If my C-section scar is raised and itchy, is it a keloid?
A C-section scar that spreads beyond the incision line and hardens suggests a keloid, while one that thickens only within the incision suggests a hypertrophic scar. Myongji Best Plastic Surgery Clinic in Myeongji-dong, Busan explains how to tell them apart, when to start treatment, injection, laser, silicone and pressure therapy, research figures, and what to check before the next pregnancy.
Quick answer
If a C-section scar spreads beyond the original incision line into the surrounding skin, rises firmly, and keeps itching or hurting, a keloid is suspected. If it has thickened only within the incision line, it is more likely a hypertrophic scar, which the Asan Medical Center disease encyclopedia says responds relatively well to treatment. Both are treated with a combination of injections, laser, and silicone or pressure, so the first step is an examination to tell them apart as soon as the scar begins to thicken.
Why it matters now
A C-section scar sits where the lower abdominal skin is under tension, and the American Academy of Dermatology notes that the hormonal changes of pregnancy raise the risk of a keloid. The first signs of a keloid can appear 3 to 12 months or longer after the wound, so a scar that looks fine right after delivery is no guarantee, and because a keloid, unlike a hypertrophic scar, does not fade on its own, the later it is identified the fewer treatment options remain.
How do I tell whether a raised C-section scar is a keloid or a hypertrophic scar?
A keloid is a raised scar that grows beyond the edge of the original incision into the surrounding skin, while a hypertrophic scar thickens only within the incision line. The American Academy of Dermatology explains that, unlike a hypertrophic scar, a keloid does not fade with time, and Myongji Best Plastic Surgery Clinic distinguishes them by comparing the original wound edge with how far the scar has grown.
| If this is the situation | What is considered | Basis and limits |
|---|---|---|
| Spreads beyond the incision line, rises firmly, and keeps itching or hurting | What is consideredKeloid examination; a combination of injections, laser, pressure, and silicone | Basis and limitsA keloid does not fade on its own, and nearly all return after excision alone. |
| Red and thickened only within the incision line | What is consideredTreated as a hypertrophic scar with silicone and pressure, plus injections if needed | Basis and limitsHypertrophic scars respond relatively well to treatment, but the distinction is confirmed by examination. |
| Less than 6 months since surgery, with only redness and itching | What is consideredMonitor with silicone sheets or ointment and sun protection | Basis and limitsA scar takes 6 months to 2 years to mature; see a doctor as soon as it begins to thicken. |
| A previous surgical scar also became a keloid, or a family member has keloids | What is consideredReport the keloid history before the next surgery and discuss a prevention plan | Basis and limitsThe American Academy of Dermatology advises telling the surgeon before surgery if you or a blood relative develop keloids. |
When should treatment of a C-section scar begin?
See a doctor right away when the scar thickens, the redness deepens, itching or pain keeps returning, or the scar begins to spread. The American Academy of Dermatology explains that the first signs of a keloid appear 3 to 12 months or longer after the wound and about 20% appear more than a year later, so keep checking the scar for changes even a year after delivery.
Right after the scab comes off
The American Academy of Dermatology advises applying silicone gel sheets or silicone gel every day for about six months after the wound scabs and protecting the area from the sun.
When it begins to thicken
Pressure can keep thickening skin from turning into a keloid, and adding injection therapy may also help.
When it persists over time
The Asan Medical Center disease encyclopedia explains that redness and raising persisting beyond 6 to 12 months raise suspicion of a keloid or hypertrophic scar.
Myongji Best Plastic Surgery Clinic criteria for a visit
An examination is needed when the scar keeps thickening or the redness deepens, or when itching or pain recurs or the scar spreads.
How does Myongji Best Plastic Surgery Clinic treat a C-section scar keloid, and what does it cost?
Myongji Best Plastic Surgery Clinic checks the scar's location, size, thickness, color, symptoms, and skin tension, and combines injection therapy, laser treatment, compression therapy, silicone sheets, cryotherapy, and surgical excision according to the scar's condition. Because keloids can recur, injections, laser, and compression are often continued after excision, and the number and interval of treatments are set by size, location, and response to previous treatment.
The published non-covered fee list does not show a separate fee for keloid treatment, while scar laser combined with a regenerative (PN) injection, used for surgical scars, is listed at 100,000 won per cm (checked October 22, 2026). The cost and number of injections, compression, and excision are confirmed with the overall plan after an examination, and non-covered fees may change.
- STEP 01
Assess scar extent and symptoms
Compare the incision edge with the current extent and check itching and pain to determine whether it is a keloid.
