Red and white stretch marks - what are the differences and which ones are easier to remove

"Can my stretch marks still be removed?" - this question depends largely on their colour. In my practice, fresh, red stretch marks respond to treatment much better than old, white ones. Below I explain the difference between red stretch marks (striae rubrae) and white stretch marks (striae albae), why the moment of starting the therapy is important and what laser stretch mark removal in Wrocław looks like in practice.

What are stretch marks

Stretch marks (striae distensae) are linear skin scars that occur when the skin is suddenly stretched and its connective tissue - collagen and elastin - is damaged [1]. They are created, among others: during pregnancy, during puberty, with rapid changes in body weight or intensive growth of muscle mass [1]. Over time, they go through two stages that look and heal differently.

Red stretch marks (striae rubrae) - fresh stage

This is an early stage: the stretch marks are slightly raised, pink to purple, sometimes itchy [1]. This colour comes from inflammation and dilated blood vessels in the skin - inflammatory infiltration and fibre remodeling can be seen under a microscope [1]. It is this "activity" of the skin that makes the red stage the best time for treatment.

White stretch marks (striae albae) - mature stage

After months to years, stretch marks fade, become white, thin and sunken - these are mature atrophic scars with atrophy of the epidermis and dense, parallel strands of collagen [1]. The skin in this place has fewer vessels and pigment, which is why white stretch marks are more persistent and more difficult to treat [1].

Which is easier to remove - and why

Fresh, red stretch marks usually respond better than white ones [1][2]. The reason is simple: the skin is still biologically "active", and treatment methods work by stimulating it to regenerate. The fractional laser creates controlled micro-damages that force the production of new collagen and elastin; in the case of white stretch marks, it may additionally support repigmentation [1]. White stretch marks can still be treated, but it usually requires more sessions and the effect may be more modest [2].

What does laser treatment look like

At MM Clinic, we reduce stretch marks with a CO2 fractional laser. The treatment is preceded by a consultation and assessment of the type of stretch marks and complexion - only then do we select the parameters. Typically, a series of 3-6 treatments is planned every 4-6 weeks, and the effects increase as collagen is rebuilt, even up to 3-6 months after the series. Details are described on page laser removal of stretch marks.

It is worth knowing that post-inflammatory discolouration has been observed more often after the CO2 laser than after some other methods, especially with darker skin [3] - that is why we always adjust the method and parameters individually.

An honest look at the results

Stretch marks are scars and rarely disappear completely - permanent, complete "removal" is not possible [1]. The aim of the treatment is to significantly reduce their visibility and improve the structure and colour of the skin. The effect is individual and depends, among others, on: from stage (red vs. white), skin tone and care.

Read also:

Stretch marks after pregnancy - how to deal with them
Do stretch mark creams work? What the research says

Sources

1. Mikes BA, Oakley AM, Patel BC. Striae Distensae. StatPearls [Internet]. StatPearls Publishing; updated 19.05.2025. ncbi.nlm.nih.gov/books/NBK436005
2. Forbat E, Al-Niaimi F. Treatment of striae distensae: An evidence-based approach. J Cosmet Laser Ther. 2019;21(1):49-57. pubmed.ncbi.nlm.nih.gov/29451986
3. Sobhi RM, Mohamed IS, El Sharkawy DA, Abd El Wahab MAEF. Comparative study between the efficacy of fractional micro-needle radiofrequency and fractional CO2 laser in the treatment of striae distensae. Lasers Med Sci. 2019;34(7):1295-1304. pubmed.ncbi.nlm.nih.gov/31044363