Caesarean Scar Care and Management

A caesarean section is major abdominal surgery, and caring for your scar as it heals can support comfort, movement and appearance over time. Every scar heals differently, but there are simple steps you can take at each stage of recovery.

Immediately After Surgery (first few days to 2 weeks)

Your body’s priority during this time is healing the incision and preventing infection. 

Focus on:

  • Keeping the wound clean and dry
  • Following your care team’s advice about dressings
  • Watching for signs of infection (increasing redness, swelling, heat, discharge, fever or worsening pain)
  • Supporting your incision when coughing, laughing or standing (using your hands or a pillow)
  • Gentle walking to support circulation and recovery

Avoid heavy lifting, intense stretching or any pressure directly on the scar. 

Early Healing Phase (2 to 6 weeks)

As the incision closes, you may notice tightness, numbness or pulling sensations. This is normal as tissues begin to repair.

Helpful tips:

  • Continue gentle movement like short walks
  • Stand tall and avoid staying hunched forward
  • Wear comfortable clothing that doesn’t rub on the scar
  • Wait until the scar is fully closed with no scabs before starting massage

If you have concerns about healing, speak with your LMC, GP or specialist.

When the Scar Is Fully Healed (usually around 4 to 6 weeks) – Scar Massage

Once the scar is completely closed with no scabs or open areas, you can begin scar massage (usually around 4 to 6 weeks after birth).

Scar massage helps improve mobility, reduce tightness and may improve the appearance of the scar by encouraging healthy collagen remodelling. It can also mobilise skin tissues, reduce scar tissue build-up, stimulate blood flow, relieve itching and may help restore sensation to the area.

If you do not feel ready to touch the scar itself, begin by gently massaging the surrounding area to get used to the sensation. You can gradually work up to massaging directly over the scar when and if you feel comfortable.

Guidelines:

  • Start from around 4 to 6 weeks once fully healed
  • Massage daily for around 10 minutes
  • Continue for at least 6 to 8 weeks
  • Scars continue to remodel for up to 18 months, so you can continue as long as you notice benefit

Use gentle pressure at first, gradually progressing to deeper movements as comfortable. You may like to use a natural oil or moisturiser to reduce friction.

Scar Massage Techniques

Up + Down, All Around

Place your fingertips on the edges of the scar. Gently move you fingertips side to side along the incision. Start from the right side of your scar and gently run your fingers from the right side, through to the left side. Then gently go across the incision line from the left side, back to the right. Take your time, see how mobile the tissue is, as there may be some tightness in places. If you don’t feel comfortable working directly on the incision, you can do these movements just above or below the scar.

 

Side to Side

Place 2 or 3 fingers about 3-4 cms from scar on either side. You can gently stretch the skin by moving your fingertips up and down around the entire scar. Try stretching side to side and clockwise or counterclockwise. Massage completely around the scar, then repeating each movement 5-10 times, (this should only take a few minutes).

Waves

Again, you can work either on the scar itself or just above and below. Gently move the tissue under your fingertips in wave like movements.

Scar Massage content kindly supplied by: Viva La Vulva - vivalavulva.co.nz

Silicone Therapy

Medical-grade silicone gels or strips are widely used to help improve scar appearance.

They may help to:

  • Reduce redness
  • Improve hydration of the scar
  • Flatten raised scars
  • Improve overall texture

Silicone is typically used once the wound is fully healed and can be applied daily according to product instructions for several weeks or months.

Long-Term Care

Scar healing is a long process, and changes can continue for up to 18 months or longer. 

Over time you may notice:

  • Colour fading
  • Softening of the tissue
  • Improved flexibility

Continuing massage, maintaining good posture, and staying active can support ongoing recovery.

Manual Therapies

Some parents find additional support from trained practitioners helpful.

  • Myofascial release: This gentle hands-on therapy can help release tightness in the surrounding tissues and improve movement. Practitioners often see improvements even in older scars.
  • Cupping: Scar cupping can help lift and mobilise tissue that feels stuck or restricted and may improve comfort and appearance over time.

If you’re considering these therapies, seek a qualified pelvic health physiotherapist or trained practitioner.

When to Seek Support

Consider seeing a health professional if you experience:

  • Ongoing pain or sensitivity
  • A scar that feels very tight or stuck
  • Bulging or pulling with movement
  • Concerns about appearance
  • Symptoms affecting bladder, bowel or core function

A pelvic health physiotherapist can provide individual assessment and treatment.