How can I avoid keloid in my Caesarean section scar?
Keloid forms if there is overhealing of the skin wound and in this case the Caesarean section scar. Often it has a familial tendency. It is more prevalent in highly pigmented people, especially women of African background. The keloid skin is raised, thickened and unattractive. As well it can be itchy and even painful.
What can be done?
The risk can be minimised with careful closure of the abdominal wall and particularly the skin. I use a closure technique and a particular dressing which helps minimise the chance of keloid occurring.
With a repeat Caesarean section, I will always excise the old scar. This will include any keloid that has occurred in association with the old scar. With fresh edges and the excision of keloid and careful closure, it is less likely that keloid will recur. If there is a marked predisposition then steroid injection with closure can help. Also, I will sometimes give patients who are predisposed to keloid, topical steroid to apply to the wound after removal of the dressing. This also can be of benefit.
I have had a quite a number of cases where I have excised the keloid scar and the new scar has no or minimal excess thickening.