Healing the Skin around the Stoma – OSTOMY TIPS (w/ Video)

Share
Share
Pin
Tweet
Email
Print

The ideal appliance will fit in a way that protects your skin while also providing a durable, and secure fit. Unfortunately, not every ostomate can achieve this balance so easily, so many will experience a breakdown of skin around the stoma.

Video

This happened to me a short while after getting my ostomy, as my new stoma was still shrinking down from its swollen state. I was quite inexperienced, so rather than change my appliance more often, I’d try to get 5+ day wear time, which meant that as my stoma became smaller, it left room for my output to eat away at my skin.

As you can see from the photos below, I had fairly deep erosion of the skin, and it hurt a lot. At the time, I had used the “crusting technique”, which involves putting stoma powder on the exposed, raw part of my skin, dust it off and apply a barrier using either barrier wipes or cavilon spray. You do this a few times to build up protection on the skin, and to allow the wafer to stick to something other than the powder. This technique does work for many people, but it worked very slowly for me.

Very painful peristomal skin 28 days post op
Very painful peristomal skin 28 days post op

More recently, as I’ve been in between wafer samples, I began to get more breakdown of the skin. I attempted to remedy this using the crusting technique, but I wasn’t getting the results I wanted; so instead, I opted to simply use a barrier ring without any powder or barrier wipes. The results impressed me, and my skin has probably never looked that good around the stoma.

Ostomy Barrier Ring on wafer
Barrier rings can be applied to a wafer (just remember to remove the release liner from the wafer first!).
Ostomy Barrier Ring on skin
Barrier rings can also be molded to fit around any size or shape of a stoma.
Healthy skin around the stoma
Healthy skin around the stoma.

And here’s another example of how quickly this method can heal damaged skin:

Stoma Healing after 2 days small
Two days and look at the difference!

Now, I continue to use a barrier ring when I notice more breakdown of the skin. I may continue to use them more regularly, but they are quite expensive and I’m not done trying new appliances that might offer a better fit.

Here’s a video showing how I change my appliance, including how I use barrier rings.

Before you change your routine, you should check with your stoma nurse first, unless you’re willing to experiment on your own.
If you’re interesting in the “crusting technique” for healing peristomal skin, check out THIS article.
QUESTION: What techniques have you tried to heal up your skin?
Share
Share
Pin
Tweet
Email
Print

106
Leave a Reply

avatar
newest oldest
john68
Member

Hi Sandra, Their are a lot of reasons for the raw skin and its a matter of trying to trouble shoot and work out why. https://www.veganostomy.ca/healing-skin-around-the-stoma/https://www.veganostomy.ca/ostomy-leaks-tips/ 

Kathleen
Member

john68 – Thank you for those tips. I will have another attempt and see how we go.

john68
Member

Hi Kathleen, those sore bits can be quite weepy and the orabase when applied can spread further than needed. Make sure the area is really dry and use sparingly. also I found that a little dust of stoma powder on top of the paste before the wafer helped. Any additional products always apply as little as possible.

Sandra Pullen
Guest
Sandra Pullen

I had my colostomy Dec 1 2017. I have tried everything that’s been suggested to me and have been to wound treatment center. It is now Oct 2018 and my area around stoma is still red and raw looking. I hope this is not what I have to look forward to from now on. Anyone have any suggestions?

madrikh52
Member

Hi Sandra, I want to reply because I have had ongoing skin issues for more than 2 years. I have had my colostomy since 2013. In August of 2016, my peristomal skin started itching. (I won’t go into every detail, I can hardly remember all of it anyway, since my mom and sister were both terminally ill and died during that 2 year period). Suffice it to say, I saw the WOC nurses many times, each had a different idea for me and none of the ideas helped. Early this summer, I just couldn’t take it anymore, so I went to my dermatologist. Long story short, I was eventually referred on to a specialist about 3 hours from my home. Her theory is that I used something around the time of the onset of the itching that I had an allergic response to and my skin has never had a chance to recover since it is constantly dealing with the insult of ostomy products. So, even though I have tested negative for an allergic response to the products I currently use, I have continued to have itchy, rashy, red peristomal skin. I hope this is making sense.Please ask me questions if you want  more details, because there is a lot more to the story and I’m not in the clear yet. My encouragement to you is, don’t give up! You shouldn’t have to live with angry skin. Marci

