Ask Well
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I had a C-section about a year
ago; my scar sometimes hurts, itches and even smells. What's going on?
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If you've had a cesarean section,
you may have expected your wound to be healed and relatively pain free after a
few months. But an estimated 7 to 18 percent of people develop chronic scar
pain after a C-section, and numbness, itching and odor can be common, too -
sometimes for months or even years after the surgery.
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About 30 percent of births are
via C-section, said Katie Kelly, a pelvic floor physical therapist in New
Brunswick. That's "a lot of women who could potentially have issues,"
she said.
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During the six to eight weeks
after a C-section, it's common to experience pain, soreness and itching around
the incision site, said Ashley Rawlins, a physical therapist in Dallas who
specializes in pelvic and obstetric health. "Our body is warning us, 'Hey,
be careful," Dr. Rawlins said, so that we move cautiously and don't
disrupt the healing process.
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Itching can arise, too, because
the body produces itch-inducing chemicals called histamines, Dr. Rawlins said,
which increase blood flow to the wound and facilitate healing. Some people can
also have allergic reactions to the disinfectants or adhesives used during
surgery, said Dr. Angela Lamb, a dermatologist at Mount Sinai Dermatology in
New York City, so if the itching is intense or your skin is red and blistery,
consult your doctor.
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If your incision smells bad
during the first six to eight weeks after surgery, it's possible that you have
an infection, Dr. Lamb said. This could either be a bacterial infection of the
wound itself, or a yeast infection of the tissue surrounding it, she added.
Call your doctor to make sure everything is healing properly, she recommended.
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To reduce the chance of an
infection, keep the area around the incision clean and dry, Dr. Rawlins
suggested. A few times a day, dab the area with a clean, dry cloth to remove
any moisture.
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Even beyond the first six to
eight weeks, though, certain symptoms can persist. Sometimes, the scar tissue
is so tight that it pulls on the surrounding skin or muscle, leading to
discomfort, Ms. Kelly said. If this happens, a physical therapist can help you
relax and stretch the tissue, Dr. Rawlins said. You can also try massaging the
scar yourself, she added, by gently pressing on it, massaging the area in a
circular motion or gently rolling the scar between your fingers.
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A brush from your underwear or
pressure from your pants seam can also be a "significant source of pain
and itch," Dr. Rawlins said. She recommended that people with sensitive
scars wear softer fabrics, seamless underwear or high-waisted clothing.
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It's also possible for the
muscles near your midsection, like the abdominal or inner thigh muscles, to
feel sore for a while, Ms. Kelly said. People tend to lean forward during
C-section recovery so as not to pull on the incision, but over time, this can
cause tight, sore muscles around the hip flexors, stomach and even the chest.
Once your incision has healed, try sitting with a straighter posture, Dr.
Rawlins recommended, and do gentle abdominal and thigh stretches.
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Certain nerves can also get
severed during surgery, leading first to numbness, and then to aches and pains
when the nerves start to regenerate, Dr. Rawlins said. Sometimes, scar tissue
can entrap nerves as it forms, causing a burning sensation in the lower abdomen
and groin, Ms. Kelly added. Nerve pain usually subsides over time, but if it
persists, see a physician.
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Scars can also keep growing
beyond the original incision site and turn into keloid scars, which are thick
and raised. These can cause pain and itching, too, Dr. Lamb said, and may be
treated with steroid injections or silicone creams or tapes.
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Infections are also possible,
even months or years after the scar has healed. One common infection is called
intertrigo, which develops when skin rubs together and moisture builds in the
crease around the scar, allowing yeast or other microbes to proliferate.
Intertrigo is typically treated with topical or oral anti-fungal medications or
antibiotics.
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If you're having a tough
C-section recovery, call your doctor, experts say.
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Women may feel hesitant seeking
help, but "it's not something that someone has to suffer in silence
with," Dr. Rawlins said.
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Melinda Wenner Moyer
