C-Section Scar Care
From initial wound care through scar massage and long-term management - what to do at each stage to minimise scarring and prevent adhesions.
About Your C-Section Scar
A standard C-section involves a horizontal incision about 10-15cm long, made just above the pubic hairline (the Pfannenstiel or bikini-line incision). This cuts through skin, fat, fascia, and the uterine wall. All layers heal at different rates.
The skin incision typically closes within 6-8 weeks. The uterine incision takes up to 12 months to fully heal from the inside. This is why certain activities and a subsequent pregnancy require longer waiting periods than the skin healing alone suggests.
What is normal in the first 6 weeks
- - Numbness above or around the incision (from nerve cutting)
- - Itching as nerves regenerate and skin heals
- - A shelf or overhang above the scar (C-section pouch) - common and often improves with time
- - Some firmness and thickness along the scar line
- - Pink or red colour that gradually fades to white/silver over 12-18 months
Care at Each Phase
Weeks 1-6: Wound protection
- - Keep wound clean and dry; shower normally, pat dry gently
- - No soaking (baths, pools, sea) until fully healed
- - High-waisted underwear or maternity briefs to avoid rubbing on the incision
- - Steri-strips will fall off on their own - do not pull
- - Watch for infection signs: increasing redness, warmth, discharge, fever, wound opening
From 6-8 weeks: Scar massage (once fully closed)
- - Use your index and middle fingers; press firmly into the scar with enough pressure to feel slight resistance
- - Move up-down, side-to-side, and in small circles - 2-5 minutes daily
- - This breaks up adhesions (internal scar tissue that can bind layers together)
- - Numbness is common - you may not feel sensation initially; continue gently
- - Apply a small amount of oil (coconut, vitamin E, or dedicated scar gel) to reduce friction
Weeks 6-12+: Silicone and sun protection
- - Silicone scar sheets worn 12+ hours daily for 2-3 months significantly reduce scar thickness and redness
- - Silicone gel (Bio-Oil, ScarAway) applied twice daily also helps
- - Keep scar out of direct sun; apply SPF 50 for at least 12 months - UV exposure darkens healing scars permanently
- - In Singapore's humid climate, keep skin clean under scar sheets and allow to air dry daily
Keloid Risk and Adhesions: What Asian Skin Means for Your Scar
Keloid scarring (a scar that grows beyond the original wound boundary and remains raised and red) is more common in darker skin tones, including Chinese, Malay, and Indian skin. If you or family members have a history of keloid formation, mention this to your O&G before the C-section and follow up with a dermatologist postnatally.
Early silicone treatment and compression dressings are the most effective keloid prevention strategies. Steroid injections into the scar can help established keloids. Surgical removal alone often causes keloids to recur bigger - seek dermatology advice before pursuing this.
Adhesions are a different concern: internal scar tissue that forms between layers (between uterus, bladder, bowel, and abdominal wall). Adhesions can cause chronic pelvic pain, bladder and bowel problems, and complications in future pregnancies. Scar massage from 6 weeks is the main prevention strategy you can do at home. A women's health physiotherapist can assess and treat internal adhesions more directly.