Stretch Marks During Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, NIH, March of Dimes guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with stretch marks during pregnancy, here is what you need to know.
The short answer
Stretch marks (striae gravidarum) affect up to 90% of pregnant people and occur when the skin stretches rapidly as the belly, breasts, and hips grow. They appear as pink, red, or purple streaks and gradually fade to silver or white after pregnancy. Genetics plays the biggest role in whether you develop them.
Key takeaways
- Stretch marks (striae gravidarum) affect up to 90% of pregnant people and occur when the skin stretches rapidly as the belly, breasts, and hips grow. They appear as pink, red, or purple streaks and gradually fade to silver or white after pregnancy. Genetics plays the biggest role in whether you develop them.
- Usually normal when: Pink, red, or purple streaks on the belly, breasts, hips, or thighs that developed during pregnancy
- Call your doctor if: Severe widespread itching, especially on the palms and soles, which could be a sign of cholestasis of pregnancy rather than simple stretch marks
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to ACOG, NIH, March of Dimes guidelines, stretch marks (striae gravidarum) affect up to 90% of pregnant people and occur when the skin stretches rapidly as the belly, breasts, and hips grow. They appear as pink, red, or purple streaks and gradually fade to silver or white after pregnancy. Genetics plays the biggest role in whether you develop them. At Second trimester, stretch marks often begin appearing in the second trimester as the belly starts to grow more rapidly. They most commonly appear on the abdomen, breasts, hips, and thighs. Keeping skin moisturized may help with comfort and itching. While no cream has been proven to prevent stretch marks, staying well-hydrated and gaining weight at a healthy pace may help. It is generally considered normal when pink, red, or purple streaks on the belly, breasts, hips, or thighs that developed during pregnancy. However, you should contact your pediatrician promptly if severe widespread itching, especially on the palms and soles, which could be a sign of cholestasis of pregnancy rather than simple stretch marks.
Normal vs. Concerning
By Age
What to expect by age
Second trimester
Stretch marks often begin appearing in the second trimester as the belly starts to grow more rapidly. They most commonly appear on the abdomen, breasts, hips, and thighs. Keeping skin moisturized may help with comfort and itching. While no cream has been proven to prevent stretch marks, staying well-hydrated and gaining weight at a healthy pace may help.
Third trimester
Stretch marks are most likely to appear or worsen in the third trimester when growth is fastest. They may initially look pink, red, or purple and feel slightly raised or itchy. This is the active stretching phase. Gentle moisturizing can help with itching. Try not to scratch, as this can worsen irritation.
Postpartum
After delivery, stretch marks gradually fade over months to years, typically becoming lighter, flatter, and less noticeable. They rarely disappear completely but become much less prominent. If you are concerned about their appearance, treatments like retinoids (not safe during breastfeeding), laser therapy, or microneedling can be discussed with a dermatologist after you are done nursing.
What to Tell Your Pediatrician
- Describe when you first noticed stretch marks during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if stretch marks are intensely itchy and the itching is spreading beyond the marks.
- Mention if stretch marks are accompanied by a rash or raised bumps, which could be PUPPP.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Pink, red, or purple streaks on the belly, breasts, hips, or thighs that developed during pregnancy
- Mild itching where stretch marks are forming
- Stretch marks appear during periods of rapid growth
- Marks gradually fade to lighter, silver tones after delivery
- Stretch marks are intensely itchy and the itching is spreading beyond the marks
- Stretch marks are accompanied by a rash or raised bumps, which could be PUPPP
- You have concerns about the appearance and want to discuss treatment options
- Severe widespread itching, especially on the palms and soles, which could be a sign of cholestasis of pregnancy rather than simple stretch marks
- Stretch marks become infected (red, hot, painful, or oozing)
What You Can Do at Home
- Keep track of when you notice stretch marks during pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that pink, red, or purple streaks on the belly, breasts, hips, or thighs that developed during pregnancy — this is generally within the range of normal.
