A lot of people believe that if they get injured or give birth, be it a cesarean section or a tear that results in episiotomy, that the injured muscle will regrow new healthy tissue and would be repaired, however this doesn't happen, rather the injury or tear is replaced with scar tissue.
Scar tissue is usually thicker, paler, denser and has limited function, movement, circulation and sensation than the surrounding or previous normal tissue. One of the most noticeable signs is that the part of the body affected will never be as strong as the tissue it replaced.
It is a manifestation of the body's healing process after a surgery or injury. There can be loss of sensation in that area, but that acts as a barrier and protects the area where the tear occurred, but unfortunately it lacks the functionality of the original tissue and has a lower elasticity.
It has been stated that the degree of scar tissue not only depends on the depth of the wound, but also the elasticity of the area, as well as the age of the individual. Since the healing process is usually stronger in younger people that will result in thinner tissue than older people.
After delivery, women are usually not schooled on scar tissue, so most of them do not realize that once the tear or incision has healed, the problem of scar tissue would be present. No instruction is given most times in the hospital on how to handle this after childbirth. This article will address this and present 15 things women should know about scar tissue.
15 Scars 101
As mentioned earlier, it is the body's natural process for dealing with injury, tear and incision. It is the fibrous connective tissue that forms a scar and can be found on the body (skin) and in the body (organs) where the cut or incision was made.
It contains the same protein - collagen - that the tissue it replaced had, but the fiber composition is different, the tissue is usually of inferior quality/functionality. Also hair follicles and sweat glands will not grow back on this tissue.
It forms due to collagen filling the site to act like a glue and repair the damage. Fibroblasts sent to rebuild the damaged tissues is what breaks down the clots present in order for collagen to come in. Scar tissue can cause a decrease in range of motion due to tightness in the area and will look pale due to limited blood supply.
14 There Are Different Types
Scar tissue differs with the amount of collagen that is released. There are five different types - the keloid, hypertrophic, atrophic, contracture and stretch marks. Keloid scars are manifest more in Asians and Blacks. They are elevated scars that are dark and sometimes red (depending on skin color).
It occurs when collagen is released in abundance. Hypertrophic scars are red or purple, they occur when the collagen is over produced and usually looks like a raised lump on the skin.
Unlike keloid and hypertrophic scars, atrophic scars are not lumps but sunken recesses. They occur like this because parts of the skin or fat has been removed leading to the production of scar tissue during healing. Contracture scars are caused by burning.
Stretch marks are formed when the skin is stretched beyond a limit and unlike the other types, it is not caused by an injury. Loss or addition of weight and some pregnant women usually experience it, but for some people, it's appearance improves over time.
13 What Are The Effects Of Scar Tissue?
Apart from the physical outward look of the scar, scar tissue and adhesion often cause no symptoms. Some scars however, can cause itching and burning sensation. Adhesion, as well as scar tissue, can produce pain and other issues like the change in shape and correct positioning of some organs. It can also prevent the movement of a part that originally should be moving.
Scar tissue can pull in other areas, blood vessels, organs and compress nerves, which would cause dysfunction and pain. It can also restrict layers of connective tissue and muscle. Furthermore, due to the weakness and lack of required elasticity, that area is more prone to re-injury.
Adhesion is another effect of scar tissue and it is so dangerous that it can lead to bowel obstruction and can be a potential life threatening condition. There is also the high risk of secondary infertility, pelvic pain and pain during intimacy.
12 Scar Tissue Due To C-Section
During a cesarean section, a four to six inch incision is made through the skin, usually horizontally just below the public hairline. Horizontal incision is used most of the time but in case it emergency and in some less developed countries, vertical incision can be used from the belly button to pubic bone.
The abdominal muscles are not cut through, rather they are moved aside to get to the uterus where another horizontal incision is made.
This cut will create scar tissue and is one of the reasons why doctors advise women who have had one for a previous pregnancy, have another with later pregnancies. It is recommended in order to reduce the risk of uterine rupture that can occur when the scar tissue tears, although this is rare. It can also change the way the placenta grows in a subsequent pregnancy.
Every woman's body is different, as some women show just slight density in their scar tissue.
