The episiotomy scar, whether recent or old, can in some cases remain painful, sensitive or uncomfortable. This discomfort, sometimes persistent, can affect quality of life, mobility, intimate hygiene, as well as sexual, mental and emotional life. Understanding the causes of this pain, the healing mechanisms and the different medical approaches available makes it possible to consider an adapted, effective and lasting treatment. Management must be global, progressive and personalized, taking into account the condition of the scar, the surrounding tissues and the patient’s personal experience.
An episiotomy consists of incising the perineal muscles to facilitate the baby’s expulsion during childbirth. After the procedure, the wound heals through a natural process, but sometimes tissue repair occurs imperfectly. Several factors can explain persistent pain : the formation of fibrosis or thickened scar tissue, poor vascularization, excessive tension on the scar, or the presence of small adhesions between the skin, the muscle and the underlying tissues.
In some cases, nerve endings may remain trapped in the scar, causing neuropathic pain, often described as burning, tingling or electric shocks. Mechanical pain may appear during walking, prolonged sitting, sexual intercourse or sports activities. Finally, a psychological or emotional component may also exacerbate discomfort, especially when there is a difficult experience related to childbirth.
A specialized consultation allows for a precise analysis of the scar, its thickness, its appearance, its suppleness, its sensitivity and the condition of the perineal tissues. The doctor also evaluates the pelvic floor muscles, the quality of healing, the presence of adhesions or a localized pain upon touch. Pain may also be linked to hypertonia of the pelvic floor muscles, postpartum vaginal dryness, or a persistent inflammatory reaction.
This global, anatomical, functional and sometimes emotional evaluation is essential to offering an adapted, coherent and progressive treatment plan.
To relieve a painful, retracted or uncomfortable episiotomy scar, several medical solutions exist to improve tissue quality, restore suppleness and reduce pain in a lasting way.
Depending on the appearance of the scar, its age, the presence of adhesions, fibrosis or hypersensitivity, targeted treatments such as hyaluronic acid injections, LED sessions, photorejuvenation laser or fractional ablative laser may be proposed. Each treatment acts specifically on the scar, softening it, rehydrating it, smoothing it or restructuring it in depth, thereby improving comfort, mobility and quality of life.
Scar massage may be recommended in the first months to soften the tissues and limit adhesions. These massages must be learned from a professional to be performed correctly and without traumatizing the area.
Perineal rehabilitation, often necessary after childbirth, can also help relieve a painful scar. It helps release muscle tension, improve vascularization and restore a harmonious dynamic function of the perineum.
The injection of hyaluronic acid is a particularly suitable treatment for episiotomy scars that are dry, retracted or painful. Thanks to its strong hydrating capacity, hyaluronic acid retains water in the tissues, thereby restoring their elasticity and suppleness. It acts as a true biological cushion, reducing mechanical tension, improving tissue mobility and decreasing sensations of tightness or burning. In addition, by filling certain scar depressions and improving tissue quality, hyaluronic acid makes the scar more flexible, less sensitive and more comfortable in daily life, especially when walking, sitting or during sexual intercourse. This approach, performed with precision and in respect of perineal tissues, also helps relieve possible pain linked to localized fibrosis or a trapped nerve ending.
The photorejuvenation laser is indicated for episiotomy scars showing texture irregularities, persistent redness or uneven pigmentation. This laser works by stimulating cell renewal and collagen production without damaging the skin surface. It improves vascularization, evens out pigmentation and regulates local inflammation. Gradually, the scar becomes softer to the touch, less visible and closer to the texture of the surrounding skin. This treatment provides a natural result and reduces certain discomforts such as sensitivity or a sensation of tension. It is part of a comprehensive approach aimed at improving the appearance, comfort and functionality of the perineal area.
The fractional ablative laser is particularly effective for fibrous, rigid or retracted episiotomy scars that cause persistent pain. It works by creating micro-channels in the scar tissue, which helps destroy the thickened fibrotic fibres and stimulate healthy tissue repair. This controlled micro-ablation promotes collagen synthesis, improves suppleness, reduces adhesions and releases localized tension. Gradually, the scar becomes less rigid, less visible and less painful. The fractional ablative laser also helps restore functional comfort, especially during walking, sitting or sexual intercourse. This treatment, performed in a specialised medical setting, provides significant results on complex, difficult or resistant perineal scars that do not respond to more traditional approaches.