john68
Member

Hi, The small points you describe sound very like granulomas. They can be quite sore depending where they are around the stoma. They can be treated by applying Orabase Paste or the silver nitrate as you describe. The silver nitrate must be used very carefully and could cause major damage to the stoma or the rest of the skin. The stoma nurse advised me to use a barrier ring on top of them as they can be weepy and cause problems under the wafer. I only use a small part as I don’t need the full ring! Again silver nitrate will burn!! and the sticks activate when wet.

Kathleen
Member

I put some orabase ointment on the sore bits but then the bag wouldn’t stick to the skin. Did I do something wrong? I am trying sudocrem next. 

Deana Riggs
Guest
Deana Riggs

Hi,

This is exactly what my stoma looks like and it hurts. I have tried both methods and neither has worked. How is this working for you?

bob
Guest
bob

Could try using cortisone CREAM but use it without aloe- as aloe is slippery- when changing the pouch- set aSIDE some time to apply cream to affected skin- allow to absorb into skin for 5-10 minutes or so (have toilet paper or paper towel ready to prevent ostomy output from flowing out all over the place while pouch is off)- wipe off as much as you can- apply karaya powder to weeping skin- then barrier spray or hollister medical adhesive over the karaya- it will take a few changes to start to see improvement- but the cortison should help heal things up nicely. I used to use Karaya pouches for nearly 30 years=- they were absolutely fantastic for nice healthy skin- never had any issues with weeping broken skin- but they stopped making them so i had to switch to hydrocolloid pouches from hollister and now have bad skin all the time because seal will not adhere to my skin tightly aroudn hte edges near the stoma- always battling skin irritation and can only wear pouches 1 day- Tried Ekins- no help- messy to change- etc- and liquid woudl work it’s way under the eakins just as bad as the regular seal. Wish htey’d brign back the Karay pouches- (Yes, they were hard to change- scraping off the stuck on Karaya was a pain, but coudl wear pouches 2 days and skin was always in great shape)

bob
Guest
bob

if you wanted to try cortison with aloe (as Aloe can be very healing as well as the cortison)- you could leave it on for 5-10 minutes, then clean it off really really well- probably with somethign like alcohol to make sure all the oils fro mthe aloe are gone before applying ostomy pouch

Robert
Member

Hi Chris looks like I’m a day late . I have used the marathon before and it worked well for me but I did not have blisters I did have a bad irritation though . So like Eric said I would be cautious about putting anything on open blisters .

Chris
Member
Chris

Thanks for your advice! I adjusted the appliance today and used a lot of stoma powder! It doesn’t hurt quite as much so I am hoping it will start to heal!

Dana
Guest
Dana

Hello my husband has a colostomy and is taking chemo. His skin around the stigma is beat red and really moist. This doesn’t happen often. But right now it is really bad. A pouch will not stay on because its so wet. What can I do to help him with this.

John Small
Guest
John Small

My peristomal skin is always a bit moist. I have a strange purple condition just under the top layers of skin that neither stoma nurses nor surgeons can quite identify or help with. It’s probably not as moist as your husband’s, but I have found that, in my case, Convatec 2-piece systems have built-in adhesive properties in the barrier ring/wafer/baseplate that work much better than Coloplast adhesives. Hollister products perform somewhere in the middle. So I get almost double the wear time and much better skin protection.

Bubbles
Member

Try Safe n Simple Barrier sheets to heal skin . Place directly onto skin then your wafer on top. 

Jimmy
Guest
Jimmy

I have had a stoma since 09 Sept 2014 as a result of my own stupidity by not taking action when I first noticed the signs of cancer as in blood in the toilet. In the last 8 months I have been having a red weeping sore around the wound. I have been using Convatec 22771 with an Eakin Cohesive ring after spraying the area with Convatec sting free skin barrier. The pain on the skin became more than I wanted to deal with so after I cleaned up I took plastic wrap and cut it to about 4 inches wide, put it over the wound leaving a ballooned area and taped it to the skin after spraying with sting free. The plastic wrap fills up once or twice a day but I change it and clean up each time but I am able to get out and do things in public without odor. After 4 days the skin issues have been resolved and I can once again use a bag.

