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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 Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

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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
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Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

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Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

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Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

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