Pregnancy stretch marks most commonly appear on the abdomen, but they also show up on the breasts, thighs, hips, buttocks, lower back, upper arms, and groin area. About 61% of pregnant women develop stretch marks in at least one of these areas, with the abdomen being the most frequent site by a significant margin.
The Most Common Locations
The abdomen is the primary site. In one study tracking 110 pregnant women, 48% developed stretch marks on the abdomen, 25% on the breasts, and 25% on the thighs. These three areas account for the vast majority of cases, and many women develop them in more than one spot.
Beyond these top three, stretch marks also appear on the hips, buttocks, lower back, upper arms, and the creases near the groin. They tend to follow a pattern: they typically show up first on the abdomen, then spread to other areas as the pregnancy progresses. This makes sense because the abdomen stretches the most, the earliest, and the fastest.
When They Appear
Stretch marks usually develop after the 24th week of pregnancy and are especially common during the last trimester. That’s the period when weight gain and skin stretching accelerate most rapidly. When exactly they appear varies from person to person. One of the first signs is itchiness in an area where the skin is thinning and pulling tight.
What They Look Like
Fresh stretch marks start out reddish or purplish, sometimes with a slightly raised texture. This early stage reflects active inflammation and changes happening beneath the skin’s surface. The redness comes from increased blood flow to the area as the deeper layers of skin tear and try to repair themselves.
Over time, they transition into a paler, silvery-white appearance. At this later stage, the surface is rougher than surrounding normal skin, but the color fades considerably. Both stages have a noticeably different texture from the skin around them. The earlier, redder marks are generally more responsive to treatment than the older, lighter ones.
Why Stretch Marks Form
Stretch marks are not just a surface issue. They happen in the dermis, the thick middle layer of your skin. When the skin stretches faster than the cells responsible for building its structure can keep up, the collagen fibers lose their normal organized arrangement and become disorganized and stiff. The elastic fibers, which normally let skin bounce back, fragment into tiny pieces. New, immature elastic fibers try to fill the gaps but can’t replicate the original structure. The result is a visible tear at the surface: the stretch mark.
Pregnancy hormones play a role too. Higher levels of cortisol during pregnancy reduce the skin’s elasticity, making the collagen and elastic fibers more vulnerable to breaking under tension. This is why stretch marks concentrate in areas experiencing the most rapid expansion.
Who Is More Likely to Get Them
Genetics are the single biggest factor. If your mother had stretch marks during pregnancy, your risk increases substantially. One large study found that a positive family history raised the likelihood by more than fourfold. Researchers have identified specific genetic variations linked to stretch mark susceptibility, including variants near genes that control elastin and collagen production, the two proteins most critical for skin flexibility.
Beyond genetics, several other risk factors matter:
- Younger maternal age. Younger skin, somewhat counterintuitively, appears more prone to stretch marks during pregnancy.
- Higher pre-pregnancy BMI. Starting pregnancy at a higher weight increases the likelihood.
- Previous stretch marks. If you developed stretch marks during adolescence (growth spurts), you’re more likely to get them during pregnancy as well.
- Skin type. Certain skin types on the Fitzpatrick scale (which classifies skin by its response to sun exposure) show higher rates.
Can You Prevent Them
No topical product has been definitively proven to prevent pregnancy stretch marks. That said, some ingredients show more promise than others. Centella asiatica (also called gotu kola), a plant extract used in many skincare products, has limited but encouraging evidence. A 2018 comparative study found notable results for products containing this extract, and it works by helping skin cells organize collagen fibers more effectively during stretching.
Keeping skin well-moisturized won’t guarantee prevention, but it supports overall skin flexibility. Many women use a combination of heavy moisturizers and oils throughout pregnancy, applying them daily to the abdomen, breasts, and thighs starting in the second trimester. The key limitation is that stretch marks form deep in the dermis, and most topical products primarily affect the surface layer.
How They Change After Delivery
Stretch marks are permanent changes to the skin’s structure, but their appearance improves significantly over time. The red or purple color fades gradually in the months after delivery, eventually settling into pale, silvery lines that blend more with surrounding skin. The timeline varies widely. For some women, the most dramatic fading happens within the first year postpartum. For others, it takes longer. They never disappear completely, but for most women they become far less noticeable than they were during late pregnancy and the early postpartum period.