How to Care for Your C-Section Scar: Healing, Recovery & What to Expect

Mr Stelios Myriknas Consultant Obstetrician & Gynaecologist · BSc MSc MBBS (London) MRCOG

Medically Reviewed

Good scar care in the weeks after a caesarean supports healing and helps reduce long-term discomfort

A caesarean section is one of the most common surgical procedures performed in the UK, yet many women leave hospital with only a brief explanation of how to look after their scar. The incision is small and usually heals well, but how you care for it in the days, weeks, and months after birth can make a significant difference to how comfortable you feel and how the scar settles over time. This guide takes you through everything you need to know, from the moment the dressing comes off to the point where your scar is fully mature.

Understanding your scar

A caesarean incision is typically made horizontally, just below the bikini line. This is known as a Pfannenstiel incision and measures around 10 to 15 centimetres in most cases. The surgeon cuts through several layers of tissue including skin, fat, and the uterine wall before delivering your baby, and all of those layers need to heal in the weeks that follow.

The visible scar on the surface of your skin is only part of the picture. Beneath it, scar tissue forms throughout the deeper layers, which is why some women experience sensations, tightness, or sensitivity that goes beyond the surface of the wound itself.

Scar healing takes place in three overlapping phases:

• Inflammatory phase (days 1 to 5): The body responds to the wound with increased blood flow. The area may appear red, swollen, and feel warm to the touch. This is a normal part of healing, not a sign of infection.
• Proliferative phase (weeks 2 to 6): New tissue forms rapidly. The scar may appear raised, firm, or darker than surrounding skin. Itching is common at this stage and is a sign that healing is progressing.
• Remodelling phase (months 3 to 24): The scar gradually softens, flattens, and fades. Final appearance varies from person to person and depends on skin type, genetics, and how well the wound was cared for in the earlier stages.

The first few days: dressings and wound checks

In hospital your wound will be covered with a dressing, which your midwife or nurse will check regularly. Before you are discharged, they will remove this and inspect the wound. In most cases you will be sent home without a dressing or with a light one, depending on how healing is progressing.

In the first few days at home:

• Keep the area clean and dry. Pat gently with a clean towel after bathing rather than rubbing.
• Avoid submerging the wound in a bath until it has fully closed, which is usually around six weeks.
• Showers are fine. Let warm water run over the area and avoid directing a shower jet directly at the wound.
• Wear loose, high-waisted cotton underwear that sits above the scar rather than pressing against it. Many women find maternity or post-surgical underwear helpful at this stage.
• Avoid tight waistbands, jeans, or anything that rubs or compresses the incision line.

If dissolvable stitches were used, these do not need to be removed. Non-dissolvable stitches or staples will be taken out by your community midwife or GP practice, usually around five days after the operation.

Weeks two to six: keeping the scar clean

Once the wound has closed, the focus shifts to gentle cleaning and keeping the area free from moisture and irritation. During this phase the scar is still fragile, even if it looks healed on the surface.

• Wash the scar daily with mild, unperfumed soap and warm water. Rinse thoroughly and dry gently by patting rather than rubbing.
• Avoid scented soaps, shower gels, or creams directly on the scar until it is fully healed. Fragrance can cause irritation and delay healing.
• Keep the area dry between washes. If your scar sits in a skin fold where moisture can accumulate, placing a small piece of soft cotton fabric in the fold can help.
• Avoid swimming pools, hot tubs, and baths until your six-week postnatal check confirms full closure.
• Protect the scar from sun exposure. UV light can cause a healing scar to darken permanently. If the area is exposed, apply a high-factor (SPF 50) sunscreen.

Scar massage: when and how to start

Scar massage is one of the most beneficial things you can do to improve the long-term feel and appearance of your caesarean scar. It helps to break down the deeper adhesions that form as scar tissue matures, reduces tightness, and restores sensation to an area that may feel numb or hypersensitive.

You should not begin scar massage until the wound is fully closed and dry. This is usually around eight weeks after the operation, though your midwife or GP can confirm when it is safe to start. Beginning too early risks reopening the wound or introducing infection.

How to massage your scar

You do not need any specialist equipment. A small amount of plain oil such as vitamin E oil, coconut oil, rosehip oil, or a purpose-made scar gel works well. Avoid perfumed products.

• Start by placing two or three fingers along the length of the scar.
• Apply gentle but firm pressure and move the skin in small circles, both clockwise and anticlockwise.
• Then try moving the skin up and down, and side to side. The goal is to mobilise the tissue rather than simply rubbing over the surface.
• You may feel resistance or tightness beneath the scar. This is the adhesion you are working to release. Work within a level of pressure that is firm but not painful.
• Aim to massage for three to five minutes daily, gradually increasing pressure over the weeks as sensitivity reduces.

Many women find the scar feels numb initially and sensation gradually returns over weeks or months of massage. Others find it hypersensitive at first. Both are normal responses and generally improve with consistent gentle massage.

Moisturising and scar products

Keeping the scar moisturised once it is fully healed helps to maintain suppleness in the tissue and can support the remodelling process. There is a range of products available, and whilst evidence varies, many women find them helpful alongside regular massage.

