Stretch Marks During Pregnancy:Whatthe Evidence Actually Says

ByA/Prof.Indika Alahakoon — Co-Founder, Pregnancy and Baby Co. | Specialist Obstetrician & Maternal Fetal Medicine Expert | Mum offour

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You've read the Instagram posts promising a miracle cream. You've seen the before and after
photos. You've been told by someone that if you just moisturise diligently enough, from early
enough, with the right product, you'll avoid stretch marks entirely.
And then you've wondered — with the particular anxiety that only pregnancy brings — whether
that's actually true.
As a specialist obstetrician who has cared for pregnant women for more than thirty years, and as
a mother of four who has been through this herself, I want to give you an honest answer.
Here is what the evidence actually says about stretch marks during pregnancy. Not what the
marketing says. The evidence.

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What Are Pregnancy Stretch Marks?
Stretch marks — known clinically as striae gravidarum when they develop during pregnancy —
are a form of dermal scarring. They develop in areas where the skin is placed under rapid
mechanical stress: most commonly the abdomen, but also the breasts, hips, thighs, and buttocks.
In the early stages, stretch marks appear as red, pink, or purple wavy bands in the skin. These are
called striae rubrae. Over time — months to years after birth — they fade to white or silver,
becoming striae albae. The fading is real; the marks do not disappear entirely, but most women
find them significantly less visible in the postpartum years.
Striae gravidarum affects approximately 60–90 per cent of pregnant women, making it one of the
most common physical changes of pregnancy. If you are sitting with stretch marks right now, or
worrying about developing them, you are in very good company.

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What Causes Stretch Marks in Pregnancy?
The cause is not, as many believe, simply a failure of moisturisation. The biology is more complex
— and understanding it will help you make genuinely informed choices.
The Mechanical Factor: Rapid Skin Stretching
Striae distensae are a form of dermal scarring resulting from the stretching of the dermis. When
the skin is required to stretch faster than the collagen and elastin fibres in the dermis can
accommodate, those fibres experience microscopic tears. The resulting repair process creates
scar tissue — which is what we see as stretch marks.
The rate and extent of stretching matters. A belly that grows very quickly over a short period
places more demand on the dermis than one that grows more gradually. This is one reason why
the speed of weight gain during pregnancy — and not just the total amount — is a relevant factor.
The Hormonal Factor: Relaxin and Collagen Bonds
Pregnancy hormones play a direct role in stretch mark development. Increased levels of
hormones during pregnancy relax the bonds between collagen fibres within the skin, making it
easier for the skin to tear when stretched. Relaxin — the aptly named hormone that loosens
ligaments to prepare the body for birth — also affects the structural integrity of the dermis,
reducing its resistance to mechanical stress.
This is why stretch marks during pregnancy are categorically different from stretch marks
caused by gym-related muscle growth or ordinary weight gain. The hormonal environment of
pregnancy specifically predisposes the skin to tearing in a way that other periods of skin
stretching do not.
The Genetic Factor: The Most Significant Predictor
Here is the most honest thing I can tell you about stretch marks: risk factors for striae gravidarum
include genetic predisposition, hormonal status, teenage pregnancy, being overweight before
pregnancy, gaining excess weight during pregnancy, and having an overweight baby — with
genetic predisposition being one of the most significant.
If your mother or sister developed significant stretch marks during pregnancy, your risk is
substantially higher — not because they failed to moisturise adequately, but because of the
inherited structural characteristics of their connective tissue, and yours.
This is not a reason to do nothing. It is a reason to understand what you are — and are not — in
control of.

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What Does the Evidence Actually ShowAbout Prevention?
This is where I want to be genuinely honest with you, because the evidence is not what most
product marketing suggests.

Studies specifically addressing the prevention of striae gravidarum during pregnancy are sparse,
and the molecular pathogenesis of striae is unclear. A 2024–2025 review of topical agents across
38 studies found that moisturisers, emollients, and common oils such as cocoa butter and olive
oil do not prevent striae formation. Centella asiatica extracts and silicone-based products show
potential for enhancing elasticity and appearance, though their efficacy requires further
controlled evaluation.
What can be honestly said is this: no topical product has been proven in robust clinical trials to
completely prevent stretch marks in women who are genetically predisposed to developing
them. Any brand — including this one — that makes that claim is overstating the evidence.
What the evidence does support is that certain approaches are associated with meaningfully
better outcomes for skin during rapid stretching. The distinction matters: supporting skin
through stretch is different from guaranteeing no stretch marks will appear.