The results of treatments for a painful episiotomy scar vary depending on the technique used, the age of the scar, its structure and the individual tissue response. However, a progressive and long-lasting improvement is generally observed. The tissues become more supple, less retracted and more mobile, allowing for a significant reduction in sensations of tightness, burning or discomfort when walking, sitting or during sexual intercourse. The aesthetic appearance of the scar also improves : the area becomes smoother, less visible, more uniform in colour and texture. Beyond these physical benefits, patients often report a real improvement in their daily life, renewed confidence and a regained sense of intimate comfort. The goal is not only to reduce a scar, but to restore functional, physical and emotional well-being.
If the pain is neuropathic in nature, meaning linked to nerve irritation or entrapment, a specific management approach is necessary. Local injections of anesthetics, sometimes combined with corticosteroids, can soothe inflammation and free the nerve tissue. Hyaluronic acid injected at strategic points can also have a protective effect around sensitive nerves. Sometimes, a multidisciplinary approach involving a doctor, a specialised physiotherapist and a psychologist is the most appropriate.
Beyond pain, some scars may present irregularities, a depression, excessive thickness or asymmetry. Targeted medical correction makes it possible to improve not only the visual appearance but also functional comfort. Hyaluronic acid injections and laser sessions strengthen the structure and improve tissue quality. The goal is to achieve a scar that is more supple, more discreet, less sensitive and better integrated.
A painful episiotomy scar does not affect only the body — it sometimes impacts confidence, femininity, self-image and quality of life. Care must be kind, respectful and tailored, taking into account each patient’s personal experience. Treatment is not limited to correcting a scar, but aims to restore comfort, serenity and intimate balance.
Treating a painful episiotomy scar means combining a precise evaluation, a targeted medical approach and attentive listening. The goal is to allow each woman to regain balance, comfort and confidence within a global, personalised and lasting approach.
The management of a painful episiotomy scar requires a personalised approach, adapted to the condition of the tissues, the symptoms and the objectives sought. The proposed treatments are carried out using state-of-the-art products and technologies. Their price reflects the precision of the procedure, the level of expertise required and the cost of the products and equipment used.
The hyaluronic acid injection, recommended to rehydrate and soften the scar, is billed at 600 CHF per syringe. Depending on the thickness, dryness or retraction of the scar, one to two syringes may be necessary, with an average effectiveness duration of one year.
The photorejuvenation laser, indicated to improve the colour, suppleness and vascularization of the scar, is offered at 300 CHF per session. A complete protocol generally includes four sessions, to be repeated every two years to maintain both aesthetic and functional benefits.
The fractional ablative laser, particularly suitable for fibrous or retracted scars, is also priced at 300 CHF per session, with an average of four recommended sessions, repeatable every two years.
The episiotomy scar can remain painful when healing has not occurred properly, in cases of fibrosis, adhesion, chronic inflammation or nerve involvement during the suture. This can cause pain when walking, during sexual intercourse (dyspareunia) or even at rest.
Several non-surgical medical treatments are available : fractional laser, hyaluronic acid injection, radiofrequency, PRP (platelet-rich plasma) or massages. The goal is to reduce pain, soften the scar and improve both the aesthetic and functional appearance.
Yes, the fractional laser stimulates tissue regeneration, improves the suppleness of the scar and reduces pain. It promotes collagen production and helps smooth fibrotic tissues while improving aesthetics and intimate comfort.
Yes. Hyaluronic acid softens the scar, reduces adhesions and improves comfort, especially during sexual intercourse. It hydrates the tissues and promotes better mobility of the perineal area.
Treatments are generally well tolerated. A numbing cream or local anesthesia may be used to ensure optimal comfort. Most laser or injection sessions are quick and minimally invasive.
Depending on the condition of the scar, an average of 1 to 3 laser or injection sessions is needed. The protocol is personalised. Some old or very fibrous scars may require several sessions.
Treatment can be considered once healing is complete, generally from 3 months after childbirth. For older scars, treatment is also possible, even several years later.
It is a medical treatment, aimed at improving comfort, mobility, perineal functionality and quality of life. The aesthetic appearance can also be improved, but this is not the main objective in painful cases.
The treatment can be performed by a doctor experienced in the management of perineal scars. It is sometimes useful to collaborate with a gynecologist or a physiotherapist specialised in perineal rehabilitation.
