In Italy, approximately 31.12% of births are cesarean sections . A narrow scar just above the pubic bone is a reminder of the operation. At first, however, this scar can be very noticeable. With proper care, within a few months it should appear as only a thin white line. In this article, we explain how to support the internal and external healing of a cesarean section and also provide some tips and instructions for a gentle scar massage .

The cesarean section , called "Sectio caesarea" in medicine, owes its name to the myth that the Roman emperor Caesar was born this way. Although no one can confirm it today, the procedure has become common practice in our time. The incision, measuring 10 to 20 centimeters and closed with sutures or metal staples at the end of the procedure, allows the wound edges to adhere within a few hours. Within five to ten days, the stitches or staples can be removed, and after three weeks, the external wound is generally well healed. However, the scar can still be red and slightly swollen; in fact, it can take up to a year to reach its final state.

Once the crust has fallen off, you can begin treating the scar to make it as inconspicuous as possible ! Scar care is not only helpful from an aesthetic point of view, but also to prevent potential sensory disturbances such as numbness or tingling near the scar itself. These sensations can occur when muscle fibers and nerve endings are affected during the procedure. With targeted stimulation, you can support their regeneration.

How to treat the wound and what to avoid

Shower instead of bath

Usually, nothing prevents you from taking a shower the day after a cesarean section—of course, only if you feel well enough. Afterwards, carefully dry the wound with a clean towel, preferably microfiber, to prevent any cotton fibers from sticking to the area. For the first few days, do not use body wash or skincare products directly on the wound to avoid irritating the area. Once the stitches or staples are removed, using body wash and soap is no longer an issue. It’s best to wait a bit longer before taking a full bath until the cesarean scar is fully healed, so the tissue doesn’t soften too much.

Wear loose-fitting clothes

To prevent clothing from rubbing against the scar and to avoid pressure on the area, wear soft, loose underwear and pants during the first few days. You’ll notice for yourself when you can wear your tight jeans again without discomfort.

Do not lift heavy loads

Once the external wound has healed, it’s easy to forget that a major internal operation also took place. Internal injuries take much longer to heal than what you can see from the outside. For this reason, during the first few months after a cesarean section, avoid lifting heavy loads or, for example, carrying large grocery bags into the house in multiple trips. Your body’s signals are the best guide to how much you can handle, but generally speaking, you can carry your baby without worry from the very beginning.

Wearing a waist cincher or abdominal binder

Opinions on wearing a postpartum belly band are mixed. For decades, it was considered useful and essential, but today many studies suggest that prolonged use may have negative effects on postpartum recovery by reducing the strength of the abdominal muscles and pelvic floor, thereby increasing the risk of incontinence. However, after a cesarean section it can be helpful, provided it is used only for short periods during the day to avoid side effects. An abdominal belt can support your belly after childbirth and help you feel more stable.

Avoid sunlight

Protect the cesarean scar from direct sunlight. As with all scar tissue, the skin’s ability to pigment is compromised, so UV rays can cause the scar to become permanently lighter or darker. In everyday life, it’s usually easy to protect the scar from the sun due to its location. Just try to avoid tanning beds and sunbathing in the affected area during the first year.

The scar massage

Once the scar has healed externally, you can start massaging it regularly.

This has a positive effect for many reasons:

• First of all, massage keeps the tissue elastic, so the scar doesn’t feel tight and doesn’t stand out unpleasantly compared to the surrounding area;

• Additionally, it stimulates blood circulation and supports the body’s healing process;

• Finally, stimulation can support the regeneration of nerve cells, which may help reduce numbness.

For the massage, you can use a natural almond oil or a calendula ointment (special scar creams are usually not necessary). Calendula also has an anti-inflammatory and decongestant effect. As an antibacterial option, St. John’s wort oil is also suitable for massaging scars. Nevertheless, remember that the positive effect of massage comes more from the touch than from the product you apply!

When massaging, you shouldn’t pull on the scar . Instead, gently massage the area in circular motions, or run two fingers along the right and left sides of the scar. Be gentle, and the touch should not feel uncomfortable or painful . In our infographic, we’ve gathered additional massage techniques—ideally, massage twice a day for 5–10 minutes.

You can use these techniques—individually or in combination—for a simple yet effective scar massage.

How to fade the scar after a long time?

There are many options available to reduce the appearance of a scar. However, it’s important to note that how much a scar can fade depends on:

• its location
• its size
• its depth
• and how much time has passed since the event that caused it

Here are some tips that might help reduce the appearance of the scar:

1. Apply a scar cream or gel: There are various scar creams and gels on the market that can help soften and fade the scar. Look for products containing ingredients such as vitamin E, like our own LILLYDOO sweet almond oil , rosehip oil, and aloe vera. Our LILLYDOO stretch mark oil for mom (it may sound strange, but try it and see) may also help, as it contains precious rosehip oil that supports skin regeneration, promotes elasticity, and helps prevent dehydration. Enriched with seaweed extract and vitamin E, it offers excellent properties for skin care.

2. Massage: Gently massaging the scar can help increase blood circulation in the area, which may support healing. You can use a moisturizer or an oil to make the massage easier (see image above).

3. Sun protection: Sun exposure can make scars more noticeable. Make sure to protect the scar with a sunscreen product and avoid prolonged exposure to the sun.

4. Medical treatments: Several medical treatments can help reduce the appearance of a scar. These include laser therapy, cryotherapy, dermabrasion, ultrasound therapy, filler injections, cortisone injections, and more.

5. Surgical treatments: aesthetic microsurgery, intralesional excision of the scar/complete excision, and repair using approximation flaps or grafts.

Especially for the last two treatments mentioned, we recommend consulting multiple doctors and gathering thorough information to determine which option is best, whether it has a chance of working, or whether it could cause further damage to the skin. Each treatment must be carefully evaluated and chosen based on the scar, its characteristics, and your specific situation.

In case of doubt, consult your doctor

During the postpartum period, the midwife will regularly monitor the healing of the cesarean scar and check that everything is going well. Usually, surgical wounds heal very easily. At first, there may be hematomas, bluish discoloration, or fluid accumulation in the tissue in the form of small bumps around the wound; this is completely normal. These usually disappear on their own within two or three weeks . And if the scar starts to itch at some point, there’s no need to worry—on the contrary, it’s often a sign that the wound is healing. The itching is caused by severed nerve endings being irritated as connective tissue regrows. However, if something seems unusual to you, don’t hesitate to ask your midwife or doctor for clarification. For example:

• if the scar starts to throb unpleasantly or suddenly becomes painful after previously improving, it could be a sign of infection;

• if you have a fever, a strong burning sensation, or notice that fluid, blood, or pus is oozing from the wound, it’s always best to contact your midwife or doctor as soon as possible.

Use a scar patch

If the wound doesn’t heal well and the scar is raised, our midwife LILLYDOO Sissi Rasche recommends a special silicone patch treatment. It seals the scar area in a waterproof way against water and air, which increases the skin temperature in that area. In this way, it stimulates metabolic processes and supports the regeneration of connective tissue . The patch can be purchased at any pharmacy and helps make the scar flatter and lighter. In any case, it should only be used after the wound has fully closed and the stitches or staples have been removed.

Some women consider their scar an aesthetic flaw and can’t wait for it to become less noticeable. It usually takes at least six months for the scar to start fading. So be patient with your scar! And even if it remains more noticeable despite treatments and massages, a cesarean scar is nothing to be ashamed of . After all, it’s a lasting reminder of something beautiful: the arrival of your little explorer!

Frequently Asked Questions