Pregnant individuals may undergo a cesarean delivery (also known as a C-section) to give birth. For some, C-section scarring may be a concern—especially when it comes to understanding how to best heal the incision.

Here, we’ll dive into how you can effectively take care of your postpartum skin and possibly reduce the appearance of C-section scarring.

Types of C-section scars 

A C-section is a method of delivering a baby through two incisions. The first incision is made through your abdomen, and may leave a visible scar on your skin. The second incision is made through the uterus and allows the surgeon to reach your baby and safely deliver them.¹

These incisions are usually horizontal but can be made vertically based on a variety of factors that are considered by the surgeon performing the procedure. 

Vertical scars

If your doctor decides to go with a vertical incision, naturally, it’ll leave a vertical scar. These incisions are usually midline and higher up on your stomach. It has been cited as the preferred method to perform an emergency cesarean, as it provides faster access to the abdominal cavity.²

Horizontal scars

Horizontal scars are the most common and they’re often called low-transverse or bikini incisions. This scar curves across the lower part of your abdomen and this method is often preferred because it is tolerated better by the patient. Horizontal scars are also known for healing well.³

Hypertrophic and keloid scars

Ideally, your incision will heal flat and leave an almost unnoticeable scar. However, in some cases, it may heal as a raised scar, such as a hypertrophic or keloid scar. The exact cause of a keloid scar is unknown but it is known that the body produces more collagen than it needs to heal the injured skin.⁴ Raised scars can be itchy or painful, and they often cause emotional distress due to their appearance.⁵ Although difficult to tell the difference, keloid scars are different from hypertrophic scars as they extend beyond the boundaries of the initial injury.⁶ 

How to take care of a C-section scar to enhance healing 

In the first few days after your C-section, it’s normal to feel pain or numbness around your incision.⁷ As your incision heals the pain should improve and eventually go away. 

To ensure your scar heals properly, there are some steps you can take to prevent infection and optimize your healing. That said, it’s important to always follow the guidance of your medical provider. 

Keep your scar clean

Keep your incision area clean.⁸ You can do this by allowing water and soap to run across your incision while you shower, and then gently patting it dry when you’re done. It’s better to avoid soaking in a tub or going swimming until your medical provider says it’s safe for you to do so. 

Don’t exercise excessively 

According to the American Pregnancy Association, it is best to keep your exercise level low until your health care provider approves an increase in activity.⁹ Among other reasons, it’s possible too much activity can increase the risk of stretching your fresh incision and reopening your skin. As a general rule, it’s recommended that you don’t lift anything heavier than your baby until approved by your medical provider.¹⁰

It’s normal to tire easily after your C-section, and you should listen to your body when you need to rest. 

Don’t neglect the basics

Taking care of your health is always important, but even more so after undergoing a C-section delivery. Visit your medical provider for follow-up care, and don’t skip any appointments! Make sure you eat well, stay hydrated, and follow the guidance of your medical provider to help your body recover as quickly and safely as possible.

Reduce scarring after a C-section

By keeping your scar clean, refraining from excessive exercise, and making sure to prioritize your health, you can help your incision heal properly after your C-section. Once your incision has healed, you can opt for different treatments that may help minimize the appearance of the scar left behind.

Silicone 

Topical silicone gel products are the recommended first-line treatment for scar management. Silicone gel has been found to help reduce the itching and overall discomfort caused by keloid scarring. Some studies have also demonstrated that silicone gel sheeting may help improve scar thickness and color.¹¹ Silicone gel sheets are easy to use, though it does take 6-12 months of constant wear for optimum results.¹² 

Steroid injections 

Steroid injections are common treatments for hypertrophic and keloid scars.¹³ To treat the scar, steroids are injected directly into your scar tissue. Research shows that corticosteroid injections can minimize the appearance of scars by decreasing inflammation. In general, several injections are required to see results.¹⁴

If these methods don’t work, you may want to consider laser or other scar revision procedures, which can be more invasive but may be an option to reduce the appearance of the scar.

Do C-section scar creams work?

