Tips to make your c-section scar less visible
The rate of c-sections continues to increase in the United States so if you’ve had a baby there is a good chance that along with your new little bundle of joy, you have also acquired a new scar on your lower tummy. Most c-section scars are horizontal and rest in the crease of your lower abdomen, though rarely, some may be vertical based on where you had the procedure done or if you had a medical indication to do so.
Once the dust settles and the baby is growing and you have healed from this major surgery, it is normal to want to do everything in your power to make sure that the incision looks good and that it does not impact your self image. The good news is that there are a lot of available methods to help the healing process and to improve the appearance of your scar. After your incision has healed, knowing how to care for the scar might help you achieve a finer and more aesthetically pleasing scar. C-section scars that heal well can appear minimally visible and even invisible to the naked eye.
How are c-section scars formed?
During a cesarean delivery, your gynecologist will make an incision on the skin of your lower abdomen to gain access to your uterus and baby. Once the baby is delivered and the uterus is repaired, your gynecologist repairs the soft tissues and closes the skin in layers as they were before the operation. The healing process follows, and during this time, your body produces collagen, a protein that is essential to wound healing. Collagen is also the protein that creates the links in your skin to keep the incision closed. The end result of this process is a scar that varies in color, texture, and appearance. This step is essential and there is nothing that you can or should do to counter it.
While the majority of women who undergo c-sections will heal with a scar that is pale, soft and flat, a minority (about 30%) will heal their incision by a process that goes into overdrive and produces an excess of collagen. This collagen excess creates a hypertrophic or keloid scar. These scars will appear hardened, raised, dark and often itchy or painful, and aesthetically unpleasing.
What can I do to minimize my c-section scar or make it fade away?
First, you have to go through the initial process of healing. This is an essential step, and it requires you to take good care of yourself and your overall health. This means that you have to eat well, sleep well and keep yourself well hydrated. Eating well requires you to eat a well-balanced diet rich in protein and in essential vitamins and nutrients so that your body can produce collagen and heal your wound well.
Furthermore, you need to take additional steps to minimize abnormal scarring. You must do your best to remain hydrated and refrain from smoking. Dehydration and smoking will reduce your skin’s elasticity and ability to heal well. Remember to also refrain from consuming alcohol and caffeine as those drinks dehydrate your skin cells, which can worsen the appearance of your scar.
How do I take care of my scar?
A holistic approach to caring for your scar will yield the best cosmetic results. First and foremost, you must take good care of your overall health and of your incision.
- Keep your incision clean by using warm water and a mild soap around the incision area to keep the skin clean; no scrubbing is necessary and should not be performed until the entire incision is healed over
- Eat nutritious foods and drink plenty of water or electrolyte infused fluid to keep your body and skin well hydrated
- Avoid cigarette smoking, alcohol and caffeinated drinks as they will dehydrate your skin cells and tissues and interfere with your skin’s regeneration process
- Limit sun exposure. Sun rays can make your scar more noticeable. It may make it darker than the skin around the scar. If you have to sunbathe, avoid direct sunlight on the scar and protect it by applying sunscreen SPF 30 or above.
Aside from these recommendations, you should ask your physician about products you can apply directly on the incision/scar to facilitate healing. Some of these can include: silicone sheeting, gel or cream, petroleum jelly, Mederma, Vitamin E, hydroquinone, sunscreens, and topical antibiotics. However you should consult with your surgeon first prior to their use and application. The goal is to keep the scar moist, light-colored, soft, and well hydrated to promote the best wound healing possible.
If despite these measures your scar is unsightly and dark with hypertrophy or keloids, you will want to consult your surgeon, a skin specialist or a plastic surgeon to enquire if you would be a good candidate for additional scar treatments and interventions.
What are some treatments that can improve the appearance of a scar?
Laser therapy. If you suffer from dark or hyperpigmented scars, laser is among one of the popular treatments used to correct discoloration. The laser can also be used for people who have thickened or hypertrophic scarring to flatten the appearance of the scar. Treating the scar with a laser can be done after your incision is fully healed. You may require several sessions to improve the appearance of the scar. The number of sessions will vary from person to person.
Steroid injections. These can be used to prevent hypertrophic scarring and Keloids and must be performed by a dermatologist or plastic surgeon. Injecting Kenalog, a long-acting steroid, can reduce inflammation, help flatten your scar, and make it less noticeable. Your physician may start treatment before closing the incision or start injections as soon as the incision is healed. You may require monthly injections. Your scar is then monitored for up to one year for additional treatments. If despite these measures your scar remains unsightly, you may be a candidate for a scar revision procedure.
Scar revision. The goal of this procedure is to remove your existing scar along with any abnormal surrounding tissue to recreate a new incision with healthy skin edges. This new incision will be closed by your surgeon with precision and plastic surgical techniques to lead to the most cosmetic outcome. Coupled with appropriate post-surgical treatments, the incision will heal with a thinner and less noticeable scar that is more aesthetically pleasing. This procedure requires consultation with a cosmetic plastic surgeon.
Finally, if you have an excessive amount of skin or excess fat on your abdomen, coupled with a poorly healed scar, you may be a candidate for a tummy tuck or abdominoplasty. Your plastic surgeon will discuss what tummy tuck options are available to you.
I hope that helps,
Stephanie Tardieu, M.D.
Senior Editor at Skin Post
Division of Women’s Health