Managing Hypertrophic Scars After Cesarean Section: Tips and Care - Dermatology

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Abdominal hypertrophic scar issues?


Hello Dr.
Wu, I had a cesarean section and it has been five months since the delivery.
One-third of my incision is smooth, while the other two-thirds are red and raised, which I believe is hypertrophic scarring.
I have been using the patches and gel recommended by the hospital (alternating between them), but the hypertrophic areas occasionally itch, and I experience slight pain when touching the scar.
Will this improve over time, or what care should I provide for the scar? Should I visit a doctor for a diagnosis?

Li, 30~39 year old female. Ask Date: 2022/03/06

Dr. Wu Yuxin reply Dermatology


In addition to continuing the use of the original patches and gels, you can also seek injection therapy from a dermatologist.

Reply Date: 2022/03/06

More Info


Managing hypertrophic scars after a cesarean section can be a concern for many new mothers. It's important to understand that while some degree of scarring is normal after surgery, hypertrophic scars can be more pronounced and may require specific care to improve their appearance and reduce discomfort.

Firstly, it’s essential to recognize that hypertrophic scars are raised, red scars that can develop after surgical procedures, including cesarean sections. They occur due to an overproduction of collagen during the healing process. While these scars may improve over time, they can also persist or even worsen if not managed properly.

Here are some tips and care strategies for managing hypertrophic scars:
1. Keep the Area Moisturized: Regularly applying a moisturizer to the scar can help keep the skin hydrated and may improve its appearance. Look for products that contain silicone, as silicone gel sheets or silicone ointments have been shown to be effective in flattening and softening hypertrophic scars.

2. Use Pressure Therapy: Applying pressure to the scar can help flatten it. This can be done using silicone sheets or compression garments specifically designed for scar management. These should be worn consistently for optimal results.

3. Avoid Sun Exposure: Protect the scar from sun exposure, as UV rays can darken the scar and make it more noticeable. Use sunscreen with a high SPF on the scar when exposed to sunlight, or cover it with clothing.

4. Massage the Scar: Gentle massage of the scar tissue can help break down collagen fibers and improve blood circulation to the area. Use a moisturizing lotion or oil to make the massage more comfortable. Aim for 5-10 minutes of massage several times a day.

5. Monitor for Changes: Keep an eye on the scar for any changes in color, size, or texture. If the scar becomes increasingly painful, itchy, or shows signs of infection (such as increased redness, warmth, or discharge), it’s important to consult a healthcare provider.

6. Consider Professional Treatments: If the scar does not improve with home care, there are professional treatments available. These may include laser therapy, corticosteroid injections, or surgical revision. Consulting with a dermatologist or a plastic surgeon who specializes in scar management can provide you with tailored options.

7. Patience is Key: Scars can take time to mature and improve. It’s common for hypertrophic scars to change over the course of several months to a year. While some may flatten and fade, others may require intervention.

8. Consult Your Doctor: Since you are experiencing itching and mild pain in the scar area, it would be wise to consult your healthcare provider. They can assess the scar and determine if there are any underlying issues that need to be addressed, such as infection or keloid formation.

In conclusion, while hypertrophic scars can be a source of concern, there are effective management strategies available. With proper care, many women find that their scars improve significantly over time. However, if you have ongoing discomfort or concerns about the appearance of your scar, seeking professional advice is always a good step. Remember, every individual's healing process is unique, and what works for one person may not work for another.

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