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What the Evidence Does Support
Consistent Daily Moisturisation — Applied Early and Often
While no specific product has been confirmed to prevent striae entirely, consistent daily
application of a moisturising formulation from the second trimester onwards is associated with
improved skin comfort, reduced itching, and potentially milder stretch mark development in
some studies. The mechanism is straightforward: well-hydrated skin is more supple and more
able to accommodate mechanical stress than dehydrated skin.
The key word is consistent. Occasional application is not the same as twice-daily massage from
13–14 weeks. The studies that show the most promise all involve regular, sustained application
over months — not short-term intensive use.
Massage — The Underappreciated Variable
Daily massages showed some promise in reducing stretch mark severity in published research.
The mechanism is likely circulatory: massaging the skin increases blood flow to the area,
supporting the delivery of nutrients and oxygen to the rapidly expanding tissue. Warm a product
between your palms and apply in gentle circular motions — the technique matters, not just the
product.
Collagen-Supporting Ingredients
Collagen and elastin fibres in the skin are necessary to keep rapidly growing skin taut. Vitamin C
is an important antioxidant that helps protect tissue from damage, and foods rich in Vitamin C,
Vitamin E, zinc, and silica help to form collagen.
This is where Vitamin C becomes particularly relevant. A 2024 randomised controlled trial
published in the Journal of Client-centred Nursing Care studied the effect of Vitamin C cream on
pregnancy striae in primiparous women from 18–20 weeks gestation and found meaningful
outcomes in the treatment group. The evidence for topical Vitamin C in pregnancy skin is

growing, and the biological rationale is sound: Vitamin C is an essential cofactor for the enzymes
that synthesise collagen, making it directly relevant to the skin's capacity to manage rapid
stretching.
This is why our Kakadu Plum Belly Oil is built around Australian Kakadu Plum — the world's
richest natural source of Vitamin C, containing up to 100 times more than an orange. Not as a
promise to prevent stretch marks, but because when I looked for a natural ingredient with a

genuine biological rationale for pregnancy skin, Kakadu Plum's Vitamin C content and collagen-
supporting mechanism were the most compelling evidence-based choice available.

Supporting the Skin Barrier with Natural Oils
Rosehip oil is packed with vitamins A, C, and E, stimulating cell regeneration, collagen
production, and skin barrier protection. With consistent use, rosehip oil can help reduce the
appearance of stretch marks. Multiple natural oils — rosehip, jojoba, sweet almond, avocado, and
macadamia — support the skin's lipid barrier and provide essential fatty acids that maintain

suppleness in rapidly stretching skin. These are not cure claims; they are the biology of well-
nourished skin performing better under stress.

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Ingredients to Avoid for Stretch Marks During Pregnancy
One important note on ingredients commonly recommended for stretch marks that are not
appropriate during pregnancy:
Retinoids (tretinoin, retinol, retinyl palmitate) — effective for treating existing striae after
pregnancy but absolutely contraindicated during pregnancy in any form
High-dose glycolic acid peels — show some improvement in existing marks but not
appropriate during pregnancy
Hydroquinone — sometimes used for the pigmentation component of stretch marks; not
recommended during pregnancy
These are postpartum options to discuss with a dermatologist. During pregnancy, the strategy is
skin support and consistency — not aggressive actives.

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A Practical Approach: Supporting Your Skin Through Pregnancy
Given everything the evidence shows, here is a genuinely useful protocol for pregnancy skin
care — honest about what it can and cannot do.
Start in the second trimester (weeks 13–14) This is when the belly begins its most rapid growth.
Starting early gives the skin the best environment to manage the increasing mechanical
demand.
Apply twice daily without exception Morning and evening. Consistency over months is what
matters — not the occasional intensive application.

