Types of Stretch Marks (With Pictures) | Striae classification

There are 7 types of stretch marks, each one of them has its particularities. This article goes over the specificities of each type - With pictures.

Did you have any idea that stretch marks come in a variety of 7 types? These remarkable skin formations, formally referred to as striae, have been meticulously classified by dermatology into the following categories: Striae Rubrae, Striae Gravidarum, Striae Albae, Striae Nigra, Striae Caerulea, Striae Distensae, and Striae Atrophicans. 

Delve into the fascinating world of these unique manifestations!

Types of Stretch Marks

Each type of stria has its specificities and occurs for different reasons.

If you want to know more about the particularities and the causes behind each type of stria, why they happen, and how to prevent and treat them the best, keep reading.

Before we delve into each variety of stretch marks, let's take a moment to refresh our understanding with some intriguing facts about these distinctive skin features.

Stretch Marks: What Are They?

The skin, our body's most flexible organ, has the remarkable ability to expand and contract within certain limits. This elasticity is attributed to a layer of skin known as the Dermis.

When our body undergoes rapid changes in shape due to factors like weight gain, puberty, muscle growth, or other alterations in weight and form, the skin stretches to accommodate these transformations.

However, if these changes occur too quickly, the skin's elasticity reaches its maximum mechanical threshold, resulting in the breakdown of collagen within the Dermis.

This, in turn, triggers a healing process by our body, ultimately giving rise to what we commonly refer to as stretch marks.

Stretch marks, or striae, are essentially a form of scars. While they gradually fade over time (often spanning several years), they never fully vanish.

Now, armed with this brief reminder, let's embark on our exploration, beginning with the first and most common type of stretch marks.

Stretch Marks type: Striae Distensae

Striae Distensae are the most prevalent type of stretch marks. They are associated with the following causes:

  1. Quick weight/shape changes
  2. Puberty.
  3. Steroid use
  4. Pregnancy
  5. Obesity
  6. Cushing syndrome

The picture below shows Striae Distensae.

Striae Distensae appear like lines pointing to the perpendicular direction of the skin. There are 2 main forms of striae Distensae: Stria Rubra and Striae Alba.

Less frequent forms of Stria Distensae are called Striae Nigra and Striae Caerulea.

In the following section, we're going to discuss each one of these forms.

Stretch Marks type: Striae Rubra

Rubra in Latin means Red, Striae Rubra is the early stage of striae Distensae. Usually, they can be red, pink, or purple. After 7 to 12 months, they start losing their color and may turn either white or black, depending on the individual skin pigmentation.

What characterizes this type of stretch marks is that they have the best response to stretch marks treatments.

Why you should treat Striae Rubra in priority

Striae Rubra is a type of stretch mark that can be treated relatively easily comparing to the other types of stretch marks. The cutaneous lesions are still fresh. Unlike the striae, Striae Rubra has a great response to the majority of stretch marks treatments available.

Stimulating collagen production in the concerned areas may reduce drastically the future aspect of stretch marks.

Topical creams treatments can be a very effective way of getting rid of this type of stretch marks.

Stretch Marks type: Striae Albae

Striae alba is the mature stage of Striae Distensiae. After a few months, striae Rubra transforms into Striae Alba. Striae alba are white stretch marks and are the hardest stretch mark to treat. Over the years, they will eventually start to diminish and fadeout to a certain degree.

Striae Alba Treatments

Unlike Striae Rubra, topical creams and even laser therapy may not be very efficient in treating striae alba. The reason is that stretch marks tissues forming this type of striae are already atrophied. However, some recent clinical trials showed promising results in the treatment of striae albae.

The treatment consists of a combination of two existing treatments: Fractionated Microneedle Radiofrequency and Fractional CO2 laser. As you can see in the picture below, this treatment shows promising results.

Sources: US National Library of Medicine: Stria alba treatment FMR + CO2

Stretch Marks type: Striae Nigra

Striae Nigra are black stretch marks. They are a rare form of striae Distensiae and develop only in people with dark skin. The reasons are not clear, but recent studies suggest that this type of stretch marks is caused by Hypermelanosis around the areas of the skin affected by stretch marks.

Source: National Library of Medicine: Striae Nigrae

Understanding Striae Caerulea

Striae Caerulea presents as dark blue stretch marks, a variation that shares similarities with Striae Nigrae. This type of striae Distensiae, however, is less common and tends to manifest primarily in individuals with darker skin tones.

