating plan with filling everyday meals for a steady, not rushed, loss. Request your free eating plan.
• Free workout videos in three levels, so muscle builds up gradually at your own pace. Get the free workout videos.
• A free video meeting (in English) to talk about your pace, your worries or where to begin. Book a free video meeting.
• Your own Club account to log walks, meals and how you feel, in private. Open your free Obesity Foundation Club account.

A daily walk is the backbone of our approach. Our guide to walking for weight loss shows how to build it up week by week.

Stretch marks show that your body has changed, and they will keep fading as time passes. Look after your skin kindly, keep moving and keep the health you are gaining.