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?
I do home healthcare for a client and he is having an issue with skin breakdown around his stoma, we have tried the caking method as well as the moldable ring and it simply is not adhering which causes the output to sit on the skin longer and then it leaks. Are there any other options for him to try??
@Michelle
Hi Michelle,
Do you have the option of consulting with a Stoma Nurse? Until you know why the skin is breaking down, it’s hard to come up with any course of action.
If they are having leaks then that needs to be controlled first. If the skin is weepy, there could also be the chance that a fungal infection may be at play, which needs to be treated on its own.
Not everyone will have pain all the time, but it does depend on the severity of the illness and where. When I was diagnosed with Crohn’s, I didn’t have pain – that came as my illness got worse, and it was excruciating. 😣
I know before surgery I had a lot of stomach pain and of course the sickness and cold sweats. And who can forget the sore bum!! Was getting to the stage where I was considering keeping the toilet paper in the fridge 😃❄️❄️.
This is my take on why we think the stoma it’s self is sore, the little guy or girl 😃 does his wriggling as we pass out put when this happens that causes a certain amount of movement skin and wafer wise hence if there is broken skin or not enough room pain occurs. I do know the proper name for the stoma moving!! Peri……Ok now it’s obvious I can’t spell it!!!!😂😂
@john68 I believe the word you’re looking for John is peristalsis. I remember a bit from my nursing days.😂! I truly felt the pain was situated only to the stoma. It was also a new pouch on when that happened. I also question that if it does not hurt, being made of the same material of the stoma why do we get pain and credit it to the bowel hurting?🤔. The erosions, tho we can’t exactly feel or place them seem to be a symptom of disease and when active I certainly have a lot more pain.🤯. There is so much more I want to understand 🤓about the guts. I know when I touch my stoma she does not hurt yet l place the pain right with my bowel.🤔. I think we need a scientist here 🏅🤓.I have to ask if everyone gets pain with the flares of disease? I know I have a different type gut being shorter then short and with bowel wall thickening, but does everyone experience the pain?🤔
@dlkfiretruckLinda—you are so funny with all your new emojis. You are like a kid in a candy store. 😂🍭 And, so you know, I always have my phone lying on the bed when I sleep, so when I am online in the middle of the night, I usually am lying in bed, often after getting up to empty my bag. 😀
I never had any pain when I had Ulcerative Colitis and have never had one since my ileo operation 3 years ago. Maybe I don’t have the nerve endings that others have. Just lucky I guess. I never have problems with the whole bag thing. :-P
Hi Mary, and Welcome. I know what you mean about the stoma hurting which is why it puzzles me that we are told it does not hurt. When I first had mine, I had made the hole too small and l could feel it was too small for the size of my stoma. Gas was trying to escape. I layed down and watched the stoma bulge with gas, escape, and then the stoma went back to its size and that particular pain went away. The hole in my wafer was not much smaller then usual, but it was small enough to make the difference. I replaced the pouch with a slightly bigger hole I had cut in the wafer and since, it has only ever felt some what I called pain in my stoma, if I had cut the hole & it had a little outward notch in the wafer that my stoma touched, it would hurt there. Sometimes if the hole l cut even a bit too small and the stoma touches the wafer and the edge of the hole is not softened yet, I will be aware of it. This is one good reason to not have an exact hole as to the edge of the skin. When you cut the hole, cut it on the outside of the line otherwise you inadvertently make the hole too small. Turn the pouch when cutting the hole , not the scissors. This avoids the bit of pointed edges I talk about. The skin does toughen up in time and can take the bit of a lot better as we go on in life. I hope this help.Linda…doesn’t anyone sleep around here, and Liza…go back to bed.😴