Topical Corticosteroid-Induced Stretch Marks: Why They Are More Challenging to Treat Than Other Stretch Marks

Stretch marks can develop for many reasons, including rapid growth, pregnancy, and weight fluctuations. However, one of the most difficult types to treat are topical corticosteroid-induced stretch marks, which result from prolonged use of corticosteroid creams, ointments, or lotions over many years.

Many people who have used topical corticosteroids for conditions like eczema, psoriasis, or other inflammatory skin disorders notice that, over time, their skin develops deep, atrophic (thinned) stretch marks, often appearing red, purple, or white. Unlike typical stretch marks, these require a different approach to treatment due to how corticosteroids affect the skin’s structure and healing ability.

How Do Topical Corticosteroids Cause Stretch Marks?

Topical corticosteroids work by reducing inflammation in the skin, but long-term use can also suppress key functions needed for healthy skin regeneration. This happens because:

   •          Collagen and elastin breakdown: Corticosteroids suppress fibroblast activity, meaning the skin produces less collagen and elastin—proteins responsible for keeping it strong and elastic.

   •          Skin thinning (atrophy): Over time, the skin becomes thinner and more fragile, making it more prone to tearing and stretching, which leads to deep, atrophic stretch marks.

   •          Reduced blood supply: Corticosteroids cause vasoconstriction (narrowing of blood vessels), decreasing oxygen and nutrient delivery to the skin. This slows down the skin’s ability to heal and regenerate.

As a result, topical corticosteroid-induced stretch marks do not respond to treatment in the same way as stretch marks caused by growth or weight changes.

Why Are Topical Corticosteroid-Induced Stretch Marks Harder to Treat?

Traditional treatments like lasers, skin needling, LED therapy, or topical retinoids (e.g., Retrieve cream) rely on stimulating collagen and elastin production to repair the skin. However, in corticosteroid-damaged skin, the fibroblast cells responsible for this process are significantly weakened or suppressed. This means:

   •          The response to treatment is much slower than with other types of stretch marks.

   •          Results from each treatment are more subtle compared to stretch marks formed from rapid growth.

   •          More sessions are required to account for the skin not being as responsive each time.

   •          The healing process takes longer, sometimes requiring at least 3-6 months between Inkless tattoo treatments to allow for recovery and prevent over-whelming the skin.

   •          The skin may look worse before it looks better, as the treatment process can initially cause additional inflammation before new collagen begins to form.

   •          Results are unpredictable, as some areas of the skin may respond better than others due to impaired cell function.

What Is the Best Treatment for Topical Corticosteroid-Induced Stretch Marks?

At Skin Conceal, we offer Inkless Paramedical Tattooing as the most effective treatment for corticosteroid-induced stretch marks. Unlike traditional tattooing, which uses ink and pigments, this technique replaces ink with a specialised serum that is tattooed directly into the skin. The process involves using a skin-needling method to create tiny micro-punctures, allowing the custom blend of healing serums and growth factors to be absorbed deep into the skin. These ingredients work together to stimulate fibroblast activity, repair the skin’s structure, and improve its texture and colour over time, resulting in a smoother, more even appearance. This "inkless" approach focuses on restoring the skin’s natural healing processes without the use of pigments.

Supporting Skin Healing Between Treatments

To optimise results and support skin regeneration, a combination of targeted skincare and supplements can help strengthen and repair the skin between sessions. Recommended Skincare Products are:

iS Clinical Sheald Recovery Balm – A soothing, reparative balm essential for post-treatment care. It protects compromised skin, reduces irritation, and promotes healing.

iS Clinical Super Serum Advance+ – A potent vitamin C serum with growth factors that stimulates collagen production and improves skin strength over time.

iS Clinical Retinol Emulsion – A gentle but effective retinol that enhances fibroblast activity, increases cellular turnover, and helps restore weakened skin structure.

Collagen Supplements

Since corticosteroid use significantly reduces collagen production, incorporating a high-quality collagen supplement can further enhance skin repair and improve elasticity.

   •          Marine Collagen Peptides (such as Vida Glow Marine Collagen) – Helps replenish lost collagen, support skin hydration, and improve overall skin integrity.

 Is Camouflage Tattooing an Option?

Many clients ask about pigment camouflage tattooing for their stretch marks, but in cases of topical corticosteroid-induced stretch marks, this is not the best option—at least not at first. The skin needs to be strengthened and repaired before pigment can be implanted successfully, as weak or damaged skin likely reject majority of the pigment and not hold colour evenly or produce natural-looking results.

Final Thoughts

If you have stretch marks caused by long-term topical corticosteroid use, it’s important to have realistic expectations and be patient with the treatment process. While improvement is possible, it will take time and commitment to restore the skin’s structure.

At Skin Conceal, we specialise in treating complex stretch marks, and we’re here to guide you through the process with honesty and care. If you’d like to learn more about your treatment options, send an enquiry or book a consultation today.