C-Section Scar Care: Your Guide to Helping It Heal

Are you worried about your C-section scar? Our primer will help you care for your incision, and clue you in on what to expect as it heals.

c-section scar care

Millions of people give birth via cesarean sections each year. In fact, according to March of Dimes, nearly 32% of all live births in the United States are delivered via this method annually. This means that many new parents have C-section scars. (And, if you are reading this, you probably do—or expect to have one— too.)

The good news is that post-surgery care is generally minimal, and these wounds tend to heal well. Most C-section scars heal within a matter of weeks—or months. Here's everything you need to know about your C-section, from what to expect after your procedure to some of the most common FAQs about one of the most common surgical incisions around.

Types of C-Section Scars

There are two different types of cesarean section incisions: vertical and horizontal. Most C-sections are done the latter way, with 95% of procedures in the United States being done via a "bikini cut." Typically, vertical incisions are used in extreme emergencies, specifically when doctors don't have time to do the more intricate and less visible horizontal incision. If they do a vertical skin incision, they're likely to do a vertical uterine incision, too.

How Big Are Most Incisions?

C-section scars are surprisingly small. In most cases, a baby's head fits through a four- to six-inch skin incision made horizontally just below the pubic hairline. The abdominal muscles are moved aside (not cut through) and a horizontal incision is also made in the uterine wall. That said, in rare cases, doctors make a vertical incision from below the pregnant person's belly button to the pubic bone. This results in a larger scar.

What Do C-Section Scars Look Like?

Since they're usually made below the pubic hairline, unless you wax or shave the area, you might not see your C-section scar at all. In either case, as it heals, it'll look red or pink for several months but eventually, it fades to a pale, flat, thin line. Some scars may appear bigger, thicker, or more raised than others, of course; however, they're rarely very obvious.

"We generally make the incision as low as possible and into the pubic hairline so that it is not visible when wearing bikinis or low-riding clothes," says Leena Nathan, MD, an OB-GYN at UCLA Health in Westlake Village, California.

How to Take Care of Your C-Section Scar

Before you're discharged from the hospital—typically around two to four days after surgery, depending on your insurance and the specifics of your delivery—your doctor will remove the staples from your incision. If you had sutures, they'll dissolve on their own.

Your C-section scar will be covered with a paper tape-like product known as Steri-Strips. These will fall off on their own in about a week. Avoid touching them before that. They're keeping your wound closed and clean.

While your scar is fresh—usually for the first two weeks—you'll be instructed not to lift anything heavier than your baby so as not to disturb the healing process. During this time, you can shower freely using mild soap without scrubbing the area. It's fine to get the incision (and the Steri-Strips) wet, but you should avoid submerging your wound in a bathtub or swimming pool during the early days. At this point, your scar will likely be puffy, and the area around it will be pink.

Potential C-Section Scar Side Effects

In the first few weeks after the procedure, you may experience a variety of symptoms at the incision site. These include the following:

  • Bleeding
  • Cramping
  • Itching
  • Numbness
  • Pain
  • Soreness

If you feel the urge to scratch your healing wound, do your best to resist. Itching the incision site or scar can disrupt the healing process and/or lead to infection.

If you notice heavy bleeding or oozing from your incision site, reddened edges, increasing C-section scar pain, or you have a fever higher than 100.4°, call your doctor right away, as these symptoms could be signs of infection.

How to Encourage C-Section Scar Healing

Eat well so your body has the right nutrients for healing and creating healthy tissues. Studies show that proper nutrition facilitates wound healing. Additionally, keep your incision clean during the initial C-section scar recovery period to prevent infection. Wear loose or soft clothing over the scar area to prevent constricting or rubbing against the healing skin. Also, avoid heavy lifting, housework, or any big movements that might stretch or irritate the scar for the first six weeks.

C-Section Scar Healing Time

After about six weeks, your C-section scar should be healed—meaning it's fully closed and you'll likely be able to resume all regular activity without disturbing it. Giving yourself at least six weeks of healing time "allows the incision lines to mature, so that when strenuous activities are performed, the integrity is not compromised," says Rajiv B. Gala, MD, an OB-GYN at Ochsner Health in New Orleans.

