Dear Dr Mitchell,
I had a C-section a year ago. At first the scar was thin and unnoticeable, but now it is raised, painful sometimes, and itchy. And it seems to be getting bigger and bigger, and it's difficult to sleep on my stomach. What is causing this and what can I do?
The problem that you are experiencing with your surgical scar is called keloid formation. This is a common problem that is seen after doing an operation. Initially the scar might be flat and hardly visible, but with time, as the healing takes place, the site of the scar tends to itch and become uncomfortable. The discomfort will cause you to scratch or rub the site of the incision and this will cause the scar to become thickened and become more visible. In some cases the scar can increase in size and become extremely uncomfortable and unsightly.
You should try not to scratch or rub the scar to reduce the rate at which it increases in size. The use of a steroidal cream can sometimes relieve the itching and discomfort. Steroid injections at the site of incision can cause the scar to shrink or can reduce the rate at which it thickens.
Ideally, if the doctor knows before that you are prone to keloid formation, then steroids can be injected into the skin at the site of the incision after closure of the skin at the time of the Caesarean section. This helps to reduce the chance of a keloid scar forming. In severe cases, radiotherapy can be applied to the site of incision to reduce the formation of a keloid.
In your case, the scar might have to be removed and the skin closed followed by steroid injections to relieve the discomfort. You should ask your doctor to refer you to a dermatologist or plastic surgeon for evaluation of the scar so that the best treatment option can be undertaken. In the meantime, try not to irritate the scar and cause worsening of the keloid.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to email@example.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.