Losing weight may boost your confidence and lower your chances of developing diabetes, but shedding extra pounds also has it’s drawbacks–like stretch marks.

Stretch marks typically occur when people lose or gain weight quickly.

Essentially a scar, the marks develop when collagen and elastin, two proteins that keep skin healthy, are damaged. Losing weight slowly can lower your chances of developing stretch marks, says Dr. Nazanin Saedi, M.D., Director of the Jefferson Laser Surgery and Cosmetic Dermatology Center in Philadelphia, Penn. According to Dr. Konstantinos Spaniolas, associate director of the Bariatric and Metabolic Weight Loss Center at Stony Brook University, it’s best to lose no more than one percent of your body weight each week. This helps you retain muscle, weight loss, and yes, reduces the likelihood of getting stretch marks.

Weight lifters who build muscle mass quickly also form stretch marks for the same reasons.

You’ll find stretch marks in many different areas, including the stomach, chest, arms, hips, and butt. They typically begin as pink or red since blood flow to the area increases in response to the damage, says Saedi. Over time, they’ll become translucent.

Stretch marks may disappear on their own–but it’s rare.

“I see it more in women who develop red stretch marks during pregnancy,” says Saedi. That said, it is possible for stretch marks to heal in anyone–if they’re still red. Older stretch marks that are translucent are much harder to treat, she says.

Creams and lotions promise to reduce the appearance of stretch marks, but they likely won’t deliver the results you want.

Numerous studies has shown that over-the-counter products are generally ineffective at eliminating stretch marks, according to the American Academy of Dermatology. However, Dr. Stanley Kovak, M.D. of Kovak Cosmetic Center explained to Women’s Health that prescription retinols may help people who have red stretch marks.

“The only type of cream that does anything is Retin-A, which has been shown in studies to decrease redness and even stop or reverse some of the scarring by causing collagen to rebuild,” he explained.

Laser therapy and microneedling are the most effective treatments

Saedi says both work by essentially damaging the skin. “In response to that injury, the skin is increasing collagen production and normalizing the damaged tissue,” she tells Men’s Health.

There are two types of lasers used to treat stretch marks: ablative and non-ablative. The first removes the outer skin layer while the latter delivers heat to stimulate collagen production.

Microneedling, as the name implies, involves using tiny needles to prick the skin.

These options come with a hefty price tag. According to the American Society for Aesthetic Plastic Surgery, one ablative laser treatments cost roughly $2,681, on average. Non-ablative laser treatments will set you back $1,410 each.

In comparison, microneedling ranges from $300-700 per session, Healthline reported.

Saedi says people with translucent stretch marks won’t experience a dramatic difference.

“The challenging part is that even with these devices and these treatments it’s really hard to get more than 50 percent improvement,” she says.

Bottom line: stretch marks are extremely difficult to treat and they often don’t go away completely.

“Have realistic expectations,” Saedi advises.

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