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.
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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.
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.
And here’s another example of how quickly this method can heal damaged skin:
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.
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Caution: Before you change your routine, you should check with your stoma nurse first, unless you’re willing to experiment on your own.
INFO: If you’re interested in the “crusting technique” for healing peristomal skin, check out THIS article.
QUESTION: What techniques have you tried to heal up your skin?
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!
Hi Pat,
Most people have difficulties when they are new ostomates because there are so many changes happening, and the skin isn’t used to all the adhesives and contact with output. Good luck!
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.
Good luck! This is only one technique that has worked for me, but there are others if you aren’t having good results.
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
I use a 2pc for several reasons. Many are listed in this article (and video): https://www.veganostomy.ca/1pc-vs-2pc-ostomy-appliance-ostomy-tips/
this is really useful, I especially like the idea of using a plastic bag to catch drips, very useful for a Urostomy!
It’s the best tip I can offer for an appliance change – it makes a HUGE difference when you use a bag to catch anything coming out of the stoma – less stress, less mess, and really convenient.
All the best to you!
What is the “bag tip” to help catch stool when changing barriers that is mentioned in the thread?Also, my husband has very excoriated skin around his stoma from liquid output. He just had his colectomy on May 1st. His stoma is flush or somewhat retracted. He is being seen by wound care once per week but they are limited to only Coloplast products.We have tried crusting and that did not work. Using a barrier ring seems to make the convexity of his wafer that he needs due to his flush/retracted stoma useless. The ring creates too much height. We are in a vicious cycle of excoriated, weepy skin causes products not to stick which then exposes weepy skin to more leakage/liquid output.We have received samples from other companies. Please help! Thanks!
You can see photos and a video of what I do here: https://www.veganostomy.ca/how-to-change-an-ostomy-appliance-ostomy-tip/
It’s worked for me for over five years and it’s something I would recommend to anyone!
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.
I’m sorry to hear that, Sharon. You mention Nu-Hope appliances. Have you tried their non-adhesive wafers to see if can help settle some of that excoriation? I don’t know if they’d work with a flush stoma, as I’ve never used them before, but I wonder if looking outside of traditional appliances might offer you a solution.
Good luck!
Yes thank you