Question:
Female, 13 years old, Deletion subtype
My daughter started the estradiol patch about 4 months ago. She hasn’t really gained much weight or gotten bigger, but she is getting stretch marks across her butt and her upper thighs. Is this common with estrogen spikes or does it have something to do with PWS? Is there anything she should or could be putting on them to lessen the severity?
Nurse Lynn’s Response:
It’s common to see stretch marks when starting puberty treatment with estradiol, especially in girls with PWS. This doesn’t always mean your daughter is gaining weight or getting bigger. Estradiol changes how the skin stretches and handles growth, and in PWS the skin is often more delicate because of differences in muscle tone and collagen. Even small changes in her body or hormone levels can cause the skin to stretch and leave marks on areas like the thighs or buttocks.
To help, keep her skin well moisturized with a gentle, fragrance-free lotion or ointment. These won’t make the stretch marks go away, but they will keep her skin soft and more comfortable. Some over-the-counter creams like Mederma Stretch Marks Therapy may help the marks fade a little faster over time. Make sure to protect the areas from the sun, because sunlight can make the marks look darker. If the marks start to bother her or spread quickly, a dermatologist can talk with you about other options, like prescription creams or laser treatments, usually when she’s older.
One more tip: try not to put the estradiol patch on the areas where she already has stretch marks, because that skin can be more sensitive and fragile. Instead, rotate the patch to healthier skin as recommended. Keep an eye on any new changes, like if the marks spread quickly or if you notice swelling or other symptoms and share that with her endocrinologist.
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Perry A. Zirkel has written more than 1,500 publications on various aspects of school law, with an emphasis on legal issues in special education. He writes a regular column for NAESP’s Principal magazine and NASP’s Communiqué newsletter, and he did so previously for Phi Delta Kappan and Teaching Exceptional Children.
Jennifer Bolander has been serving as a Special Education Specialist for PWSA (USA) since October of 2015. She is a graduate of John Carroll University and lives in Ohio with her husband Brad and daughters Kate (17), and Sophia (13) who was born with PWS.
Dr. Amy McTighe is the PWS Program Manager and Inpatient Teacher at the Center for Prader-Willi Syndrome at the Children’s Institute of Pittsburgh. She graduated from Duquesne University receiving her Bachelor’s and Master’s degree in Education with a focus on elementary education, special education, and language arts.
Evan has worked with the Prader-Willi Syndrome Association (USA) since 2007 primarily as a Crisis Intervention and Family Support Counselor. Evans works with parents and schools to foster strong collaborative relationships and appropriate educational environments for students with PWS.
Staci Zimmerman works for Prader-Willi Syndrome Association of Colorado as an Individualized Education Program (IEP) consultant. Staci collaborates with the PWS multi-disciplinary clinic at the Children’s Hospital in Denver supporting families and school districts around the United States with their child’s Individual Educational Plan.
Founded in 2001, SDLC is a non-profit legal services organization dedicated to protecting and advancing the legal rights of people with disabilities throughout the South. It partners with the Southern Poverty Law Center, Protection and Advocacy (P&A) programs, Legal Services Corporations (LSC) and disability organizations on major, systemic disability rights issues involving the Individuals with Disabilities Education Act (IDEA), Americans with Disabilities Act (ADA), and the federal Medicaid Act. Recently in November 2014, Jim retired.