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?
Hi Mary, when we have pain it’s not the stoma but the skin around the stoma. Is this pain new or part of on going skin problems. It could also be that the wafer is to tight or pulling on the skin. Changing to often can cause problems but if it’s causing distress I would change. Have a good look at the wafer and skin when doing.
I have an ileostomy,
I changed my appliance yesterday, Wednesday, this evening my stoma hurts?
Should I change the appliance again?
Crusting and other remedies are good for a small or mild troubles but Eric is right seeking help from a stoma nurse is best
Hi, I’m new to the forum but have had my ostomy since 2016 and have tried a few appliances because I have a sensitivity to the adhesive and finally found one that has worked for me. However, lately the base plate hasn’t been adhering well and then starts to lift around the edges and that gets very itchy for me and I try soooo hard not to scratch but I do a lot of it when I’m asleep and now my skin has been so red and raw and I’m having to change my bag too frequently, please what can I do for that? Is there a tape that heals the skin at the same time? I’ve also tried the crusting but find that things don’t stick well after that either. I wish they made a base plate made of all skin barrier ring. :)
@Tina
Hi Tina, red and raw skin are not good signs. You may have an allergy or fungal infection, or it could be mechanical in nature (like if the wafer pulls on your skin).
I would strongly suggest having a stoma nurse assess your skin so you can get on the right healing plan.
Good luck!
Hello all,
I have found Eric’s videos and info very helpful. My surgery was 8 weeks ago and I am very happy with my recovery (and freedom from the toilet!). The lower half of the colon was removed, and while I did have solidified output at the beginning, the past 4 weeks have been like mud – not quite diarrhea. However, there is a problem with the juncture of skin and stoma. That is to say, as the stitches dissolved, the skin wasn’t yet closed around the stoma. Now a real gap is evident, and the skin’s edge is raised, like a bumper, and irregular. There is also a broad area of skin at one side that has remained a red wine colour – it is sore to the touch. Of course, I have seen the surgeon several times since the surgery, and as it became more painful at about week 4, instead of less, he prescribed 10 days of two antibiotics at week 6. At the visit after that he again examined things, poked etc. While it is less painful than before the drugs, the gap appears wider. He is concerned, yet suggested a wait and see approach, and return in two weeks. I asked if he could restitch but he said this is not possible.
Today’s pouch change revealed seepage under the wafer, again. The “bumper" isn’t helping I suppose. Yes I have tried convex wafer (suggested by visiting stoma nurse, made it hurt a lot), rings (suggested by hospital stoma nurse, seemed to make stoma retract, more seepage), and paste (seemed to dissolve, and fail). This last time I tried cutting the wafer tighter to the stoma, and used no extra product. This was more comfortable, but was just an illusion of success! I have let the skin “air" a couple of times, sitting in the sun awhile. Yet the problem continues. Today I turned again to the Google search, and of course there really only is your site! I watched the “crusting" video (thank you and will try that now.) But I was very struck by how different my stoma looks – and now I am getting rather worried.
So here are my questions (at last). Has anyone had this issue of the skin remaining apart from the stoma? What was done to help it heal properly? I do trust my surgeon, but it seems time to reach out for other input.
Cheers,
Alison
Hi Alison, this is something that happens unfortunately, but it should be addressed by your surgeon.
Do you have a stoma nurse who can assess your stoma and recommend how to better apply a pouch over it? I would be cautious of using a convex wafer because the additional pressure it adds may cause that separation to worsen.
The sore redness you describe could be the skin that’s burned from your output, at least that’s what I’ve encountered in the past. More frequent appliance changes helped me during that time and I always measured my stoma to get a perfect fit.
Best of luck!