Other scar care is rarely necessary, but if topical products fail to deliver the results you seek, you can discuss other, more invasive options with your dermatologist, including:
Application of glycolic acid generates a peeling of the superficial layer of the skin, forcing it to regenerate and aiding old stretch mark improvement of their appearance. A recent study showed that glycolic acid decreases stretch mark width and improves colour by increasing melanin. Ideally, you should wait 2 weeks between each peel, as it can be aggressive for the skin. Several peels may be needed to obtain satisfying results. Home-use chemical peels can be found, but may not provide the same level results as those used by trained professionals and dermatologist as they’ll be able to adapt chemical concentrations to your skin type. This can also increase the effect of topical creams.
Microdermabrasion is a mechanical peeling technique. Aluminium oxide/sodium chloride crystals are propelled onto the skin surface at a programmable pressure, and immediately vacuumed back up along with skin debris. By removing the superficial layer of the skin, it stimulates skin regeneration and collagen production. At least 5 weekly sessions are needed before seeing any significant results.
Fractional microneedling radiofrequency (FMR)
While penetrating into the skin, microneedles apply radiofrequency energy, inducing collagen and elastin production. After at least 4 monthly sessions, stretch mark width has been shown to be reduced.
By heating the skin, laser beams stimulate collagen and elastin production. This results in improved elasticity, structure and colour of the skin. Several sessions are generally needed to obtain good results, and the treatment must be supervised by a dermatologist.
As a last resort, and when the methods above did not work, surgery can be considered as an option. It involves excising the skin containing the stretch marks and is only performed when there is excess skin (after weight loss, for example). It is a heavy and expensive surgery which requires post-operative care and a few weeks of down-time.
As Chemical Peeling, Microdermabrasion, FMR and Laser are aggressive for the skin, it is important to apply a good skin barrier to improve skin comfort and facilitate healing process.