Can you use camouflage tattooing to cover stretch marks?

There is a lot of buzz on social media about using skin-toned tattoo pigment to cover up stretch marks. Anyone with significant stretch marks will tell you that they would try anything within their means to hide this condition, especially if someone is leading them to believe it is a “fix” and not one of the other many failed attempts at improving the appearance of their skin.

 I have recently started getting a surge in inquiries about camouflage tattooing for stretchmarks and I am certain it is because there are YouTube and Facebook videos circulating showing tattooing to hide stretch marks and under-eye circles, and hypertrophic (red, raised scar tissue).

 For those of us that have performed cosmetic and medical tattooing for years, we know that conservative, dilute amounts of skin-toned pigments used to camouflage surgical, traumatic accident and burn scars are highly effective in the hands of an experienced and well-trained practitioner. But we have also learned the hard way over time that the titanium dioxide (white pigment) used as the base for all skin-toned camouflage pigments does not age well, especially in large amounts.   Titanium has a very large molecular size compared to other colorants found in tattoo pigments. As the flesh colors (created with iron oxide pigment, which have a much smaller molecule) begin to fade and disappear, it is the titanium that is left behind in the skin. It likes to clump together and become more yellowish than the original white, eventually looking like curdled milk or cottage cheese under the skin. Once this happens, if you attempt to recolor the area, you will also be adding more titanium, and the whole cycle continues, adding more and more opaque, dense pigment to the skin. It is VERY difficult to remove titanium from the skin, as the laser removal method will turn the titanium black and the topical removal solution method is not very effective due to the large molecular size of the particles.

 First let’s dissect the stretchmark and its causes. It is important to understand the physiological process that took place to create the rippled, striated, discolored skin that can be found anywhere on the body, usually dependent upon the causative factors. It is more common in women and found in about fifty percent of women.   Our skin is fairly elastic and can expand and contract – to a point.  Skin type and heredity are factors that influence how much so. If the skin contracts beyond its ability to retract, much like stretching a rubber band too far and it breaks, once those collagen and elastin fibers in our skin break, that’s it.  The breaks repair, but collagen fibers form in striated patterns, not a nice open “basket weave” pattern of healthy collagen.  It is like dropping a plate and gluing it back together. Whether the break is repaired cleanly or not, the crack is still there and always will be.

 Common causes of stretchmarks:

 · Pregnancy: Between 50 and 90 percent of women experience some degree of stretchmarks. Interestingly, according to the linked article in the Journal of American Dermatology, the younger the women at the time of pregnancy, the more likely she was to develop significant striations in the skin.

· Puberty: rapid growth or growth “spurts” can cause stretch marks

· Rapid weight gain

· Medical conditions : Certain conditions can cause stretch marks, such as Marfan syndrome or Cushing's syndrome. Marfan syndrome can lead to decreased elasticity in the skin tissue, and Cushing's syndrome can lead the body to produce too much of a hormone that leads to rapid weight gain and skin fragility.

· Corticosteroid use: Prolonged use of corticosteroid creams and lotions can decrease levels of collagen in the skin. Collagen strengthens and supports the skin, and a reduced amount can increase the risk of stretch marks.

The skin consists of three key layers. Stretch marks form in the dermis, or middle layer, when the connective tissue is stretched beyond the limits of its elasticity. This is normally due to rapid expansion or contraction of the skin.  As the body grows, the connecting fibers in the dermis slowly stretch to accommodate slow growth. However, rapid growth leads to sudden stretching. This causes the dermis to tear, allowing deeper layers of skin to show through.  This can form stretch marks and contributes to the way they look.  Stretch marks eventually fade to a silvery, white, or glossy appearance, due to the pale fat beneath the skin becoming visible instead of the usual blood vessels.  The marks initially develop as wrinkly, raised streaks that can be red, purple, pink, reddish-brown or dark brown, depending on skin color. The streaks eventually fade and flatten.  Stretch marks may gradually become less noticeable, but this can often take year

Stretch marks are not physically harmful but can cause issues around self-image. For some people, stretch marks are a mild cosmetic concern but do not affect their day-to-day living. For others, the condition creates self-esteem issues that can be anxiety causing and can become emotionally debilitating.

The most common areas affected include:

·       abdomen

·       breasts

·       hips

·       flank

·       buttocks

·       thighs

 Treatment and Prevention:

People spend millions of dollars on cosmetic promises of creams and oils and potions that purport to “cure” stretch marks. There is zero clinical evidence that any topical preparation helps the condition.

It is possible to decrease your risk of developing stretch marks by maintaining an even weight and avoid yo-yo dieting, eating a diet rich in vitamins and minerals, strive for slow and steady weight gain during pregnancy, and drink plenty of water.

There is some medical promise of newer lasers and microneedling helping the appearance of stretchmarks. By stimulating the wound healing response, often the skins appearance is improved by the formation of new collagen and cellular renewal. Fractional, non-ablative lasers have shown to improve the appearance of striae in the skin, but skin type is big factor. Patients with darker skin tones are at risk for hyper-pigmentation with any type of laser treatment.

Microneedling shows the greatest promise for best results with little to no downtime and affordable treatments. Microneedling works by causing tiny micro-perforations in the skin, causing the wound healing process to generate new collagen and elastin, helping to lift the depressions in the skin, soften the tension of the stria and make the area look remarkably more smooth with a noticeable difference even after the first treatment.

 The Take Away:

Do not be fooled by the people on social media who are posting YouTube and Facebook videos of “magical” transformations for stretch marks, undereye circles, dark or raised scars or birthmarks.  This is a foolish and regrettable practice that will lead to worse problems later.

If you have stretch marks, or other skin imperfections, consult a good cosmetic dermatologist or a Board Certified Plastic Surgeon’s office where they offer microneedling services, laser treatments and other options for addressing these types of issues.

In my office, Dr. Jonathan Zelken and his staff at The Zelken Institute offer a wide range of laser and microneedling services, among all of the other non-surgical treatment offerings. You can visit their website here for more details or schedule an in-person consultation to discuss your concerns and desired improvements.