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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

What Our Patients Have to Say

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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 Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

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.

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