Striae and Ethnicity

The results of the studies published in The American Journal of Dermatology show that black women have higher chances than Caucasian women of developing striae Distensae. Darker skin increases the chances of striae distensae to occur.

However, if you have dark skin, you can still reduce this risk by applying measures that aim to prevent stretch marks, such as having a balanced diet, working out, moisturizing the skin, and controlling your weight.

Striae (Stretch marks) and Gender Prevalence

A study conducted on a group of 131 adolescents showed that males have almost the same chances of getting affected by striae distensae as females when exposed to a stretch marks cause.

Source: Gender Prevalence of Striae Distensae

Summary: Striae Distensae

Striae Distensae are the most prevalent type of stretch mark among men and women. They may occur when a person experiences significant weight loss or gain, puberty, pregnancy, obesity, and Cushing syndrome. There are 4 different forms of Striae Distensae.
  1. Striae Rubra: early stage of Striae Distensae (red or purple stretch marks) and the easiest to heal.
  2. Striae Alba: mature Striae Distensae (white stretch marks)
  3. Striae Nigra and Caerulea: mature Striae Distensae (black or dark blue stretch marks), which develop among persons with darker skin.

In the next section, we're going over the most widespread type of stretch marks among women, which is Striae Gravidarum.

Stretch Marks type: Striae Gravidarum

Striae Gravidarum refers to stretch marks caused by pregnancy. Most pregnant women will get this type of stretch marks (the incidence rate is between 50% to 90%). Their thickness is larger than that of regular Striae Distensiae.

Striae Gravidarum are formed usually after the 24th week. However, they can show up sooner in 43% of cases. Research indicates that these types of stretch marks are caused by a change in the skin collagen structure due to hormonal changes during pregnancy and the uterus growth.

However, you can prevent stretch marks during pregnancy by following these steps:

  1. Exercise
  2. Avoid stress
  3. Have a vitamins-rich and balanced diet
  4. Moisturize your skin
  5. Monitor your weight
For further info, feel free to check out our article: How to prevent stretch marks during pregnancy?


How Striae Gravidarum Looks?

When they start showing up, the Striae Gravidarum will look like red to pink bands or streaks (Striae Rubra). After a few weeks following their appearance, they will get bigger and start to turn red-violet. 

As months pass by, they will start fading out and become white. Striae Gravidarums are typically located on the belly, hips, and breasts.

Risk Factors of Striae Gravidrum

Some behaviors and factors raise the risks related to the Striae Gravidarum. Recent research showed that a high BMI (basal mass index) before pregnancy, which is associated with overweight, raises the chances of developing Striae Gravidrum and striae Distensiae.

The research showed also that genetic factors increase the chances of having striae Gravidrum. If your mother or close relatives have them, you will more likely have them too.

Other stretch marks risk factors include smoking, prolonged exposure to sunlight without protection, unbalanced diet.

How to Prevent Striae Gravidarum

Striae Gravidarum are not unavoidable; you can reduce the risk and their appearance by doing the following things:

  1. Moisturize your skin
  2. Apply topical cream that increases collagen production
  3. Massage your hips, belly using bio-oils, almonds oil, or olive oil.

Resource: Research: Striae gravidarum management

Stretch Marks type: Striae Atrophicans

Striae Atrophicans are a particular type of stretch marks that are caused by the use of some drugs that damage the skin or chronic diseases. They are much bigger than regular stretch marks. They can appear on the belly, hips, thigh, shoulders, chest, or the back.

The picture below shows a Striae Atrophican on the thigh of a male using steroids.

Picture Striae Atropicans Source

Even if they are painless, you should consult a doctor as soon as they appear because they may be the sign of more grave health issues.

Drugs that may cause Striae Atrophicans

  1. Steroids
  2. Corticoid

Diseases associated with Striae Atrophicans

  1. Cushing syndrome
  2. Anorexia nervosa
  3. Marfan syndrome
  4. Liver disease
  5. Febrile illnesses

Striae Atrophicans and Bodybuilding

Striae Atropican is a prevalent issue among bodybuilders that use steroids, along with that steroids damage the liver, kidney, and mess up the hormonal balance of the body.

Resource: NIH - Stretch Marks (Striae).

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