- STEP 02
Review history
Review how previous surgical scars healed, family history, past injections, laser, or surgery, and any recurrence.
- STEP 03
Decide the treatment combination
Set the order and interval of the needed methods among injections, laser, pressure or silicone, cryotherapy, and excision.
- STEP 04
Monitor recurrence
Regularly check changes in thickness, color, pain, and itching after treatment.
What do the numbers say about the results and side effects of treating a C-section scar keloid?
Myongji Best Plastic Surgery Clinic has no published statistics on C-section scar or keloid treatment outcomes. In a nationwide Japanese survey, 66.0% of women 6 to 18 months after a C-section had abnormal scars, and the American Academy of Dermatology notes that 50 to 80% of keloids shrink after injections but many regrow within five years.
Myongji Best Plastic Surgery Clinic data
C-section scar and keloid treatment outcomes and recurrence statistics: no published data
Sugita et al., 2026 (Japan, cross-sectional survey of 991 women)
Abnormal scars were found in 66.0% (654) of women 6 to 18 months after a C-section: 64.4% hypertrophic and 1.6% keloid. Women with keloids had higher postpartum depression risk scores.
Ito et al., 2021 (Japan, prospective study of 60 women)
Among women who wore a silicone gel sheet from 2 to 6 months after a C-section, 64.0% had no abnormal scarring and 36.0% had mild hypertrophic scarring. Mild side effects were reported, including itching in 47.2% and folliculitis and dry skin in 7.5% each.
Kim et al., 2022 (Korea, retrospective study of 35 patients)
After excision of hypertrophic C-section scars, an average of 4.23 sessions of pulsed dye laser combined with triamcinolone injection lowered the Vancouver Scar Scale from 9.29 to 3.11. Outcomes differed when keloids were present elsewhere on the body.
American Academy of Dermatology treatment guidance
50 to 80% of keloids shrink after injections, but many regrow within five years, and nearly 100% return after excision alone. Pressure treatment works only when worn 12 to 20 hours a day for several months.
What to keep in mind about these figures
All three studies are single-country or single-center data, lack a control group, or focus on hypertrophic scars, so they cannot be applied directly to keloid treatment outcomes.
Should it be treated before the next pregnancy, and what about the next C-section?
If you are planning another pregnancy, it is safest to be examined beforehand to confirm whether the scar is a keloid and to set the treatment order. The American Academy of Dermatology explains that the hormonal changes of pregnancy raise keloid risk, and advises telling the surgeon before surgery about your own or a relative's keloids and seeing a doctor right away if the scar thickens after surgery.
Before pregnancy
Check the scar's thickness, extent, and symptoms to decide how far to take injection, laser, silicone, and pressure treatment.
Before the next surgery
Tell the obstetric team about your keloid history and family history, and plan preventive care such as silicone and pressure for after surgery in advance.
Excising the keloid during the next surgery
A randomized trial that excises an existing C-section keloid during the next C-section and injects triamcinolone at closure has been registered, but as of our check its results have not been published.
After surgery
Use silicone sheets or gel every day for about six months after the wound scabs, and start pressure and see a doctor right away at any sign of thickening.
Distinguishing a keloid from a hypertrophic scar, the treatment combination, and the timing of treatment around pregnancy depend on the scar's condition and pregnancy plans, so the medical team confirms the plan after an examination.
Frequently asked questions
Why does my C-section scar itch
Redness, raising, and itching can occur during the 6 months to 2 years it takes a scar to mature. A growing keloid also causes itching and pain, however, so if the itching comes with a scar that spreads beyond the incision line or rises firmly, have it examined to check for a keloid.
How long should I wear silicone sheets on a C-section scar
The American Academy of Dermatology advises using silicone gel sheets or silicone gel every day for about six months once the wound has scabbed. In a Japanese study, 64.0% of women who wore a silicone sheet from 2 to 6 months after a C-section developed no abnormal scarring.
How many injections does a C-section keloid need
Injection therapy is usually repeated over several sessions, and Myongji Best Plastic Surgery Clinic sets the number and interval based on size, location, and response to previous treatment. The American Academy of Dermatology notes that 50 to 80% of keloids shrink after injections but many regrow within five years, so progress is monitored after treatment.
About the clinic behind this article
Myongji Best Plastic Surgery Clinic is a board-certified plastic surgery clinic in Myeongji-dong, Gangseo-gu, Busan. Dr. Hyungseok Noh, board-certified plastic surgeon and medical director, provides care.
