Striae in Child
Alerts and Notices
Synopsis
Periods of rapid growth, such as puberty, pregnancy (striae gravidarum), training with weight lifting, rapid weight gain, and adolescent growth spurts, are common triggers. Striae also commonly occur in the setting of obesity. As 60%-70% of the US population is labeled as overweight or obese, the prevalence of striae from obesity is estimated at 40%. The skin findings themselves are rarely symptomatic, but they may occasionally indicate an underlying disease state (such as Cushing syndrome). In Marfan syndrome, striae are seen in around two-thirds of patients. Striae tend to flatten and become less conspicuous over time.
Bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor, has been reported to cause ulceration of striae that have been induced by concurrent systemic glucocorticoid therapy.
Related topic: drug-induced skin ulcers
Codes
ICD10CM:L90.6 – Striae atrophicae
SNOMEDCT:
201066002 – Skin striae
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Anetoderma is caused by focal loss of elastic fibers within the dermis and presents as flaccid, well-circumscribed areas of slack skin. Sac-like protrusions can occasionally be observed in some lesions.
- Lichen sclerosus presents as flat, yellowish-white plaques surrounded by a red, purple, or violet border.
- Steroid atrophy may accompany striae caused by topical corticosteroids.
- Scars are raised, firm nodules or plaques at sites of previous trauma.
- Linear focal elastosis (elastotic striae) is a rare condition that presents as asymptomatic atrophic yellow lines on the mid- or lower back, thighs, arms, or breasts.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:09/22/2019
Last Updated:09/17/2020
Last Updated:09/17/2020
Patient Information for Striae in Child
Overview
Stretch marks (striae) are stripe-like skin marks that develop as a result of rapid weight gain or loss, when the skin is stretched, and as a result of some diseases.Who’s At Risk
- In children who are not yet teens (adolescents), most stretch marks occur in those who are overweight.
- In the US, almost all pregnant individuals, 70% of adolescent girls, and 40% of adolescent boys have stretch marks. These are due to growth and stretching of the skin.
- Stretch marks are more common in women, occurring equally in people of all ethnicities / races.
- Stretch marks are also seen with prolonged use of oral or topical corticosteroids, disease of the adrenal gland, or rare genetic disorders.
Signs & Symptoms
When due to being overweight (obesity) in children, stretch marks are usually seen on both sides of the body (symmetrically); they are most visible on the thighs, arms, and belly and are sometimes seen over the back, buttocks, and knee regions.Stretch marks may be widespread, or they may appear in other locations in people who use corticosteroids or have certain diseases.
Stretch marks change in appearance with time:
- In early stages, they are faint, pink, parallel, band-like marks arranged in a line, and they might itch slightly.
- They gradually enlarge and become red to purple, often with a wrinkled surface.
- Finally, they become white, slightly depressed, crepe-paper-like linear marks, 1-10 mm wide and many centimeters long.
Self-Care Guidelines
- Stretch marks appearing during the teen years (adolescence) often improve in appearance with time. No treatment is needed.
- Where applicable, stop using topical corticosteroid creams in the child's skin area.
- Over-the-counter creams are useless.
- If the stretch marks are cosmetically distressing, early red areas can be treated, but these treatments would not be covered by insurance.
When to Seek Medical Care
See your child's doctor if stretch marks appear without an obvious cause, such as rapid weight gain or adolescent growth.Treatments
- If the appearance of the early lesions is bothersome, tretinoin cream may improve the appearance.
- Laser treatments and chemical peels may also be used.
- If the diagnosis is not certain, a biopsy and blood tests might be done.
References
Bolognia, Jean L., ed. Dermatology, pp.1542-1543. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.1028. New York: McGraw-Hill, 2003.
Striae in Child