Tretinoin is a well-established prescription treatment for tackling acne and skin ageing. It largely works by speeding up skin cell turnover and boosting collagen production. There is growing awareness in the value of using Tretinoin cream for stretch marks. Long before the current hype, it has had off-license uses for years to help fade pigmentation, improve texture and strengthen the stretch marked skin. In this article we review the scientific evidence for using Tretinoin as a treatment for both new and older stretch marks. We’ll also explore how its used, safety, limitations and alternative or complimentary treatments.
Is Tretinoin Cream Effective for Stretch Marks?
The interest in Tretinoin as a potential treatment for striae distensae (the medical term for stretch marks) stems from its well-documented effects on skin remodelling. Originally developed in the 1960s, Tretinoin was first prescribed for acne due to its ability to normalise follicular keratinisation and reduce inflammation. Over time, researchers and clinicians noticed its ability to boost collagen production and smooth fine lines. This led to its use in anti-ageing and hyperpigmentation and increasingly even stretch marks treatments.
Stretch marks, especially in their early inflammatory stage (striae rubrae), involve a breakdown of collagen and elastin fibres in the dermis. This is usually following rapid skin stretching. Tretinoin can interrupt this process by penetrating the epidermis and stimulating fibroblasts in the underlying dermis. These fibroblasts play a central role in making new collagen which strengthens and supports the skin’s structural integrity. Beyond collagen stimulation, Tretinoin also enhances skin cell turnover. This helps shed damaged superficial surface cells and encourages the emergence of fresher more uniform skin. This can also help with fading the reddish or purplish hue of newer stretch marks and softening their texture.
A number of scientific studies back up the benefits of using Tretinoin on stretch marks. One of the most cited studies found that participants who applied high strength Tretinoin cream daily for 24 weeks showed significant improvements in the length and width of their stretch marks. Improvements were particularly evident in newer stretch marks. However, its benefits appear to taper off in older stretch marks. This is possibly because collagen degradation is more advanced and the skin’s ability to regenerate has slowed.
Which Type of Stretch Marks is Tretinoin Best for?
Stretch marks evolve through different stages of their life cycle. Each of these stages has distinct characteristics and varying responsiveness to treatment. The effectiveness if Tretinoin depends on the type and age of stretch marks. Here’s how Tretinoin interacts with each of the stretch marks stages:
- Striae Rubrae (New/Inflammatory Stretch Marks): These are the earliest and most treatable form of stretch marks. They are typically red, pink, purple or bluish in tone, striae rubrae indicate ongoing inflammation and disruption in the skin’s collagen and elastin matrix. At this stage, the skin is still biologically active meaning it can respond well to topical treatments. This is when Tretinoin is most effective as it helps reduce inflammation, stimulates new collagen production and encourages rapid cell turnover. Together, these actions can help soften the texture, fade discolouration and support skin repair before scar tissue fully sets in.
- Striae Albae (Mature/Atrophic Stretch Marks): Over time, stretch marks transition into a chronic stage known as striae albae. These appear as pale, silvery or white streaks where the skin has thinned and flattened. By this point, the collagen and elastin fibres have undergone significant breakdown. There’s also far less metabolic activity in the tissue. While Tretinoin may still offer some improvements by gently smoothing the texture and enhancing skin tone, its effects are generally limited. Collagen stimulation at this point is modest and additional treatments are often needed for more noticeable results.
- Striae Atrophicans (Deep Stretch Marks with Skin Thinning): In severe or long-standing cases, stretch marks may become deeply atrophic. This results in skin that appears fragile, thin and crepey. These types of stretch marks are often accompanied by a pronounced loss of elasticity and dermal support. Tretinoin alone is unlikely to produce meaningful change in striae atrophicans. The underlying damage goes beyond what topical treatments can repair and more intensive interventions such as fractional laser are usually required to stimulate deeper tissue regeneration and improve the skin.
