keloid scarring from episiotomy?(10 Posts)
I have some bad keloid scars from having a couple of cysts removed and have just started to really worry about potentially having to have an episiotomy.
Has anybody developed a keloid scar after an episiotomy?
I'm prone to keloids. I had stitches from 2nd degree tear and they (touch wood) haven't developed into keloids, even though I now have keloids from stitches elsewhere on my body for procedures done after the birth.
I did raise the issue of keloids from tearing/episiotomy before I had DD but didn't get much help - a couple of times I had to explain what they were. Perhaps at your next ante-natal appointment you could ask for a referral to a dermatologist. In fact, do insist on seeing a dermatologist if you feel you're just getting the brush-off ( I certainly did as I was told that keloids were "just one of those things", Yes, but I wanted help to minimise it). I was told to ask to see a dermatologist whilst I was still in hospital after DD was born but forgot. So instead I asked my GP for a prescription of Dermatix (gel used to reduce keloids). I think there are also gel-sheets but the doctors should be able to recommend a suitable treatment.
Thanks wotsits, I wasn't sure that anyone would reply to this as most people don't know anything about keloids, midwifes included!!
It has reassured me a bit that you haven't developed keloids after your stitches down there. I know that certain parts of the body are more susceptible to them.
I did mention it to my midwife and she didn't have a clue. She just said to mention it to the midwives etc when I was actually in hospital.
I've got a GP appointment on Monday so will ask again then.
I hadn't heard of Dermatix gel, but have used the gel-sheets before.
i have also had steroid injections and dye laser treatment which worked quite well on the keloids I have at the moment.
You're welcome .
Am intrigued by the success you've had with steroid injections and dye laser treatment. Will definitely be asking the GP about that.
Have you heard of perineum massage to try and reduce the risk of tearing?
Thanks belgo, I intended to try massage, but never really got round to it and it's probably too late as I'm 39 weeks tomorrow.
TBH it wasn't until one of my friends asked me about my scarring last week that I thought about it and started to panic about it.
Wotsits, the steroid injections were really effective, the scar on the top of my leg is completely flat and has faded to pretty much the same colour as the rest of my skin.
They didn't work quite as well on my shoulder although the scar is miles flatter than it was. I then had the dye laser which has faded it a lot. Felt like someone burning me with a cigarette though, but was well worth it!
I personally suffer from keloid scars and as a mother to be have looked into Caesareans and episiotomy. I hope my findings below will be of help.
This piece has been written for pregnant women who have had or are prone to keloid scars, and are concerned about keloid scarring resulting from labour and birth.
Clinical evidence in both the Fast East and West shows that keloid scars often form following Caesarean sections during labour for women who have had or are prone to keloid scars. In the Fast East, in particular, where keloid scar is more prevalent, many such cases have been observed, and the scarring can be quite severe. Keloid scars are commonly found on areas where the skin is naturally dry and tight, and where there are underlying blood vessels. It is believed that these are the main reasons why keloid scars are often found on central chest, the back, shoulders and the ear lobes. The skin area around a Caesarean section has these typical characteristics, and they may be why keloid scars often form there. Therefore, elective Caesareans should be avoided.
Nevertheless, Caesareans may become necessary during labour because of concern for the safety of the mother or baby. In this case, safety naturally becomes a higher priority. I have not researched into the care of Caesarean scars post operation, but currently I believe the normal course and options of treatment for general keloid scars would apply. In the UK, these may include steroid injections, radiotherapy, or laser treatments.
In short, and contrary to Caesareans, there is no clinical evidence to suggest that keloid scars tend to form following episiotomy. The reasons for this, it is believed, are that:
■The skin area concerned is not naturally dry or under tension; and
■The muscle composition where episiotomy takes place is different (though it is not completely understood why it makes keloid scarring less likely)
The clinicians I have spoken to have, reassuringly, not come across any keloid scars following episiotomy. However, in the unlikely event that they become a problem, radiotherapy has been suggested as the best treatment option.
General Care for Wounds
For those who want to take active and preventative steps to minimise the chance of keloid scars forming, the following could be helpful.
It is suggested to keep wounds moist and covered during healing, with the application of a lubricant followed by a dressing. For infection-free wounds, a suitable lubricant is plain petrolatum (no aloe) and for dressing non-stick types like Telfa (held in position by tape), DuoDerm, or silicon gel pads (no vitamin-E).
I have also personally found Dermatix, a clear gel that is available at UK hight street pharmacies without prescription and can be very easily applied over scars, to be very effective in reducing pain, itchiness, and redness in scars on the central chest and fingers, though I have not looked into whether it is appropriate for scars resulting from Caesareans or episiotomy.
Sources of information: consultation with GP, plastic surgeons, clinician, and medical publications.
1.Beth G Goldstein, MD. Adam O Goldstein, MD, MPH. 2010. from www.UpToDate.com.
Bit late replying but I have a keloid cs scar from dc1. Then had second degree tear with dc2 (VBAC) and it seems to have healed fine, anecdotally confirming schao's very informative post!
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