I am going to try some of the possible solutions that I have read here and will make a follow up comment if this helps my situation.

Lori
Guest
Lori

Hello Jimmy, I actually use tissue paper folded up and use press and seal (just next to plastic wrap in strores) over it so you avoid using tape on your skin . The press and seal sticks on your skin and tissue paper absorbs any fluid . When changing just wrap up everything in the press and seal and dis guard. Good luck.

Tammi
Guest
Tammi

I want to thank you for your web site and videos. My husband has a colostomy after surgery for colon cancer then a perforated colon with sepsis and months in the hospital so I am the one changing his appliance as he was/is too weak to do so. I have had to deal with several issues and an ever changing stoma. They found another colon leak so in a few weeks he will have surgery to reconnect his colostomy and then they will create an ileostomy. Your web site has been a tremendous help. I really appreciate it!!!

Tom
Member
Tom

Hey! Been following your blog since I got my temporary double barrel ileostomy back in November. Thank you so much for the wealth of information and tips. It’s been like having a second stoma nurse!

I just needed a tip on the size of my stoma. I’ve put weight on since having the stoma and It’s prolapsed a bit. The colon end of my stoma is rather bulbous and it makes changing my appliance hard, so i kind of have to wait until some peristalsis happens. My question is that I’ve noticed when i lay on my back, the actual circumference of my stoma hasn’t changed since surgery but when I’m upright (like anyone is for most of the day), the stoma kind of “fills out”. I’m not sure what to do as I’ve been cutting my appliance to the size of it as it appears when it is larger, which is fine as it seels the gap between stoma and bag, but when I lay on my back at night, it shrinks. This has lead to irritated weepy skin and the powder isn’t helping much. I’ve ordered some protective sheets from Brava i hope will help.

Thanks!

Rob
Guest
Rob

Hello to all,

I am a new permanent ileostomate(3 weeks). At the age of 54, I now am cured of my 20 years of having UC. I am so relieved and happy to have had the surgery and now will be involved with using stoma appliances and I am actually excited…There are soo many options and remedies that it truly puts my mind at ease and am very happy for this site.
I am currently using Coloplast products and their customer service is excellent. I have had no issues with getting samples. One of there recommended sites for ordering supplies is CanMedDirect.ca. There prices are actually very reasonable.

VO, in my opinion, your videos and advice are top notch!

To all, take care and all the best!

Rich T
Member
Rich T

This may be a weird one, but have you ever had sores and bleeding not on the skin at the base of the stoma, but around the shaft of the stoma itself. I have tried barrier rings molded up and around the stoma, doing the turtleneck thing, but the blood and (i guess clear inflammatory fluid) are REALLY doing a number on the survivability of the stoma cover (it doesn’t leak poop ever, but blood is what starts to leak out.

Would you recommend barrier ring, just stick with it for a while longer, or do you know of any tips for this situation? The stoma nurses at my hospital are usually great, but they just kind of shrugged about this one.

John
Guest
John

Hi Rich. I sometimes have several small points around the outside of my stoma that bleed, just as you describe, and blood is obvious in the bag when I empty it. My surgeon looked at it and pointed it out to me and told me to use silver nitrate sticks to chemically burn/cauterize those points. The areas where I touch the stick to turn gray and the bleeding stops. Those spots will heal. I discard the used stick carefully by wrapping the tip in a tissue before putting the stick in the garbage. Be sure kids or pets don’t get into that garbage and be sure to lock up the silver nitrate sticks. They are sort of dangerous for kids/pets. Every time I change the bag I look to see if more spots have sprung up on my stoma. I bought a tube full of 50 silver nitrate sticks from Shoppers Home Health Care for maybe $50 or something.

