Red stretch marks are still healing. White ones have finished. That single fact changes everything about treatment.
What is the best treatment for stretch marks? Microneedling has good evidence as a stand-alone treatment for both new and mature stretch marks, alongside laser and radiofrequency options — but early, red stretch marks respond considerably better than mature white ones, and no treatment removes them completely.
What stretch marks are
Scars, not surface marks
Stretch marks are linear scars formed when skin stretches rapidly and collagen and elastin fibres in the dermis tear — which is why surface creams achieve so little.
Two stages
Striae rubrae are new, red or purple and still inflamed. Striae albae are mature, white or silver and have finished healing.
Why timing matters most
Red respond better
A comparative study of microneedling found early-stage red stretch marks showed greater overall improvement than mature white ones, likely due to the heightened vascular activity and collagen remodelling potential during the acute stage.
Mature still improve
The same study supported microneedling as safe and effective for both types — mature marks improve, just less dramatically.
Microneedling: the best-evidenced option
Collagen induction
Controlled micro-injuries trigger collagen and elastin production, remodelling the scar tissue over time.
Protocol and results
The study used four monthly treatments, with sustained improvements at three and six months after the final session — indicating remodelling continues well beyond treatment.
Other options
Alternatives and additions include:
- Fractional laser resurfacing for texture and colour
- Radiofrequency microneedling for deeper remodelling
- Vascular-targeted treatment for very red early marks
- Topical retinoids for early striae, where suitable
- Combination approaches for better outcomes
What to expect
| Aspect | Typical |
|---|---|
| Sessions | 4 or more, monthly |
| Stretch mark type | Red responds better than white |
| Results build | Continues 3–6 months after |
| Realistic outcome | Improvement, not removal |
| Downtime | 1–3 days redness per session |
A guide only; your plan is confirmed at consultation.
The honest limitation
No treatment fully resolves them
Published research notes that while various treatments are available, none completely resolve the visual or structural changes of stretch marks.
What success looks like
A meaningful reduction in visibility, better texture and closer colour match to surrounding skin — not disappearance.
Sun and tropical considerations
Protect treated skin
Freshly treated skin is more sun-sensitive, and mature white stretch marks do not tan — so they become more obvious against tanned skin.
Plan around beach time
Sun protection on treated areas is important both for safety and for keeping the colour contrast minimal.
How to approach stretch mark treatment
A sensible plan:
- Have a consultation to identify whether marks are red or mature.
- Treat early if the marks are still red, for better results.
- Commit to a course of at least four monthly sessions.
- Follow aftercare and avoid sun on treated areas.
- Allow three to six months after the course for full remodelling.
- Set expectations around improvement rather than removal.
Body and skin treatments at LIV Clinic Koh Samui
At LIV Clinic, Dr. Narathai assesses stretch marks and advises honestly on what is achievable. Read about microneedling, or book a consultation.
Frequently asked questions
What is the best treatment for stretch marks?
Microneedling has good evidence for both new and mature stretch marks, alongside laser and radiofrequency options. Early red marks respond considerably better than mature white ones.
Do stretch marks ever go away completely?
No. Published research notes that no available treatment completely resolves the visual or structural changes of stretch marks. Meaningful improvement in visibility is the realistic goal.
Are red or white stretch marks easier to treat?
Red ones. Research found early-stage red stretch marks showed greater overall improvement, likely due to heightened vascular activity and collagen remodelling potential during the acute stage.
How many microneedling sessions do stretch marks need?
Studies used four monthly treatments, with improvements sustained and continuing at three and six months after the final session as remodelling progresses.
Does microneedling work on old stretch marks?
Yes, though less dramatically than on new ones. Research supported microneedling as safe and effective for both early red and mature white stretch marks.
Why do stretch marks look worse when I tan?
Mature white stretch marks contain little pigment and do not tan, so they stand out more against tanned surrounding skin. Sun protection helps keep the contrast minimal.
Safety and consultation
Stretch mark treatment is a medical procedure and, like any energy-based or resurfacing treatment, carries some risk — common temporary effects can include redness, mild swelling and sensitivity, while less common effects such as pigment changes are minimised by correct settings for your skin type. Results vary from person to person, and no specific outcome can be promised. This article is general information, not medical advice.
At LIV Clinic, every treatment begins with an in-person assessment by Dr. Narathai Vichienkalayarut, M.D., who reviews your skin, medical history and goals before recommending a personalized plan. Book a consultation to find out whether this treatment suits you.
LIV Clinic — “Live Your Life Young”
Doctor-led aesthetic and wellness clinic on Koh Samui and Koh Phangan, serving both international visitors and local residents.
Koh Samui (Bophut): 1/63 Thaweeratpakdee Rd, Bo Put, Koh Samui, Surat Thani 84320 · Tel 065-996-4242
Koh Phangan: 116/16 Moo 1, Koh Phangan, Surat Thani 84280 · Tel 093-254-5259
LINE: @Livclinic · Book a consultation
Explore our laser and skin and Thermage services.
ฆสพ.สฎ. 78/2567