Keloid Formation After Cesarean Section: Symptoms and Solutions

Cesarean section and keloid predisposition?

Hello Doctor: I had a cesarean section 1 year and 2 months ago, and recently I've noticed some swelling on the left side of the incision, which sometimes feels slightly painful.
1.
Could this be due to my tendency to develop keloids? 2.
Is it possible that the internal incision from the cesarean section has not fully healed? 3.
Should I go to the hospital for an examination, such as an X-ray or other detailed tests?

Xianxuan, 20~29 year old female. Ask Date: 2021/07/10

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
It is necessary to visit the outpatient clinic for a diagnosis to determine if the scar is still in the proliferative phase.
2.
The average recovery period for a typical cesarean section wound is 6 to 12 months, and cases of sudden proliferation after one year are very rare.
3.
X-rays cannot assess soft tissue issues.

Reply Date: 2021/07/10

More Info

Keloid formation is a common concern following surgical procedures, including cesarean sections. It occurs when the body produces an excess of collagen during the healing process, leading to raised, thickened scars that can extend beyond the original incision site. In your case, experiencing swelling and mild pain on the left side of your cesarean scar over a year post-surgery raises several important points to consider.

1. Keloid Formation and Genetic Predisposition: If you have a history of keloids or a family history of keloid formation, it is possible that you may have a predisposition to developing them. Keloids are more common in individuals with darker skin tones and can be influenced by genetic factors. If you suspect that you are prone to keloids, it is essential to discuss this with your healthcare provider, as they can offer tailored advice and management options.

2. Healing Process: After a cesarean section, the healing process can vary significantly among individuals. While most surgical wounds heal within a few weeks, complete healing, including internal structures, may take several months. If you are experiencing discomfort or swelling at the incision site, it could indicate that the healing process is not yet complete, or there may be other underlying issues such as infection or inflammation.
3. Need for Medical Evaluation: Given your symptoms of swelling and pain, it is advisable to seek a medical evaluation. A healthcare professional can assess the incision site and determine if there are signs of keloid formation, infection, or other complications. Imaging studies, such as an ultrasound or X-ray, may be warranted if there is concern about internal healing or if there are other symptoms that suggest complications.
4. Management Options: If keloid formation is confirmed, several treatment options are available. These may include corticosteroid injections to reduce inflammation and flatten the keloid, silicone gel sheets to help soften the scar, or surgical removal of the keloid, although this can sometimes lead to recurrence. Additionally, laser therapy and cryotherapy are other modalities that may be considered for keloid management.

5. Preventive Measures: If you are at risk for keloid formation, preventive measures can be taken during the healing process. This includes keeping the incision site clean and moisturized, avoiding tension on the scar, and following your surgeon's post-operative care instructions closely. Some practitioners may recommend specific treatments or interventions to minimize the risk of keloid formation during the healing process.

In conclusion, while keloid formation is a possibility given your symptoms, it is crucial to have a thorough evaluation by a healthcare professional to determine the exact cause of your discomfort and to discuss appropriate management strategies. Early intervention can often lead to better outcomes and help alleviate any concerns you may have regarding your healing process.

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