Lori Bayne
Member
Lori Bayne

I just wanted to send a quick note to say thank you so much for your videos and advice! I have a temporary ileostomy. I am two weeks in with this which I will have for three months if all goes well. I too have experienced the skin breaking down around the wafer just recently. I think I did not anticipate how quickly the stoma would shrink and sized my wafer way to big. My stoma does not stick out very far and the ostomy nurse said it would likely cause more irritation as a result. I tried barrier rings for the first time today and I am hoping and praying it works. The irritation is very painful when I walk. There are lots of good ideas here I am going to try. I have been told to change the wafer every 4 days or every 7 days, but I am reading here I may need to change sooner with the irritation. This whole process can be emotionally and physically draining for us new ostomy folks and finding your site has been a life line. Thank you!!

Mary Ann
Member
Mary Ann

Hi Lori,
I just got a temporary diverting ileostomy which I will have for 3 months also. If you don’t mind, may I ask why you had your procedure. Mine is a trial for conservation of colectomy for slow transit constipation.
I did fine up until 8th day post-op when I started having increased pain and tenderness over the stoma. Pain goes from rib to groin.

Mary Ann
Member
Mary Ann

Lori,
I am new to this site as I read further, you explained your situation. I hope you are doing well In your recovery.
My situation/diagnosis of slow transit constipation seems rare. My colon just refuses todo its job! 🤪

Sarah
Member
Sarah

I have had my ileostomy for about 3 months. Recently I have noticed breakdown of the skin just underneath my stoma. I use the stoma powder and then apply the barrier ring and the the wafer. And I was changing about every 3-4 days. But the last couple changes I noticed the red skin not healing. It is not bleeding or oozing anything but I am concerned with it seeming to get larger every time I change. I am not having any leaks, I just notice this when I change the bag. I called my nurse and she said it sounded like I was doing everything right and maybe I need to change more often. But that concerns me of what it will do to the rest of my skin, especially the already irritated part. I use all Hollister products and through trial and error thought I had it mostly figured out. But now I am not so sure. I just don’t want the irritated skin to get worse and am not sure what to do next? My stoma does contract and sink down at times so I am not sure besides the barrier ring what else to do to help with that? Any help would be appreciated. Thanks!

Reva
Member
Reva

My urostomy is 7 months old and buried. I have lots of bumps and folds in my belly which made it very difficult to find products. I finally found a bag and wafer that works for me but the area around my stoma has broken down. My doctor says the longer I keep the bag on the better, but it’s not getting any better. I am using calamine lotion and airing out the stoma for about an hour. Is it better to change the bag more often?

Rachelle
Member

My stoma nurse recommended two products that healed my very deteriorated skin surrounding my stoma super quick. The first was using Domboro soaks for 15 minutes on the skin around my stoma for 15 minutes with every change. It is found at a pharmacy and is an antiseptic powder you mix with water. I would simply soak paper towel strips in the solution and wrap around my stoma. After dry, I applied Hollihesive under my flange and within a few weeks (4-5 changes every 3-4 days) the skin was tremendously improved. Good luck!

sally
Guest
sally

for those who are having rashes etc. I swear by calalum lotion it has helped me in a big way . doesn’t cost a lot , just make sure it is dry before you but the bag on can buy it in the drug store . belive me it works .I I was beside myself with raw skin . great stuff and you save a ton of money . I don’t spend money on all this stuff they have out , good luck

Jenifer Olson
Guest
Jenifer Olson

I’ve had my ostomy for 10 years now and I’ve tried so many things to help with skin erosion, oddly enough after all the expensive treatments I found that plain old diaper rash cream works best for me. If it gets real bad there’s a product called Marathon liquid skin protectant…. Its pricy but works of you have a large affected area and lasts about 3 days.

Is there a way that he can donate them?
Guest
Is there a way that he can donate them?

My boyfriends stoma was injured and he had to have his stoma repaired. The surgery change the size of his stoma.
He has stoma supplies that he no longer can use. Is there a way that he can donate them?

Kimberly Aikey
Member
Kimberly Aikey

I’m sure anyone would take them. I am only allowed enough for 8 a month

Janice Sabin
Member

Have you asked, your Doctor, to send a request to the insurance company, explain that you need more then right a month. Between my Doctor and Stoma nurse, I know can get 20 of wafers and 30 bags a month. I have a lot of leakage, do to a crease right next to my stoma. I also have to use a convex wafer, because I have a innie stoma.

