Are They Forever or Fixable?
By Bill Murphy, MD, Medical Director, Turquoise Springs Medical Spa
Scars and stretch marks affect people of all ages, skin types, and genders. These visual surface irregularities can be a source of angst, insecurity, and frustration with one’s appearance. Changes to the skin at the surface and at the deeper dermal layer can be left behind from acne, pregnancy, weight fluctuations, or even growth spurts during puberty. While completely eliminating them isn’t always possible, medical aesthetic science has made remarkable advances in minimizing their appearance.
Stretch marks, or striae, form when the skin stretches or shrinks rapidly, disrupting collagen and elastin fibers in the dermis. Fresh stretch marks often appear red or purple (striae rubrae), while older ones fade into a silvery white line (striae albae). They are caused by changes in the skin that damage the integrity of the support structure of the skin. Causes may include such stressors as rapid weight gain or loss, pregnancy, and even bodybuilding.
Acne scars, on the other hand, result from inflammation deep within the deeper layers of the skin. They can appear as depressed or ice pick scars, raised scars, or discolored patches due to post-inflammatory hyperpigmentation or a combination of all of these features.
Both issues involve a disruption in the skin’s structure and typically require more than just topical treatments to see substantial improvement. The changes under the skin need to be treated, and the main “workhorses” in our clinic to help reverse the changes are micro-needling with radiofrequency heat, and light/laser treatments.
Microneedling involves using a device fitted with tiny, sterile needles to create micro-injuries in the skin to the depth of the dermis or skin collagen changes. These controlled punctures trigger the body’s natural wound healing response, stimulating collagen and elastin production. For acne scars, the increased collagen fills in atrophic depressions, improving texture and reducing depth. For stretch marks, the treatment can fade discoloration and gradually smooth and strengthen the torn collagen structure. I like to use a natural substance, platelet-rich fibrin, made from my patient’s blood sample, to hasten healing and improvement. I also add radio-frequency energy to the needles to further stimulate collagen production. This can be especially effective for deeper scars and stretch marks.
The results aren’t instantaneous, as most people need a series of three to six sessions spaced about one month apart, but patience is a virtue when dealing with both of these issues.
Laser treatments are another helpful treatment when the right laser and wavelengths of light energy are used. The two main types used for scars and stretch marks are ablative and non-ablative lasers. I prefer non-ablative lasers as they have minimal recovery time and are much more comfortable to use. They stimulate collagen from within the dermal layer, helping to decrease and normalize the discoloration of the tissue. I use an Nd:YAG 1064 and an Er:YAG 1545 erbium laser for the best effect and improvement. Lasers can resurface the skin and remodel collagen, and are especially effective for texture irregularities and discoloration. Lasers help by fading excess pigmentation and promoting collagen to fill in the indented lines.
Both RF micro-needling and laser treatments are effective, and most of the time, I will use a combination for the best results, depending on the individual needs of my patient. For example, alternating between RF micro-needling and laser sessions can maximize collagen remodeling while minimizing skin trauma. At times, I will design a treatment regimen that combines both technologies into a single session.
In some patients, I will add non-invasive body contouring treatments with Tru-Body treatments to decrease fat pockets with radio-frequency bulk heating to the tissue. I may also add muscle stimulation to firm and build muscle tone with Trusculpt Flex. These treatments add the “cherry on top” to better looking skin, with improved and customized body shape.
The patient in the before and after pictures above had a combination of RF-Microneedling with PRF, Erbium laser treatments, and Tru-Body iD and Flex over a 6-month period with incredible changes and improvement. She wishes to continue treatment to maximize results.
Stretch marks and acne scars are deeply personal but also incredibly common. While there are no magic eraser treatments, RF- micro-needling and laser therapy offer real, science-backed improvements that can boost both skin texture and self-confidence. The key is to consult with a qualified, experienced, and licensed aesthetic clinician who can tailor a plan to your unique skin.
Patience is essential—skin remodeling takes time—but for those willing to invest in the process, smoother, clearer skin is in your future. For a consultation to see what is best for you, call Turquoise Springs Medical Spa at 210-253-3313.