How is Tretinoin Cream Used to Treat Stretch Marks?
As with all prescription treatments, how you apply Tretinoin can significantly influence both your results and the likelihood of experiencing side effects. Your doctor will start you on a strength and frequency that they deem is appropriate based on the quality of your skin and any conditions or sensitivities. They’ll also issue you with step by step instructions tailored to your specific case. Below are common general recommendations patients are usually given when using Tretinoin cream for stretch marks:
- Be Patient & Consistent: Tretinoin doesn’t offer instant results. Improvements in stretch marks typically become noticeable after months of regular use. Early signs of progress may include softer texture, gradual fading of colour and smoother skin tone.
- Prepare the Skin: Boost absorption by gently cleansing and drying the treatment area. Avoid harsh exfoliants or scrubs, which can compromise the skin barrier and increase irritation.
- Apply a Small Amount: A little goes a long way! Using clean dry fingertips, apply the amount of Tretinoin cream instructed by your doctor to the stretch marked areas. This product is potent and more is not better.
- Start Slowly & Build Tolerance: If you’re new to Tretinoin, your doctor may start you with application every other night or just two to three times a week. This allows your skin time to adjust to the retinoid so you can gradually increase to nightly use.
- Follow Up With Moisturiser: Once the Tretinoin cream absorbs apply a hydrating moisturiser to lock in moisture and soothe the skin. Look for ingredients like hyaluronic acid, ceramides and glycerin.
- Use Sun Protection: Tretinoin increases your skin’s sensitivity to ultraviolet light which makes it more susceptible to sunburn and hyperpigmentation. If your skin will be exposed, you need to apply a broad-spectrum sunscreen with at least SPF 30 every day and reapply every couple of hours. This includes cloudy days or when indoors near windows.
Risks & Side Effects
Although Tretinoin is largely safe even when used in higher strengths as is often done for stretch marks, there are still some potential risks. Common side effects include:
- Redness and irritation
- Dryness and peeling
- Increased sensitivity to sunlight
- Itching or burning sensation
- Post inflammatory hyperpigmentation
Alternative Stretch Marks Treatments
Tretinoin is a prescription only medicine and is not appropriate for all types of stretch marks. It also can not be used in pregnant or breastfeeding women or those with allergies or sensitivities to Retinoids. Thankfully, there are a number of treatments that may serve as alternatives to Tretinoin or additional therapies for stubborn stretch marks:
- Hyaluronic Acid: This hydrating ingredient can improve skin elasticity and texture. Whilst it is not a standalone treatment, hyaluronic acid can help reduce the visibility of small stretch marks especially when used alongside other therapies.
- Microneedling: This procedure involves tiny needles that stimulate collagen production and improve skin texture. As such, microneedling can help reduce the appearance of fresher stretch marks.
- Laser Therapy: Various laser treatments can promote collagen growth and improve skin pigmentation. Deeper lasers can help make even older or more complex stretch marks less noticeable.
- Chemical Peels: These involve applying a chemical solution to exfoliate the skin which encourages new skin growth and fades pigmentation. Depending on the type and strength, peels can potentially help reduce the appearance of stretch marks.
Tretinoin cream can be a useful option for treating stretch marks thanks to its ability to stimulate collagen and speed up cell turnover. However, results vary depending on the age of the stretch marks and each individual’s skin response. It also usually needs several months of regular application before any visible improvements. For those unable to use Tretinoin cream or who have more advanced stretch marks, there are a number of professional treatments that can help. That’s why its best to seek help early with stretch marks in order access the most appropriate treatment for your individual skin needs.
At City Skin clinic, we are devoted to personalised skincare. Our virtual skin clinic offers safe and effective custom creams using ingredients like Tretinoin where appropriate to treat skin conditions like stretch marks, acne, hyperpigmentation, melasma and skin ageing. Book a virtual consultation with one of our doctors today. The journey towards great skin starts here.
