November 15, 2021
3 minutes to read
Source / Disclosures
Disclosures: Johnson does not report any relevant financial disclosure. Wang reports that he was the principal investigator of an industry-sponsored study on early molecular changes in stretch marks, which is separate from the current article on emotional impact. Please see the study for relevant financial information from all other authors.
Stretch marks can negatively impact pregnancy, quality of life, and the psychological and emotional well-being of those who experience them, according to researchers at Michigan Medicine.
“Almost 15 years ago, we started to study stretch marks at the molecular level in the lab. We have found many alterations in collagen and elastic fibers, which normally provide strength, support and elasticity to the skin, ”author Frank Wang, MD, William B. Taylor, full professor of clinical dermatology at Michigan Medicine, told Healio.
Wang and his colleagues focus on the formation of the very first stretch marks, or striae gravidarum (SG), and he said that many pregnant volunteers have allowed them to take skin samples as soon as they form during pregnancy.
“One thing we heard regularly from many of these participants is that stretch marks were very annoying for many of them, affecting various aspects of their lives. This prompted us to formally study the emotional and psychological impact of stretch marks, which validated the importance of the type of work we do in the lab, ”he said.
Researchers interviewed 116 pregnant patients with ILI who were planning to give birth at Von Voigtlander Women’s Hospital in Ann Arbor, Michigan.
The 35 questions in the single cross-sectional survey were based on questions from the Dermatology Life Quality Index (DLQI) regarding the impact of skin diseases on discomfort and discomfort, clothing choices, leisure activities and interpersonal issues. , as well as the authors’ own experiences with patients with ILI.
“We suspected that stretch marks caused distress and stigma to pregnant patients, so we created a survey that included questions about anxiety, depression, embarrassment and shame,” author Timothy Johnson, MD, Arthur F. Thurnau, professor of obstetrics and gynecology at Michigan Medicine, told Healio.
“Allergies and depression are problems for many of our patients, often exacerbated by the stress of pregnancy. We were not at all surprised that stretch marks were a stress that had not been well studied or recognized. We have many large studies on perinatal depression that have been done and are underway at our facility, ”Johnson said.
According to the survey, 45% of participants had a history of ILI from previous pregnancies, 33% had ILI from other causes, and 65% had a family history of ILI. The area most commonly affected by ILI was the abdomen (n = 87; 75%), followed by the breasts (n = 50; 43%), hips (n = 50; 43%), thighs (n = 42; 36%), buttocks (n = 22; 19%) or other areas (n = 7; 6%).
In the survey, 75% (n = 87) of participants said they were most concerned about the lesions becoming permanent. Discoloration (n = 43; 37%) and discomfort such as itching or pain (n = 26; 22%) were also cited as concerns.
In terms of severity, 21% (n = 24) said their lesions were “very significant”, 49% (n = 57) rated them as “moderate” and 30% (n = 35) said they were were “barely visible”.
SG had the most impact on embarrassment and embarrassment, with 22% (n = 26) saying they felt moderately embarrassed and 16% (n = 19) reporting “a lot” of embarrassment. Embarrassment and self-awareness also had the strongest correlation with injury severity (Spearman’s product-moment correlation coefficient [r] = 0.54; P <.0001>
The severity of the lesions also affected the general quality of life (r = 0.43; P P P P P P = .02).
“More than half of our participants said they tried something to prevent stretch marks, like creams or oils. It really indicated that the stretch marks were embarrassing for them, ”Wang said.
OS also correlates with a variety of facets of quality of life, Wang continued.
“In other words, a person who was embarrassed by their stretch marks was also subject to other emotional / psychological consequences, such as feelings of anxiety / depression, and negative consequences on the choice of dress and clothing. social activities, ”he said.
Additionally, many of these women reported that ILI caused as much distress as other skin conditions like acne or psoriasis which are known to negatively impact quality of life, Wang said.
Providers could therefore approach ILI like other skin problems and ask patients if their ILI has caused emotional distress and if prevention or treatment strategies should be used, even if they are not fully effective or if they are. potentially costly. Doctors might also consider psychological support and coping strategies for these patients.
“They can empathize with pregnant patients, tell them about the natural history of stretch marks and explain how they usually regress, which certainly happens with purplish (bright red) stretch marks, which become less red and less obvious afterwards. pregnancy. ”Johnson says.
“Simply recognize stretch marks as stress [and] depression and anxiety trigger in pregnant patients and talking about them and acknowledging their negative effects can reduce their impact and the fears associated with them, ”Johnson said.
Researchers are continuing to investigate the molecular causes of OS to find targets to prevent new lesions and better treat existing ones. They say they hope their science-based approach will lead to therapies that are genuinely effective and less expensive.