- At Second trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if severe widespread itching, especially on the palms and soles, which could be a sign of cholestasis of pregnancy rather than simple stretch marks.
Related Conditions
Skin Darkening, Linea Nigra, and Melasma in Pregnancy
Skin darkening (hyperpigmentation) during pregnancy is very common and affects up to 90% of pregnant people. It is caused by increased melanin production driven by pregnancy hormones. Common changes include the linea nigra (dark line on the belly), melasma (dark patches on the face), and darkening of the areolas, freckles, and moles.
Itchy Skin During Pregnancy (Non-Cholestasis)
Mild itching during pregnancy is very common and usually caused by the skin stretching, dry skin, or hormonal changes. It typically affects the belly, breasts, and thighs. While usually harmless, severe or widespread itching, especially on the palms and soles, should be evaluated to rule out cholestasis of pregnancy.
PUPPP Rash in Pregnancy
PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) is the most common pregnancy-specific skin rash, affecting about 1 in 160 pregnancies. It appears as itchy red bumps and hive-like patches that typically start in the stretch marks on the belly and may spread to the thighs, arms, and buttocks. It is not harmful to you or your baby.
Related Resources
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is stretch marks during pregnancy normal?
When should I call the doctor about stretch marks during pregnancy?
When is stretch marks during pregnancy normal?
What causes stretch marks during pregnancy?
What should I mention to my pediatrician about stretch marks during pregnancy?
Is stretch marks during pregnancy normal at Second trimester?
Is stretch marks during pregnancy normal at Third trimester?
Should I go to the ER for stretch marks during pregnancy?
Does stretch marks during pregnancy go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. Skin Conditions During Pregnancy. ACOG FAQ, 2022. ACOG
- [2]National Library of Medicine. Striae Gravidarum. StatPearls, 2023. NIH
- [3]March of Dimes. Common Discomforts of Pregnancy. March of Dimes, 2023. March of Dimes
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Stretch Marks During Pregnancy.
Things to mention
- Describe when you first noticed stretch marks during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if stretch marks are intensely itchy and the itching is spreading beyond the marks.
- Mention if stretch marks are accompanied by a rash or raised bumps, which could be PUPPP.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Stretch marks are intensely itchy and the itching is spreading beyond the marks
- Stretch marks are accompanied by a rash or raised bumps, which could be PUPPP
- You have concerns about the appearance and want to discuss treatment options
Urgent signs to report immediately
- Severe widespread itching, especially on the palms and soles, which could be a sign of cholestasis of pregnancy rather than simple stretch marks
- Stretch marks become infected (red, hot, painful, or oozing)
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of stretch marks during pregnancy are normal. Talk to your pediatrician if severe widespread itching, especially on the palms and soles, which could be a sign of cholestasis of pregnancy rather than simple stretch marks.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Maternal Concerns
Skin Darkening, Linea Nigra, and Melasma in Pregnancy
Skin darkening (hyperpigmentation) during pregnancy is very common and affects up to 90% of pregnant people. It is caused by increased melanin production driven by pregnancy hormones. Common changes include the linea nigra (dark line on the belly), melasma (dark patches on the face), and darkening of the areolas, freckles, and moles.
Itchy Skin During Pregnancy (Non-Cholestasis)
Mild itching during pregnancy is very common and usually caused by the skin stretching, dry skin, or hormonal changes. It typically affects the belly, breasts, and thighs. While usually harmless, severe or widespread itching, especially on the palms and soles, should be evaluated to rule out cholestasis of pregnancy.
PUPPP Rash in Pregnancy
PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) is the most common pregnancy-specific skin rash, affecting about 1 in 160 pregnancies. It appears as itchy red bumps and hive-like patches that typically start in the stretch marks on the belly and may spread to the thighs, arms, and buttocks. It is not harmful to you or your baby.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.