Additionally, although the integrity of the scar may be intact, you may still note that it has turned a reddish-purple color. Don't worry, that's completely normal. The color will persist for about six months before fading to a less noticeable whitish line, says Shawn Tassone, MD, Ph.D., an OB-GYN in Austin and author of the books Hands Off My Belly! and Spiritual Pregnancy.

What's a Keloid C-Section Scar?

While uncommon, your scar may have a raised, thickened characteristic, known as a keloid. Doctors aren't sure what causes keloid C-section scars. "But there is obviously a hyper reaction to the healing process that causes the scar to grow outside its original boundaries," says Dr. Tassone. Risk factors for developing a keloid include being under the age of 30 and having darker skin.

Some physicians attempt to counter the effect by injecting cesarean wounds with a steroid called Kenalog at the time of surgery or applying a steroid cream postoperatively. However, the results are mixed—as are treatments such as lasers and injections of interferon.

Do I Need C-section Scar Creams?

You may be eager to try vitamin E or over-the-counter creams like cocoa butter, but they are unlikely to be helpful. "There have not been any good scientific studies demonstrating that any over-the-counter preparations are better than just proper wound care," says Dr. Gala. "Most of the expectations presented in online advertisements are best-case scenarios and may not be realistic in typical cases."

You should also be mindful to avoid certain cosmetic creams if you're nursing. "There are things that will work on scars and stretch marks, like Retin-A, but these need to be administered after pregnancy and breastfeeding," says Dr. Tassone.

Should I Give Myself a C-Section Scar Massage?

Massages can reduce C-section scar tissue formation and can help ensure a smooth, flat, pain-free, and supple scar, says Leslie Lo, DPT, a physical therapist at Northwestern Memorial Physicians Group in Chicago.

Beginning four to six weeks post-surgery (get your doctor's clearance first), gently massage the scar, working it with a rubbing motion—first side to side, then up and down; then diagonal. "You can also lift and roll the scar between your thumb and forefinger," says Lo. Doing this two to three times a day for five to 10 minutes at a time can keep the scar more pliable, soft, and cosmetically appealing.

Appearance concerns aside, Lo says a C-section scar massage can help prevent chronic pelvic pain, which can occur postoperatively, as well. "If the scar is thick and deep, it can limit the mobility of muscles and connective tissue, contributing to pain and immobility," Lo says.

Ways to Minimize the Appearance of a C-Section Scar

If you're not happy with the appearance of your C-section scar, there are possible ways to change its look—and not all require surgery. For a less invasive option, you can apply a silicone sheet to the scar, starting two weeks post-C-section. It may prevent long-term redness or bumpiness by hydrating the scar, David Cangello, MD, an attending plastic surgeon at Lenox Hill Hospital and New York-Presbyterian Hospital. "But you need to wear it 24/7."

A scar revision, which takes place under local anesthetic or sedation, involves opening the scar (but not the underlying muscle) and re-closing it. Recovery time is about three to four weeks, says Dr. Cangello.

"I'm not at all saying that OBs don't know how to close [a wound] properly," emphasizes Dr. Cangello. "But an OB's concern is delivering a healthy baby—that's their expertise. In this case, our expertise is making things look beautiful." Insurance does not cover a plastic surgeon's involvement. Dr. Cangello charges $3,000 and says that the fee is on par with other surgeons'.

Consider, however, that not everyone is concerned about the look of their C-section scar. Some choose to appreciate what it symbolizes, instead. Others let their public hair cover it or get C-section scar tattoos or body art which covers the incision site. The most important thing is that you do what makes you happy and learn to love the skin you're in.

Key Takeaways

Your C-section scar will heal in approximately six weeks. Taking care of your C-section during recovery includes resting and keeping the area clean. There are some methods that can reduce the appearance of your C-section scar, including scar massage, steroid injections, topical creams, or scar revision.

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Sources
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