Hypertrophic Scar Episiotomy: Can I Do Anything?

April 27, 2024

Have you read, in a medical report, “Hypertrophic Scar Episiotomy” and are wondering if there are any solutions?

In this article, we discuss how to treat a hypertrophic scar, why a scar becomes hypertrophic, how to prevent this from happening, and how to recognize a hypertrophic scar.

We will also discuss how to soften an episiotomy scar and how long such a mark lasts after birth.

How is a hypertrophic scar treated?

A hypertrophic scar, in general, presents as red, stiff, raised scar tissue.

In the case of episiotomy, the scar is located in the perineal area and can cause discomfort and pain.

To treat it, it is essential to carefully follow the instructions of your gynecologist or obstetrician.

They may recommend the use of moisturizing and healing creams, rich in vitamin E and hyaluronic acid, to increase skin elasticity and reduce excessive scar tissue formation.

In addition, physiotherapy and gentle massage can be helpful to improve circulation and promote a faster healing process.

Pressotherapy, using specific devices that exert targeted pressure on the scar, can be a solution to reduce the risk of hypertrophy.

It is important to avoid sun exposure without adequate protection, and in severe cases, surgery could be considered to remove the hypertrophic scar and allow the formation of a new, thinner, less noticeable scar.

Why does a scar become hypertrophic?

Hypertrophic scars are the result of an abnormal healing process.

The body, in an attempt to repair injured skin, may produce an excessive amount of collagen that leads to the formation of a raised and often rigid scar.

Genetic factors, localized tension, infection, or inadequate wound care can affect this process.

Episiotomy, being a surgical cut, can be particularly susceptible to abnormal scarring if the tissue is not carefully realigned or if it undergoes additional stress during the healing phase.

In addition, a woman’s specific hormonal conditions in the postpartum period may contribute to the onset of hypertrophic scarring, making constant monitoring and targeted care to prevent this crucial.

Here is a table of the steps by which a scar can become hypertrophic:

Healing Process PhasesDescription
1. Inflammation– The wound begins to heal, and the body responds with inflammation and blood clotting.
– Immune cells start repairing damaged tissues.
2. Proliferation– Skin cells begin to multiply to fill the wound.
– New skin forms over the wound, forming a scar.
3. Remodeling– The scar undergoes structural changes as the body attempts to strengthen the scar tissue.
– During this process, the scar may become hypertrophic if there is an excess production of scar tissue.

During the remodeling phase, a scar can become hypertrophic if there are abnormalities in the healing process, such as excessive collagen production or an abnormal immune response.

How to prevent a scar from becoming hypertrophic?

First, it is essential to follow proper cut hygiene, keeping it clean and dry to prevent infection.

In addition, wearing soft, nonabrasive clothing can help reduce tension on the scar.

Following a balanced diet, rich in essential skin nutrients, and maintaining adequate hydration are other important steps in preventing hypertrophic scarring and other conditions like cellulite after pregnancy.

Some physicians may recommend the use of silicone bandages or specific gels that can help maintain moisture in the scar and reduce the formation of excessive scar tissue.

It is also vital to avoid intense physical activities or other exertions that may put additional strain on the affected area during the healing period.

hypertrophic scar episiotomy

How to soften hypertrophic scar episiotomy?

To soften the episiotomy scar and reduce the risk of hypertrophy, there are several effective strategies.

Gently massaging the scar with specific creams can help break up scar tissue and improve skin elasticity.

This should be done only when the scar is completely healed and with the approval of your physician.

In addition, the application of warm compresses or the use of natural oils, such as rosehip oil or sweet almond oil, can be beneficial for the skin and the scar.

These oils are known for their moisturizing and regenerative properties and can help reduce the stiffness of scar tissue.

How long does a hypertrophic scar last?

The duration of a hypertrophic scar can vary significantly from person to person.

Generally, a hypertrophic scar forms within the first few months after surgery and may continue to develop for up to 6 months.

However, without proper treatment, the hypertrophic scar may not regress and remain stable or even worsen over time.

In some cases, with appropriate care and treatment, the scar may begin to improve after about a year, becoming less prominent and softer.

It is essential to continue the treatment recommended by the doctor and to constantly monitor the scar to assess its evolution.

In some cases, it may be necessary to consider more invasive treatments, such as corticosteroid injections or laser surgery, to reduce the hypertrophic scar.

How to recognize a hypertrophic scar?

Recognizing a hypertrophic scar is critical to taking the right treatment measures.

This type of scar is distinguished by its appearance: it is usually thicker, raised, and can range in color from red to purple.

Unlike keloids, hypertrophic scars do not extend beyond the original boundaries of the wound.

To the touch, a hypertrophic scar may feel hard and stiff and may be associated with itching or pain

It is important to consult your physician as soon as you encounter these signs to receive an accurate diagnosis and begin an appropriate course of treatment.

A timely approach is crucial to effectively manage the scar and minimize associated discomfort.

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How is hypertrophic episiotomy scar treated?

The treatment of hypertrophic episiotomy scar requires a combination of treatments. They may recommend the use of moisturizing and healing creams, physiotherapy, gentle massage and pressure therapy. In some cases, surgery may be necessary.

Why does a scar become hypertrophic?

Hypertrophic scars form because of an abnormal healing process, often caused by genetic factors, localized tension, infection, or inadequate wound care.

How to prevent a scar from becoming hypertrophic?

To soften the episiotomy scar, specific creams and gentle massage can be used. In addition, warm compresses and natural oils such as rosehip or sweet almond oil can be beneficial. Avoid exposure to the sun.

How long does a hypertrophic scar last?

The duration of a hypertrophic scar varies from person to person, but it usually forms within the first few months and can continue to develop for up to 6 months. With proper treatment, it can improve over time.


Mony MP, Harmon KA, Hess R, Dorafshar AH, Shafikhani SH. An Updated Review of Hypertrophic Scarring. Cells. 2023 Feb 21;12(5):678. doi: 10.3390/cells12050678. PMID: 36899815; PMCID: PMC10000648.

About the Author

Severino Cirillo

Health, Wellness and Education Expert. With a degree in Community Health, he is the CEO of Informed Parent and is responsible for validating the blog's scientific information and coordinating the editorial team of experts, consisting of gynecologists, midwives, psychotherapists, and others in pregnancy, perinatal, and parenting wellness and health.