Stretch Marks During Pregnancy
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.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
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.
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.
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 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)
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
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.