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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 T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

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A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

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While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

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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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Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

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Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

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