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Tips For Scar Management and Desensitization After C-Section

Also After Hysterectomy and Other Laparoscopic Procedures

After delivery via cesarean section, hysterectomy or other laparoscopic procedure, there will be an incision site that you will have to manage according to the directions of your doctors and nurses to keep the site from becoming infected. Although the incision site will close after about 2-3 weeks, scar tissue will continue to form. It is important to begin scar massage and desensitization techniques to help prevent scar tissue build up, puckering, and ongoing pain.

Managing Scar Tissue

A trained physical therapist can perform soft tissue mobilization and other modalities such as cold laser over the scar site. As a part of your treatment, your therapist will teach you skills to manage the scars at home for the following benefits:

  • Prevent scar tissue build up and puckering of scar site
  • Soften and flatten scar tissue by promoting collagen remodeling
  • Decrease itching
  • Provide moisture and flexibility to the scar
  • Desensitize the scar tissue, reducing pain

Moisturize

Apply lotion to the scar regularly to keep the scar moisturized. You will also use lotion for the scar massage techniques outlined below.

  • Use unscented lotion, do not use heavily perfumed lotions
  • Do not use lotions with artificial dyes or colors
  • Do not use any lotion containing vitamin E for the first month following your surgery or injury. You may use vitamin E containing lotions after the first month.
  • Avoid paraben, glycerine, and lanolin

The following is a list of some examples:

  • Eucerin®
  • Cetaphil®
  • Organic coconut oil

Scar Massage

Once the incision site is closed (usually around 2-3 weeks), you can begin scare tissue massage. Wait until your healthcare provider has removed any sutures/staples (if used) and all scabs have fallen off by themselves. Do not pick at or pull scabs off.

Directions:

  • Apply lotion to fingerpads and scar site.
  • Use the pads or soft tips of your fingers to massage the scar and tissue around the scar.
  • Massage in three directions:
  • Circles: Using two fingers make small circles over the length of the scar and the skin surrounding it.
  • Vertical: Using two fingers massage the scar up-and-down, like an “inchworm”
  • Horizontal: Using two fingers massage the scar from side-to-side, across the grain of the scar.

Pressure

Apply as much pressure as you can tolerate. Begin with light pressure. As you desensitize the scar, apply deeper and firmer pressure. Applying enough pressure to make the scar area lighten in color or turn white.

How Often?

Massage the scar 2-3x daily, for no more than 2 minutes per inch of scar.

You should massage your scars for at least six months following your surgery or injury. Your body will continue to lay down collagen and scar tissue at the site for the rest of your life, with the most tissue formation happening within the first 3-12 months.

Your goal is to make your scar tissue slide just like the skin around it, in all directions. This will result in a pain free scar without restriction.

Contact your doctor if you experience:

  • Redness
  • Bleeding
  • Scar is pussy, yellow, or weeping
  • Scar feels warmer than the skin around it
  • More pain than usual at the site of the scar

Sun Exposure

Avoid sun exposure on the scar site for one year. Sun exposure may cause your scars to become pigmented and turn darker than the surrounding skin. Use sun block or cover with clothing.

See a Therapist

If you have any questions, schedule an appointment with a trained physical therapist to help your incision heal fully.

 

Resources

Moffitt Cancer Center. (2006). Managing your scar. https://moffitt.org/media/1086/managing_your_scar.pdf

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Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

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