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How Do I Treat Episiotomy Scars?

By Meshell Powell
Updated Mar 03, 2024
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Episiotomy scars develop as a result of a surgical incision that is sometimes made in the perineal area of a woman during childbirth. The perineal area stretches from the vagina to the rectum, and the resulting episiotomy scars can sometimes become inflamed and very uncomfortable. Proper treatment begins immediately after childbirth and includes proper hygiene, the use of pain-relieving techniques, and special exercises designed to strengthen the perineal area. Sitz baths may also bring considerable relief, and steroid injections and even surgery may be necessary to treat inflammation of the scar tissue. Any questions or concerns about the proper treatment of episiotomy scars on an individual basis should be discussed with a doctor or other medical professional.

Treatment for scars begins just after childbirth. An over-the-counter pain relief spray may be recommended and used as needed. Prescription pain relievers are rarely needed, although non-prescription medications such as ibuprofen or acetaminophen may be helpful. Drinking plenty of water can help to prevent constipation, as excessive straining during a bowel movement may rupture the sutures from the episiotomy. Foods that are high in fiber may also assist in more comfortable bowel movements.

One of the best ways to reduce pain and inflammation is through the use of sitz baths. A special basin may be sent home with the new mother from the hospital. This basin is made to fit comfortably on the toilet. The basin can then be filled with cool water and used to soak the entire perineal area, including any episiotomy scars. Sitz baths can be used several times per day to provide relief from inflammation and discomfort.

In most cases, episiotomy scars heal properly within a few weeks and do not cause any further problems. If the healing process does not occur normally, complications, including infections, may occur. Any severe pain, swelling, or abnormal discharge should be reported to a doctor for further medical evaluation. If an infection is caught in the earliest stages, oral or topical antibiotics can usually clear up the infection within a matter of days.

Some patients have reported pain and inflammation involving episiotomy scars a few months or even years following the procedure. This is extremely rare and is most likely due to improper healing or the development of scar tissue. Women who experience this complication frequently report a worsening of symptoms at predictable intervals surrounding the menstrual cycle. Steroid injections may be helpful in reducing the inflammation that arises due to irritation of the scar tissue, although surgical intervention may occasionally become necessary.

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Discussion Comments
By donasmrs — On Apr 16, 2013

@anamur-- Aside from the tips in the article, I recommend cleaning the area very well after bowel movements. Witch hazel wipes and pads are great for this. It prevents infection and also helps with the inflammation.

I had a lot of swelling around my episiotomy scar and I would put the witch hazel pads in the fridge and apply it on the area. It would reduce the swelling.

As for intercourse, it's not allowed until after six weeks. A friend of mine had serious pain during intercourse months after her surgery due to scar tissue. She had to have scar repair done.

By serenesurface — On Apr 15, 2013

Does anyone have any recommendations for preventing damage to scarring during bowel movements and intercourse after an episiotomy?

By fBoyle — On Apr 14, 2013

Hot salt water baths are the best after an episiotomy. It was the only thing that would ease my pain and soothe the inflammation after the procedure. I was in a very bad state, I had pain even while walking and sitting.

I had the baths for ten to fifteen minutes every day. I think it helped my episiotomy scarring heal faster and I'm sure the salt prevented infection too.

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