- Address
- Units 302–305, Building 1, 3 Myeongji-gukje 2-ro 28beon-gil, Gangseo-gu, Busan
- Main Line
- 051-711-7991
- Clinic Hours
- Weekdays AM 10:00 ~ PM 07:30Saturday AM 10:00 ~ PM 03:00Sundays & Public Holidays Closed
- Treatment guide
- View the keloid treatment page
- Booking
- Naver Booking
REFERENCES
References
This article uses the clinic’s published information together with authoritative medical sources.
- Myongji Best Plastic Surgery ClinicKeloid treatment guide
Supports: Definition of a keloid, treatment combinations, continued care after excision, recurrence factors, and changes that need a visit
Because keloids can recur, injections, laser, and compression care are often continued even after excision.
- Myongji Best Plastic Surgery ClinicScar treatment guide
Supports: Scar laser used for post-surgical scars
It can be used for deeply depressed scars, old acne scars, and scars left after surgery or injury.
- Myongji Best Plastic Surgery ClinicNon-covered fee guide
Supports: Published per-cm fee for scar laser combined with a regenerative (PN) injection
Scar laser + regenerative (PN) injection: 100,000 won per cm
- American Academy of DermatologyKeloid scars: Overview
Supports: How a keloid differs from a hypertrophic scar and why it does not fade
Unlike a hypertrophic scar, a keloid doesn't fade with time.
- American Academy of DermatologyKeloids: Signs and symptoms
Supports: When the first signs of a keloid appear, the share appearing after a year, and itching or pain
After you injure skin, it's likely to take 3 to 12 months or longer to see the first signs of a keloid.
- American Academy of DermatologyKeloids: Who gets and causes
Supports: Surgical wounds as a cause of keloids, hormonal changes in pregnancy, and family history
The hormonal changes that occur during pregnancy increase the risk of developing a keloid.
- American Academy of DermatologyKeloids: Diagnosis and treatment
Supports: Shrinkage rate after injections and regrowth within five years, recurrence after excision alone, pressure treatment hours, and combining treatments
Between 50% and 80% of keloids shrink after being injected.
- American Academy of DermatologyKeloids: Self-care
Supports: Reporting keloid history before surgery, duration of silicone use after scabbing, and pressure and a visit when thickening begins
Tell your surgeon before the surgery that you or a blood relative develop keloids.
- Asan Medical Center disease encyclopediaScars
Supports: How long a scar takes to mature, suspicion of keloid or hypertrophic scar when it persists beyond 6 to 12 months, and treatment response of hypertrophic scars
A hypertrophic scar does not tend to grow beyond the wound or incision line and responds relatively well to treatment.
- PubMedImpact of abnormal cesarean section scar formation on quality of life and postpartum depression: A cross-sectional study in Japan
Sugita Y, Komatsu H, Kodera C, et al. Int J Gynaecol Obstet. 2026;172(2):1015-1022. doi:10.1002/ijgo.70469. PMID: 40810613
Supports: Rates of abnormal, hypertrophic, and keloid scars among 991 women 6 to 18 months after a C-section
(654/991) developed abnormal scars (64.4% hypertrophic, 1.6% keloid).
- PubMedSafety assessment of the prophylactic use of silicone gel sheets (Lady Care®) for the prevention of hypertrophic scars following caesarean section
Ito Y, Konishi A, Okubo M, et al. J Obstet Gynaecol. 2021;41(3):380-384. doi:10.1080/01443615.2020.1852540. PMID: 33632049
Supports: Abnormal scar prevention results and side effects in 60 women using silicone gel sheets after a C-section
Following Lady Care® application, no abnormal scarring and mild hypertrophic scarring was observed in 32 (64.0%) and 18 (36.0%) patients respectively.
- PubMedEvaluating outcomes of pulsed dye laser therapy combined with intralesional triamcinolone injection after surgical removal of hypertrophic cesarean section scars
Kim JW, Huh CH, Na JI, Hong JS, Yoon Park J, Shin JW. J Cosmet Dermatol. 2022;21(4):1471-1476. doi:10.1111/jocd.14238. PMID: 34008912
Supports: Scar scale change and number of sessions in 35 patients treated with laser and injections after excision of hypertrophic C-section scars
The mean final VSS was 3.11 ± 1.52 and was significantly lower than that of the previous VSS (9.29 ± 1.74, p = 0.000).
- PubMedEfficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol
Chua SC, Gidaszewski B, Khajehei M. Trials. 2019;20(1):363. doi:10.1186/s13063-019-3465-6. PMID: 31215471
Supports: Design of a randomized trial excising and injecting an existing keloid during the next C-section (results unpublished)
One of the first-line options to treat keloid scars is corticosteroid injection after excision of the existing scar.
Published 2026.10.23Last updated 2026.10.23