Aimee
Member
Aimee

Do you have any home remedies to suggest? I am an RN, with “some” experience w/ stomas. My colleague is currently on a medical mission in Mongolia and has a young man w/ a post op Day 7 stoma. She’s sending me pictures later today, but due to limited supplies, I was wondering if there is any household products one can use to protect the skin. I know corn starch may be available. Thank you!

Dixie
Guest
Dixie

I have had my ostomy for about 25 years. The ostomy bags and wafers I used for almost 20 years is no longer available because the company stopped making them–I even called the company trying to get them. In the nightmare of finding some that will work I have had trouble with irritated skin. Using corn starch helps with absorbing the moisture. Additionally I use products made for babies diaper rash. But not the ones that have a greasy feeling…. Desitin and butt paste. I apply it while taking a bath or shower and let it set (the flange won’t stick with it left on.) Hopefully this will help someone.

Teddy
Guest
Teddy

Well….I’ve had my Ileostomy for 46 years….and STILL have raw, excoriated skin right around the stoma. NOTHING will stick to excoriated skin because as soon as you dry the skin, a wetness will reappear in a minute. I’ve tried Barrier Wipes, Powders, well – everything out there, with no luck. I’m somewhat of an “expert” after all these years at putting on appliances – and must have tried every brand out there. Friars Balsam does not heal that RAW skin either. Even if I apply a sticky, mouldable wafer, as soon as I bend down or move around, the carefully applied, snug mouldable seal just “lifts” away from the wettish skin. It only takes an hour or so with an “around the stoma” leak (even if the appliance wafer is still fitmly in place), and the skin is exposed to effluent – and becomes raw again. If anyone comes across anything that will STICK to RAW SKIN while it heals, PLEASE let me know by posting on here. I’ve seen Stoma Nurses, and appliance Reps…..and no-one has a fix for my problem.

Rachelle
Member
Rachelle

For those having difficulty with an appliance sticking to deteriorated skin, or to cover challenged skin around the stoma and protect it, have you tried Hollihesive? It is a large square patch that you cut a hole in for your stoma, but it doesn’t act like a barrier ring and respond to the wetness. I used the stoma powder in the holes around my entire stoma which had fully separated the skin from my stoma and was cleared up very quickly. I use Convatec Mio Sensura pouch but used the Hollihesive product with it until it was healed. I also did a Domboro soak around my stoma for 15 minutes with each change which helped the healing tremendously. It is a safe antiseptic powder you mix with water, soak paper towel in it and surround your stoma with it to soak. Worked wonders.
Good luck!
Rachelle

Lyle
Guest
Lyle

I have read about people using aquacel for wet wounds. It absorbs moisture and may help heal up the site. Also read someone was using for similar adhesive problems with decent results.

Aishwarya P Kumar
Guest
Aishwarya P Kumar

Hi
My mother has a temporary ileostomy since last 5 weeks (Post op Ca rectum) and she is now on chemotherapy. The skin around the stoma just keeps on eroding and changing the wafer is a nightmare for her. We switched to a 2piece bag 4 days back but the skin doesnt seem to be healing as she still finds every movement painful. The barrier ring seems to be really good, but the link provided mentions that it is to be applied to dry, UNBROKEN skin. So isnt it useful in healing the eroded area? Please advice.
Mom’s so frustrated, she even contemplates stopping the chemo and getting an early reversal done.

Thanks in advance
Aishwarya Praveen Kumar

dana
Member

Remember, YOU HAVE TO DO WHAT YOU HAVE TO DO. Instructions (if you followed them) would keep you from using the product for many reasons (that were why you bought it to begin with!!!) If there is alcohol in the product, I would advise common sense, knowing how bad it would sting.
Otherwise, there’s no harm (compared to what’s happening NOW) in using these products. They won’t stay on as long as they promise, but nothing does.

Barb Hackworth
Guest
Barb Hackworth

My mother has a black/blue ring around her stoma. Can you tell me what causes this?

dana
Member

I also wrote about the purple/black ring around my stoma and got no reply.
So I don’t think there’s ANY help out there. It’s not skin, but more like a shiny “glass” looking piece of Saran Wrap.

dana
Member

After 30 years of wearing the sharp-edged, firm, convex Coloplast wafers the skin around my stoma has developed a “not skin” appearance, as if the dermis is gone and the color is purple/black (as if I’m seeing inside my body), and maybe I am. The rest of the skin looks fine.