11 Can Internal Scar Tissue Cause Problems?
When scar tissue forms after surgery or injury, it does not only affect the outer layer (skin), it goes to the inside to the organ (uterus in C-Section) that has been affected. It affects the organs, muscle and connective tissue. One of the biggest problems that can erupt from internal scar tissue is adhesion.
Adhesion connects two internal parts that can result in restriction of movement, as well as hindering the affected organs from performing their required function.
Apart from scar tissue in the cervix, women who had a C-Section are more liable to develop adhesion than those who had a vaginal delivery. Adhesion binds together to create glue-like bonds that could last a lifetime. It can be formed in the bowels, which will result in digestive problems or pain.
It can also form in the tissues of the reproductive tracts that can lead to pelvic pain, pain during intercourse and secondary infertility.
10 Scar Tissue Due To Vagina Delivery
People underestimate scar tissue in vaginal delivery. Scar tissue can form as a result of an episiotomy, damaging of the labia and trauma. It forms mostly at the lower edge of the vagina from cuts or tears during delivery. Though tears are repaired within an hour after delivery and stitches can heal within a month, the scar can remain.
As a result, there can be pain during intimacy even more than 11 months after delivery. Some women could develop excessive scar tissue in the area that can itch. There can also be scar tissue on the cervix due to cervical tearing as a result of manual dilation, pushing before dilation and large fetal head or shoulders.
This form of scar tissue can lead to lack of dilation in the next pregnancy therefore resulting in a long labor, pausing of dilation, having a fully effaced yet not dilated cervix and the overwhelming urge it push with very little dilation.
9 Scar Tissue Can Cause Pain
Both for women who has a cesarean section and women who have scar tissue due to vaginal delivery, a number will state that the scar causes pain. There can be pain or tightness in the scar when lifting, leaning, reaching up, standing straight or walking. This pain can - for some women - cause a limit in movement that can lead to a change of posture, which could result in lower back pain.
It can also cause pain in the urethra, clitoris, anus, as well as an urgency to urinate. Sometimes during suturing, the ligament in the area of the labia can be caught up in the scar tissue - irrespective of the method used - which would result in labia pain. The pain of a scar tissue can travel down to the hips or up to the diaphragm and in C-Section, it can result in lower back pain and pelvic organ prolapse.
8 Can Scar Tissue Be Prevented?
The simple answer is no. Every woman's body is different so while some women would develop very little scar tissue, others will have more dense ones. However, the possibility if a formation of adhesion from internal scar tissue can be prevented.
In C-Section for example, before the delivery, there should be a discussion with the OB-GYN about peritoneum repair. The peritoneum is a serous membrane covering the abdominal and pelvic cavity. In time past, it was believed that not stitching it would reduce adhesion, this belief has been debunked by recent studies.
Apart from this - in whatever method of delivery - attention should be paid to changes in the area where the scar tissue is in case of issues such as inflammation. Other methods can be used to reduce scar tissue and prevent adhesion, and they will be shared below. We all want to avoid scars that become densely fibrous with lack of movement, energy flow and create adhesion.
7 Simple Exercises Can Improve Scar Tissue
After delivery, go for walks as soon as possible. This is a very important exercise for healing as movement promotes lymph and blood flow that will facilitate the movement of oxygen and nutrients in the whole body. Naturally this speeds up healing.
Crunches will not help, mostly for women who had C-section, rather, pelvic floor exercises and exercises that strengthen the lateral abdominal area are advised. Lower back exercises a little later down the line are also advised.
When the vagina, anus and stomach muscles are being strengthened, pressure on the incision and tissue surrounding it would be reduced, which will promote faster healing and aid the scar tissue process in order to reduce the risk of problems.
These exercises will not only help with the development of minimal scar tissue but also in avoiding blood clots, preventing constipation and gas build-up, so it is a win-win situation.
6 Massages Are Awesome For Scar Tissue
The use of massage. both for C-section and vaginal birth scar tissue can never be overemphasized. Unfortunately, a large number of women do not know this since they are only told to look for infection, thus leaving these women in pain that can even last for a year. Massage can begin between four to six weeks after delivery, but should only be done with the approval of a physician.
The beauty of the use of massage is that it breaks down adhesion, eliminates pain and can restore normal tissue functioning. It can be done by the woman herself or by a physical therapist.