Use a warm, slow massage technique Warm the product between your palms before applying.
Use slow, circular, upward motions across the belly, hips, thighs, and breasts. Take five minutes.
The massage itself — not just the product — is part of the benefit.
Choose a formulation with collagen-supporting ingredients Look for natural Vitamin C,
rosehip oil, Vitamin E, and carrier oils that provide essential fatty acids. Our Kakadu Plum Belly
Oil was formulated around exactly these criteria — 11 natural ingredients, 100% natural,
pregnancy and breastfeeding safe, built around the world's richest natural Vitamin C source.
Stay hydrated and nourish from within Drink sufficient water daily. Eat a diet rich in Vitamin C,
Vitamin E, zinc, and protein — the nutrients that support collagen synthesis systemically, not
just topically.
Manage weight gain gradually Steady, gradual weight gain within the recommended range for
your pregnancy places less acute mechanical stress on the skin than rapid gain over short
periods.

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Products Designed to Support Stretching Pregnancy Skin
At Pregnancy and Baby Co., every product in our range began with a real concern raised by real
women in clinical practice. Our Belly Oil was formulated specifically to answer the most common
question I heard as an obstetrician: what should I actually use on my belly during pregnancy?
Kakadu Plum Belly Oil — $79 100% natural. 11 ingredients. Australian Kakadu Plum as the
Vitamin C hero. Lemon Myrtle for morning sickness comfort during application. Rosehip for
collagen and skin repair support. Pregnancy and breastfeeding safe.

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FrequentlyAsked Questions
Do stretch marks during pregnancy go away? Stretch marks generally fade significantly over
time but do not disappear completely. Striae rubrae (the red/purple early marks) tend to fade to
striae albae (pale silver-white) over 12 to 24 months after birth. Most women find them much less
visible a year or two postpartum.
When do stretch marks appear in pregnancy? Most commonly in the second and third
trimesters, as the belly grows most rapidly. Some women develop them as early as 12–14 weeks;
others not until the third trimester. The timing varies significantly between individuals.
Can I use retinolfor stretch marks while pregnant? No. Retinoids in any form — including
retinol — are not recommended during pregnancy. They are an option to consider postpartum,
once you have stopped breastfeeding, in discussion with a dermatologist.
Does bio-oil work for pregnancy stretch marks? Bio-Oil is a widely used product and is
considered safe during pregnancy. However, the evidence that any specific product prevents
stretch marks is limited. Its benefit is likely as a consistent moisturising formulation used
regularly — the same mechanism as other well-formulated oils.

When should I start using a belly oil in pregnancy? From the beginning of the second trimester
— around 13 to 14 weeks — when the skin begins its most rapid growth phase. Earlier application
builds the habit and supports the skin from the outset of the stretching period.

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A Final, Honest Word
Stretch marks are one of the most emotionally charged topics in pregnancy skincare — in part
because the marketing around them makes a degree of prevention sound straightforwardly
achievable with the right product. The evidence is more nuanced than that.
What is true: consistent daily care of stretching pregnancy skin, with well-formulated,
pregnancy-safe products, gives your skin the best possible support through one of the most
demanding physical changes it will ever experience. Whether or not stretch marks appear — and
how severely — will also be shaped by factors you cannot control: your genetics, your hormone
levels, and the particular way your baby chooses to grow.
Both things can be true at once. You can care for your skin thoughtfully and consistently. And
you can also be kind to yourself if stretch marks appear despite everything you did.
Your body is doing something extraordinary. What it looks like while doing it does not diminish
that in any way.

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Explore the Kakadu Plum Belly Oil → pregnancyandbabyco.com.au/products/kakadu-plum-
belly-oil

Download your free Pregnancy-Safe Skincare Guide →
pregnancyandbabyco.com.au/pages/free-guide
Related reading:
The Benefits ofAustralian Kakadu Plum Extract in Skincare →
Pregnancy and Melasma: Managing the Mask of Pregnancy →
Pregnancy-Safe Skincare: What to Use and What to Avoid →

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This article is for general informational purposes only and does not constitute medical advice.
Please consult your GP, midwife, or obstetrician for guidance specific to your pregnancy and
circumstances.
© 2025 Pregnancy and Baby Co. Pty Ltd | pregnancyandbabyco.com.au

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