• Silicone gel or sheets: These are among the most evidence-supported options for reducing scar thickness and improving appearance. Silicone sheets are worn over the scar for several hours a day, while silicone gel is applied and left to dry. Both work by hydrating the scar and reducing collagen overproduction.
• Vitamin E oil: Widely used and generally safe, though clinical evidence on whether it improves scar appearance is mixed. Many women find it helps with dryness and itching.
• Rosehip oil: Contains fatty acids that some studies suggest may support skin healing and reduce hyperpigmentation.
• Purpose-made scar creams: Products such as Mederma or Bio-Oil are commonly used and are safe to apply once the wound is fully closed.

Whatever product you choose, consistency matters more than the specific product itself. Daily application alongside massage will yield better results than occasional use of the most expensive cream available.

Physical recovery and returning to activity

A caesarean section is major abdominal surgery, and the internal healing that takes place is just as important as the surface scar. Returning to physical activity too quickly can place strain on the healing tissue and increase the risk of complications.

General guidance on returning to activity

• Walking: Short, gentle walks are encouraged from the first week and help to prevent blood clots. Gradually increase distance as you feel able.
• Driving: Most women can return to driving around six weeks after a caesarean, once they can perform an emergency stop comfortably and without hesitation. Check with your insurer as policies vary.
• Lifting: Avoid lifting anything heavier than your baby for the first six weeks. This includes pushchairs, car seats, and older children.
• Exercise: Gentle postnatal yoga and low-impact movement can usually begin from around eight weeks, following clearance at your six-week check. High-impact exercise, running, and core work should be introduced gradually and ideally with the guidance of a women's health physiotherapist.
• Sex: Most couples wait until at least six weeks and until any bleeding has stopped. There is no fixed rule, and comfort and readiness are the most important factors.

Sensation changes around the scar

It is very common to experience altered sensation around and above the caesarean scar for months after the operation. This happens because small nerve fibres in the skin are cut during the incision and take time to regenerate, if they do so fully at all.

Sensations women commonly describe include:

• Numbness or a loss of feeling in the skin directly above the scar
• A numb or tingling patch extending above the pubic hairline
• Heightened sensitivity or a burning sensation along the scar line
• A feeling of tightness or pulling when bending, stretching, or moving
• Occasional sharp, shooting, or electric sensations as nerve fibres regenerate

In most cases these sensations improve gradually over 12 to 18 months. Regular scar massage is the most effective self-care measure for encouraging nerve recovery and reducing sensitivity. If numbness or sensitivity is significant and affecting daily life, a women's health physiotherapist can offer additional treatment including desensitisation techniques.

The scar shelf and skin overhang

Some women develop a fold of skin that overhangs the scar, which is sometimes called a c-section shelf or scar shelf. This is a normal result of the way the skin and underlying fat heal after surgery and is not a sign that anything went wrong. It tends to be more noticeable in women who had some weight gain during pregnancy.

In many cases the shelf reduces over time as the deeper tissue continues to remodel. Keeping the area clean and dry is particularly important here, as the fold can trap moisture and become prone to irritation or skin breakdown.

If the shelf is causing persistent discomfort or hygiene difficulties, it is worth discussing with your GP. A referral to a physiotherapist or, in some cases, a surgical review may be appropriate.

Signs that something may be wrong

Most caesarean scars heal without complication. However, it is important to know what to look out for so that any problems can be identified and treated promptly.

Contact your GP or midwife if you notice

• Increasing redness, swelling, or warmth around the wound
• Discharge from the wound, particularly if it is yellow, green, or has an unpleasant smell
• The wound edges opening (known as wound dehiscence)
• A painful lump or hardening beneath or along the scar
• Persistent pain that is not improving or is getting worse after the first few weeks
• Fever above 38°C alongside wound symptoms

Seek urgent medical attention if you experience

• Significant bleeding or soaking through dressings
• Severe abdominal pain
• A high temperature alongside feeling unwell and wound changes
• Signs of a blood clot such as a swollen, painful, red leg or sudden breathlessness

Long-term scar considerations

For most women the caesarean scar becomes a thin, pale, flat line that is barely noticeable within one to two years. However, a small number of women develop complications that persist beyond the usual healing period.

Hypertrophic scarring

A hypertrophic scar is raised, red, and may be itchy, but stays within the boundaries of the original incision. It is more common in women with darker skin tones and in those who had wound complications such as infection. Silicone gel or sheeting, used consistently, is the first-line treatment. In some cases steroid injections or laser therapy may be considered.

Keloid scarring

A keloid scar grows beyond the original wound edges and can be thick, raised, and discoloured. Keloids are more common in women of African, Asian, or Hispanic heritage. Treatment options include steroid injections, silicone, pressure dressings, and in some cases surgical revision. Any treatment should be discussed with a dermatologist or plastic surgeon.

Scar endometriosis

In rare cases, endometrial tissue can implant in the caesarean scar, causing cyclical pain that worsens around the time of your period and a palpable lump at the scar site. If you notice a painful, changing lump at your scar that appears to be related to your menstrual cycle, please seek a review as this requires specialist assessment.

Future pregnancies after caesarean

If you are planning another pregnancy after a caesarean, it is important to discuss your previous delivery with your consultant early on. The scar on your uterus, rather than the visible skin scar, carries the main significance for future pregnancies. Most women with a previous caesarean are offered either a planned vaginal birth (VBAC) or a repeat caesarean, and the right choice depends on a range of individual factors. Please see our guide to caesarean section: what to expect for more detail on planning your delivery.

Frequently asked questions