Severe disruption and disorganization of dermal collagen fibrils in early striae gravidarum. (1st March 2018)

• Record Type: Journal Article
• Authors: Wang, F.; Calderone, K.; Do, T.T.; Smith, N.R.; Helfrich, Y.R.; Johnson, T.R.B.; Kang, S.; Voorhees, J.J.; Fisher, G.J.
• Is Part Of: British journal of dermatology. Volume 178:Number 3(2018)
• Page Start: e237
• Page End: e237
• Publication Date: 2018-03-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.16390
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Stretch marks affect 50‐90% of pregnant women and can cause emotional distress. Stretch marks initially appear reddish, and mature over months to years, becoming permanent white streaks with a depressed, scar‐like appearance. As little is known about how stretch marks develop, this study, from the University of Michigan in the US, aimed to examine the molecular changes occurring in early stretch marks, with the reasoning that findings may explain the appearance of mature stretch marks. For the study, women in their second or third trimester of pregnancy provided skin samples of recently developed, reddish stretch marks on the abdomen; additionally, some women provided skin samples after delivery. The skin samples were analyzed using laboratory techniques to examine the appearance, organization and production of collagen, the main protein that provides strength and support to the skin. The authors found that collagen appeared abnormal in early stretch marks. In particular, collagen bundles, which are normally densely packed, appeared markedly separated, as if "pulled apart" by extreme skin stretching. The skin attempts to repair these separated, damaged collagen bundles by making more collagen. However, this reparative process is inadequate, and produces abnormally thin, disorganized collagen strands that fail to form normal bundles. These changes persisted in stretch marks after delivery, and likely explain why mature stretch marks appear depressed and lacking in structural support. The study's findings suggest that methods of preserving the normal organization and structure of collagen may prevent stretch marks. Once stretch marks have formed, treatments that stimulate the production of collagen that is properly organized as densely packed bundles may improve the appearance of stretch marks. Many treatments available for improving stretch marks are not effective, likely because they do not stimulate normal collagen rebuilding. As such, the authors' findings not only provide insight into how stretch marks develop at the molecular level, but also provide a therapeutic strategy for improving stretch mark appearance.