Introduction
C-section or cesarean section is the surgical procedure to deliver a baby through an incision (cut) made on the mother’s abdomen and uterus (womb). This is opposed to the traditional method of delivery which is vaginal delivery. The first C-section was reported to have occurred in 1020 AD; ever since it has evolved remarkably. Many women deliver their babies through C-sections. According to a report, approximately 32 percent of all live births in the United States are delivered through this procedure. Sometimes it is a planned way of delivery, and in other cases, it is a medical emergency. C-sections are generally safe, but since it is a surgical procedure, it involves some scarring after the cut heals. Millions of mothers have such scars, and most C-section scars heal within weeks or months. This article discusses C-section scars in detail.
What Are the Types of C-Section Incisions?
The look of the scar depends on the cut made during the C-section. There are two types of incisions made on the abdomen. Both types of incisions result in scarring, but the look of the scar will differ depending on the cut's direction.
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Horizontal Incisions - Also known as ‘bikini cut,’ it is the most common type of incision done during planned C-section deliveries. It is a low transverse cut done just above the pubic area across the lowest part of the uterus, which is thin, causing less bleeding. Most women prefer horizontal incisions as they are easier to hide and heal more quickly than vertical incisions.
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Vertical Incisions - Also known as a ‘classical’ C-section, it is usually done in emergency deliveries and to access preterm babies. Vertical incisions generally start at the lower abdomen and extend to the belly button. A vertical cut makes the procedure easier in case of pregnancy complications. Vertical incisions are comparatively painful and take longer to heal.
What Are the Healing Stages of a C-Section Scar?
A woman’s body takes time to recover from the C-section and involves healing of the incision site and scar. Healing of incision occurs in different stages, and the scar tissue looks different in each stage.
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Inflammatory Stage - This stage lasts for a few days after the C-section. During this stage, the bleeding stops, and white blood cells flood the incision site to protect against infection. The incision at this stage is swollen and pink or red.
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Proliferative Stage - This stage lasts for three to four weeks. During this stage, fibroblasts start to assemble and proliferate at the incision site. Fibroblasts produce collagen, which helps to strengthen the incision site and pull the edges together. Later, new blood vessels are formed, and the collagen is broken down. The scar in this stage gets thicker, and as it contracts, the color changes.
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Remodeling Stage - This stage lasts for months or a year. During this stage, the thick and puffy scar tissue flattens gradually and loses its color. Hence, the C-section scar fades away and starts to look better.
Generally, it takes about six weeks for a scar to heal. However, the time of healing for a C-section incision varies. Factors such as poor nutrition or infection can slow the healing process. Eating properly and staying healthy will help the body do its job properly.
What Are the Types of C-Section Scars?
Some C-section scars heal and gradually fade away, while some are stubborn. C-section deliveries can result in two types of scars.
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Keloid Scars - This type of scar occurs when the scar tissue extends beyond the edges of the incision resulting in lumps of scar tissue around the incision.
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Hypertrophic Scars - This type of scar is firmer, thicker, and more raised than a normal scar. This means that the body created more scar tissue than necessary. Unlike a keloid, this scar stays well within the edges of the incision. A hypertrophic scar is harmless; however, it may irritate when one wears clothes, or it may be a cause of concern because of how it looks.
After healing, a C-section scar is four to six inches long, though the length may vary depending on the type of incision and the space required by the baby to come out. Any redness may reduce over time. One can have a keloid or hypertrophic scar, depending on how the body heals.
What Are the Signs of C-Section Scar Infection?
Consult a doctor immediately if experiencing any of the following symptoms:
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Redness or swelling of the incision site.
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Fever (body temperature higher than 100.4 degrees Fahrenheit).
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Foul smell from the incision site.
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Drainage or oozing from the incision site.
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Increased pain around the incision.
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In case the incision splits open.
Certain things are normal to experience during the healing process of the scar. One of them is itching. It is normal to have itching but keep away from scratching to avoid any risk of infection. Some may even experience numbness along with itching, which may increase the urge to scratch and hurt themselves. An ice pack wrapped in a towel can gently apply pressure and relieve itching.
How to Minimize Scarring After a C-Section?
Usually, the C-section scar fades away on its own over time. However, some tips can help minimize scarring.
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Silicone Sheetings - Some studies have shown that silicone sheeting helps to soften and flatten the scar, especially if a person tends to form hypertrophic or keloid scars. Silicone sheeting should begin three to four weeks after the C-section. It may show results within a month.
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Silicone Creams or Gels - These creams and gels serve the same purpose as silicone sheetings. Silicone can strengthen the connective tissue and restore the skin. It should be noted that always consult the doctor before starting any treatment for the scar.
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Scar Massage - After the scar is healing, massaging it regularly can help reduce its appearance. Massage increases the blood flow and stimulates the skin, which in turn increases collagen growth, and eventually, the scar fades. Massage the scar for five to ten minutes daily in a circular motion using the index and middle fingers. Silicone gel or vitamin E can be added while massaging.
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Avoid or Limit Sun Exposure - Sun exposure can make the scar darker or lighter than the complexion of the surrounding skin making it more noticeable. So limit the direct sun exposure for the first year after the C-section and apply sunscreen thereafter.
What Are the Cosmetic Options to Reduce the C-Section Scars?
When the scar does not heal properly and has become more noticeable, certain cosmetic treatments can be done to improve the look of the scar. Though there is no possible way to remove the scar completely, its appearance and feel can be improved.
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Laser Therapy - Lasers are used to remove the discoloration and soften the texture. It can help get rid of raised scars. Laser therapy can be started soon after the stitches are removed. Multiple laser sessions will be needed to achieve the desired results.
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Steroid Injections - These injections help to flatten and improve the appearance of the scar, along with reducing pain and inflammation throughout the body. Multiple monthly injections are needed to see noticeable results.
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Scar Revision - This is a surgical procedure in which the surgeon removes the damaged skin around the skin completely and sutures the new wound with precision leaving a less visible scar. The scar revision surgery aims to allow the area to heal again with a less noticeable scar. This surgery is helpful if the C-section scar is wide and thick or has formed a hypertrophic or keloid scar.
Conclusion
C-sections scars are experienced by every mother delivering her child through a C-section. Some people tend to scar more than others after the surgery. However, proper care, such as keeping the incision site clean and avoiding scratching, can help make the scar less noticeable. Before taking any treatment to heal the scar tissue, always consult the doctor.