The ostomy nurse didn’t have the knowledge my 30 years have given me so I left without advice. Just an expression of “wtf is that?” from the nurse. I’ve now switched to the hollister convex with ceramide, (I’m hoping for a ciramide miracle).

I have to change every two days because my stoma “sinks in” when active and oozes under the opening.

My Insurance supplies five boxes per 90 days. I USE NINE boxes in 90 days. I just ordered cerimide lotion to assist, but there’s no way any wafer will stick to skin that has lotion on it. ANY THOUGHTS??????

TPD
Member
TPD

Dana,
How about those extended tapes they sell? Like the ones that are supposed to increase wear time or the ones for swimming?

dana
Member

Theresa, I thought of that a few months ago and cut up the tape and placed it around the stoma. No improvement. Layers of real skin seems to have disappeared. At first I thought it was like a pressure sore from constant pressure due to wearing convex. My stoma is a perfect length, but it sinks INWARD, pulling the skin with it, when it ejects liquid. If not for that, I’d never leak. Then I figured the ring of skin around the stoma (think 1/2″ and full circle) looked odd and wasn’t skin at all. Shiny, but transparent. Not wet, just not true skin. It’s so slick that nothing wants to truly adhere to it. The doctor and ostomy nurse were totally useless, but in Florida, most of the medical providers are. I went to Amazon and ordered spray glue for around the wafer opening, and a tube of ceramide cream. I figured I’d rub the cream in (although this shiny skin will NOT absorb), layer tape over it, spray glue on the Hollister opening (Convatec caused this after 30 years. So I recently went to a cloth/soft wafer: Hollister) and try not to eat or move for three days. LOL

TPD
Member
TPD

Hi Eric
Thanks for being a lifeline to so many of us ostomates. I had my ileostomy in November of 2016, and have been on a whirlwind of a ride. I’ve got things pretty much settled now, except for the barrier ring business. I started with the Ekan and after awhile ended up with raw, irritated skin. After healing that up I switched to Hollister and was doing great. But now when I take off my barrier ring my skin looks shiny pink. It fades after awhile, but never looks like “normal” skin like yours does. Any suggestions?
Thanks, Teri D
BTW congrats for being up for all those awards

Jim
Guest

I have found that the most inactive time of my stoma is first thing in the morning is first thing when I awake 6am

Shirley Houck
Member
Shirley Houck

i have an itchy rash from the bag with the summer heat. please help me. Thank you

Geylen
Member
Geylen

Thanks for this site and all the videos! I’m a new post-op and my skin is already breaking down with the adhesives from the bags. This has some great tips and tricks. I’ll be watching!

Andrea Bashore
Guest
Andrea Bashore

Thank you so much for posting this. My son has a new stoma and we have really been having problems with the skin around the stoma. I think we will try this.

Vana Oslowski
Guest
Vana Oslowski

This was very informative. Nice calm presentation. I will definitely use the bag on waist as I can never seem to find the best time to make a change. Why do you use two piece appliance? Thank you for your clear and concise demonstration, VO

ShropshireLady
Member
ShropshireLady

this is really useful, I especially like the idea of using a plastic bag to catch drips, very useful for a Urostomy!

Sharon
Guest
Sharon

I have 3 1/2 year old flush stoma to my skin . With a bit of a belly due to a large hernia. Tried several wafers and and eons and powders. The wafer one piece I use barely last 2 days. Always deal with Excoriation. . I have to deal with Marlen for wafers . They are harder to get. Order ahead of time. Or New Hope is even harder to get.My output is watery to somewhat pasty if I’m lucky. I’m tired of the pain. But my sarcoidosis keeps me from reversing it. Some times it looks inverted. But it hurts my stoma and stomach to always use deep convexity. And it only holds for 2 days. Stoma nurse said I was lucky for 2 days. Gosh there gotta be something better out there. Tired of changing so often. Inconvenient. And allergic to the adhesives on the tape. . Gosh I even have trouble with rectal mucus too. I am a wreck.