Aside from silicone gel, many C-section creams out there may not really do much. However, you can look out for creams with certain ingredients that have been shown to help fade scarring.

Some studies suggest these ingredients can speed up scar healing, which may include scars from a C-section:

• Calendula ointment: According to the results of one clinical trial, using calendula ointment significantly increases the speed of cesarean wound healing.¹⁵

• Mitomycin C: This antitumor antibiotic has been shown to prevent the recurrence of a keloid scar following surgical removal.¹⁶

• Turmeric: Turmeric offers many benefits. Research shows that it can speed up wound healing after a Cesarean operation. The curcumin found in turmeric may help C-section wounds heal by decreasing inflammation.¹⁷

When to contact your medical provider 

If you suspect you have an infection, you should see your medical provider right away. You can get an infection if bacteria spreads to your surgical site. 

Signs of infection include:¹⁸

• Severe pain 

• Fever

• Scar swelling and redness

• Discharge or pus coming out of your incision 

• A foul smell from your incision area

The moment you suspect something is wrong, call your medical provider to get proper treatment.

Taking care of your skin postpartum

When C-section scars heal, they can appear flat or as raised scars. In most cases, they usually won’t go away entirely, but you can take measures to minimize their appearance.

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P.S. we did the homework so you don’t have to:

1. Sung, S. and Mahdy, H. Cesarean Section. StatPearls. (2022, September 18).

2. Sung, S. and Mahdy, H. Cesarean Section. StatPearls. Ibid.

3. Sung, S. and Mahdy, H. Cesarean Section. StatPearls. Ibid.

4. Ludmann, P. Keloid Scars: Causes. American Academy of Dermatology Association. (2022, August 30).

5. Bağlı, İ., et al. Predictors of the recurrence of surgically removed previous cesarean skin scars at cesarean section: A retrospective cohort study. Scars, Burns & Healing. (2021, June 25).

6. Bağlı, İ., et al. Predictors of the recurrence of surgically removed previous caesarean skin scars at caesarean section: A retrospective cohort study. Scars, Burns & Healing. Ibid.

7. The American College of Obstetricians and Gynecologists. Cesarean Birth. (May 2022).

8. Martinez, L. Going home after a C-section. MedlinePlus. (2022, November 21).

9. American Pregnancy Association. Cesarean After Care. (n.d.).

10. American Pregnancy Association. Cesarean After Care. Ibid.

11. Bleasdale, B., et al. The Use of Silicone Adhesives for Scar Reduction. Advances in Wound Care. (2015, July 1).

12. Bleasdale, B., et al. The Use of Silicone Adhesives for Scar Reduction. Advances in Wound Care. Ibid.

13. Juckett, G. and Hartman-Adams, H. Management of Keloids and Hypertrophic Scars. American Family Physician. (2009, August 1).

14. Chua, S.C., et al. Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after cesarean section: a single-blind randomized controlled trial protocol. Trials. (2019, June 18).

15. Jahdi, F., et al. The impact of calendula ointment on cesarean wound healing: A randomized controlled clinical trial. Journal of Family Medicine and Primary Care. (September-October 2018).

16. Sidgwick, G.P., et al. A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring. Archives of Dermatological Research. (2015, June 5).

17. Mahmudi, G., et al. The Impact of Turmeric Cream on Healing of Cesarean Scar. West Indian Medical Journal. (September 2015).

18. National Health Service. Caesarean Section Recovery. (2023, January 4).

19. National Health Service. Scars Overview. (2020, October 23).

20. Commander, S.J., et al. Update on Postsurgical Scar Management. Semin Plast Surg. (August 2016).

21. Commander, S.J., et al. Update on Postsurgical Scar Management. Semin Plast Surg. Ibid.

Laura Phelan is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Benedictine University and went on to get her post-master’s certificate as a Family Nurse Practitioner at the University of Cincinnati.

*Cancel anytime. Subject to consultation. Results may vary.

Written by

Curology Team

Medically reviewed by

Laura Phelan, NP-C