It is easier to massage the abdomen after a C-section than the perineum after a vaginal delivery, but not impossible. A simple Google search can give directions on how to go about these massages. No matter how far it is from the time the incision or tear occurred, it is never too late to gain benefit from massaging that area.
5 Sound Assisted Soft Tissue Mobilization
This is one great method of breaking down scar tissue. It is a form of manual therapy that with the use of appropriate instruments, a local inflammatory response is stimulated by introducing controlled microtrauma into the scar tissue.
This in turn stimulates a reabsorption of the excessive scar tissue and facilitates a natural healing process what will remodel the affected tissue. Since adhesions and scar tissue has been broken down, full functional restoration can occur.
Apart from a scar tissue problem, it can also be used for low back pain and cervical pain. However, before this method is decided, it is important to speak with a physical therapist or physician because unlike massage, this treatment does not benefit everyone. Some individuals have past medical history that can affect how the process works.
This however, is one of the most defective processes/methods of preventing adhesion, as well as stimulating healing.
4 Steroid Shots May Be Effective
Steroid injections are commonly used for scar tissue be it cosmetic surgeries or C-section. It is injected into the scar itself and since only very little of it is absorbed into the bloodstream, the side effects may be minor. It is a treatment that is repeated most times in a six week interval period.
A long-term injection of corticosteroid into the scar may help flatten the scar tissue and soften the appearance of the keloid and hypertrophic type of scars.
In simple terms, for areas that are too firm, hard or lumpy from scar tissue when injected with corticosteroid by an experienced dermatologist or physician, can help and is more effective when the healing is still going on. However, there are women who have recorded in improvement from the use of steroids.
Some doctors are reluctant to use it and would rather advise that massage be used. In very severe and rare cases, side effects include hypertension, low potassium level in the blood and high sodium levels.
3 Surgery For Scar Tissue
As stated earlier, it is not possible to totally remove scar tissue but surgery can alter the shape, density and visibility of the tissue. It depends on the type of scar tissue involved because hypertrophic and keloid scar tissues cannot be helped by surgery, rather the risk of the scar tissue recurring, as well as even worse scarring can occur.
The good news is that only some C-sections and episiotomy result in these type of scars.
The problem with the use of surgery however is that it can become an awful cycle. In some cases, after surgery has been used to remove adhesion and excessive scar tissue, it can take about a year or more, but it will grow back.
There are women who have used surgery even up to ten times for this same thing, yet it keeps on recurring every time healing has occurred, thus making it for them only a temporary fix. Fortunately for some, it actually removes the excessive dense tissue and the one that replaces it is much thinner.
2 Do Natural Remedies Work?
Some doctors may claim these do not help, but a number of women have used these and testified to them, but remember that not everyone reacts the same way to a method of healing. They include aloe vera, essential oils and lemon. Aloe vera can be effective when applied to the skin, it can cause the softening and loosening of the tissues.
Natural oils like coconut oil, lavender and castor oil can accelerate the healing process of the scars.
Lemon juice can help scars look healthy. It can also stimulate the formation of healthy cells, however commercial skin care producers - though they claim to help - may worsen the condition. Speak with a physician concerning such products first rather than trusting they will work.
Also, thorough research should be done on these products and make sure the testimonials relied on are genuine and not just paid reviews.
1 Silicone Gel Is An Effective Scar Treatment
This is one of the easiest home remedies for reducing the look of scar tissue. It helps with the thickness, look and color of the tissue. It also reduces itching in the area of the scar. The awesome part is that not only is it effective, it is also cheap. There is a gel/cream and also a sheets.
It's use can begin around three or four weeks for women who have had a cesarean and for now, it is rare to see women who had episiotomy use it, so it is safer in either case to first consult a physician.
The sheets are removable and washable. They are recommended to be worn for between twelve to twenty-three hours for seven days, but there may be need to use it for longer for aggressive scar tissue. Most women who have used this method have stated that it is comfortable and it works.
So the most noticeable change that can happen in the space of two weeks or even shorter is that the scar will be flatter, paler and in some cases shorter. The reason it works do well is because it seals in moisture, which improves scar tissues.