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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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I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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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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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!

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I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

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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!

Read more: Testimonial by Mary L.

Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

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