Stretch Marks: Do Red and White Marks Need Different Treatments?
Many people leave stretch marks untreated because they believe nothing can improve them. Treatment differs for red and white marks, and starting while they are red generally produces more fading. White marks also become narrower and lighter with lasers that stimulate the dermis.
Why do stretch marks form?
Stretch marks are scars that form when rapid stretching disrupts and alters collagen and elastic fibers in the dermis. Although they look like fine lines, the underlying fiber structure is disorganized. Histological studies have also reported sex-hormone receptor expression in affected areas. Common settings include pregnancy, puberty, rapid weight or muscle gain, and prolonged steroid use.
Patterns vary by cause. Growth-related marks commonly affect the calves, thighs, buttocks, and waist. Pregnancy-related marks occur in about 90% of pregnant women. Steroid-related marks tend to be wider and deeper, while rapid weight changes commonly affect the buttocks, thighs, and abdomen. We therefore ask when and why they appeared: cause and age affect depth, width, and treatment choice.
How do red and white stretch marks differ?
Marks begin as red or purplish lines and gradually become white and wrinkled. The stages differ in appearance, underlying tissue, and treatment targets.
| Category | Red stretch marks | White stretch marks |
|---|---|---|
| Stage | Recent, early-stage marks | Older, later-stage marks |
| Appearance | Red or purple, sometimes slightly swollen | White, narrow lines with a wrinkled surface |
| Under the skin | Persistent vessel dilation and inflammation | Thinned dermis and established fibrous change |
| Treatment target | Reduce redness and encourage repair | Dermal renewal and improved texture and width |
| Response | Generally more responsive | Can improve, but takes longer |
If red marks are beginning to turn white, we recommend having them assessed soon, because they often respond better while they are still red.
Can creams remove stretch marks?
Patients often ask why regular cream use has not changed their marks. Creams and oils are common, but evidence is limited. A systematic review of topical treatments found no product proven to reliably remove stretch marks or clearly outperform the others; cocoa butter and olive oil were ineffective. Moisturizing can reduce itching and dryness, but established dermal fiber damage needs treatment that reaches the dermis.
How do lasers fade stretch marks?
Lasers create microscopic thermal stimulation in damaged dermis to encourage new collagen and elastic fibers. A network meta-analysis of 14 randomized trials involving 651 participants ranked fractional CO2 highest among lasers for clinical effect and satisfaction; RF combinations also performed well. A course of several sessions that addresses scarring, firmness, pigment, and repair usually achieves more than a single session. One patient receiving laser treatment said they had seen considerable benefit and thought the marks might be barely visible after a few more sessions.
Are white stretch marks harder to treat?
They respond more slowly than red marks but can improve. In a split-area study of abdominal white marks in 24 Korean patients, three sessions of nonablative fractional or fractional CO2 laser 4 weeks apart both significantly improved clinical and histological findings. For white marks, we prioritize texture and width before color. Reversing that emphasis can create a mismatch between expectations and results.
How does Dong-An Joongsim Clinic treat stretch marks?
At Dong-An Joongsim Clinic, your doctor personally handles your consultation and treatment, with individual attention throughout. Stretch Mark Remover is our combination program. Based on mark age and skin firmness, it combines scar lasers, tightening lasers, BENEV stem-cell growth factors, and the natural skin substitute SynNanoskin. Your doctor selects devices and energy from options including UltraPulse, Deep Pulse, Harmony XL4D-1, 1540XD, Legato II, and body Thermage. For larger areas such as the abdomen and thighs, we may also use the larger body Thermage tip. We have recently added a 1565 resurfacing laser. One patient reported visibly lighter marks after laser treatment.
Dr. Chang-Hwan Cho lectured on stretch marks and acne scars at the 2023 international aesthetic conference in Jakarta and ASLS HCM 2024 in Ho Chi Minh City. For accompanying texture or firmness concerns, we may consider Opus, which combines plasma and RF and can also suit thin skin when laser side effects are a concern.
What should you know before treatment?
The goal is narrower, shallower marks with color closer to the surrounding skin, rather than complete removal. A systematic review covering 4,806 treatment outcomes found low complete-clearance rates. Improvement and session numbers depend on mark age, width, and skin firmness. Redness, bruising, or reduced sensation may occur but usually settle within 1–2 weeks. A firm or cold feeling immediately afterward is temporary. Moisturize carefully after treating a large area. We also recommend a multivitamin containing vitamin C during the course.
Stretch marks: common questions
How should I choose a stretch-mark laser clinic in Apgujeong, Gangnam, Seoul?
Check whether the clinic distinguishes red from white marks, combines devices according to the condition, and whether the doctor who consults you also performs the treatment.
When is the best time to start?
Early treatment while marks are red generally responds better. White marks can also be treated, so assessment is worthwhile at any stage.
Are stretch marks in men treated the same way?
Yes. In men, growth or rapid muscle gain commonly produces marks on the arms, flanks, and thighs. The mechanism is the same; we choose a combination based on stage and firmness.
What determines the cost?
Cost depends on the location and area, laser combination, and session count. Your doctor assesses the marks before explaining the cost.
References
- Lu H et al., “Comparative effectiveness of different therapies for treating striae distensae: A systematic review and network meta-analysis”, Medicine, 2020. https://doi.org/10.1097/MD.0000000000022256
- Yang YJ, Lee GY, “Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO2 Fractional Laser: A Randomized Controlled Trial”, Annals of Dermatology, 2011. https://doi.org/10.5021/ad.2011.23.4.481
- Ud-Din S et al., “Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae”, Journal of the European Academy of Dermatology and Venereology, 2016. https://doi.org/10.1111/jdv.13223
- Zhu CK et al., “A Systematic Review on Treatment Outcomes of Striae”, Dermatologic Surgery, 2024. https://doi.org/10.1097/DSS.0000000000004151
- Wollina U, Goldman A, “Management of stretch marks (with a focus on striae rubrae)”, Journal of Cutaneous and Aesthetic Surgery, 2017. https://doi.org/10.4103/JCAS.JCAS_118_17