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’ve been dealing with the same issues, but as Eric was experiencing, Lillie (my stoma) is shrinking down to size from its swollen state (surgery date: 11/15/22). I also try to get a longer wear time, around 4-5 days, and have been experiencing excoriated peristomal skin.
So far, I use the “crusting" technique and also use a barrier ring over the crusting. I’m wondering if I should just try the barrier ring like Eric said and see if that helps better than both. ? I’ve also been in between samples of systems, so this is an experimental phase of system application.
I’ve seen some pretty gnarly images of peristomal breakdown and am very grateful that the excoriated skin is close by the stoma and not inching its way further out! Thats when the leakage gets super bad ? ?
Thank you so much, Eric, for creating this space for all us ostomates and for all your amazing articles and videos! You rock!!
Hi Lillie,
Since your surgery was pretty recent, I would personally focus on getting healthy skin rather than longer wear times. As your skin adjusts, and your stoma finally settles, you’ll likely find that your wear times will be longer.
Barrier rings were super helpful when I needed my skin to heal, so they could also help you. If you can get samples from a few companies, it may be worth trying. I found that on average, it took around two weeks for my skin to adjust to any new appliance/supply.
Good luck!
Hi – thanks very much for the tip to try placing the Ekin Barrier ring directly on the skin around the stoma instead of placing it on the bag. My skin was very irritated on the bottom side of my stoma and I tried your advice to place the ring directly on the skin and mold it around my stoma. The barrier ring is much more flexible than the bag wafer. My skin is much better thanks to your advice. Thanks.
hi i use a barrier ring and under that skin beat red n sore n buring pain i cant get it to stop i use powder and no sting spray and in a few day hurting again badly can u help me fix this
Hi Harley, that sounds painful :( I suggest speaking with a stoma nurse who can look at your skin and assess why it’s red and sore. There could be several reasons, and it’s best not to guess or it may get worse.
Best to you.
@archr Thank you for sharing those tips, and welcome to the forum!
Hello, I have had an ileostomy for 24 years and have always had problems with leaks because my stoma is small, oval and with sloped sides like a cone. Sometimes it is agonizing and I am glad to have found this excellent resource online. I too am a long-time vegetarian (but not vegan). The last time I had major problems was around 2012/2013 and there was nothing much on the web.
I have a couple of tips to offer the forum:
1. I see some mention of nasal spray. I can recommend Flovent (fluticasone propionate) in a puffer. It is a corticosteroid prescribed for asthma. Spray a puff or two on excoriated skin for instant relief and healing. It really is instant. You will need a prescription for it. (When using it, try to avoid blasting your stoma.)
2. My strategy for prolonging wear time is the following ritual which I call “caulking”. It has worked for me for most of the 24 years and although tiresome, it is simply part of my routine. Since I can’t usually go more than 16 hours without leakage, I do this twice a day. Take off the pouch, clean out around the stoma with a cotton-tipped swab, add a little powder to dry the exposed skin and insert a bead of paste (I use Eakin — cut out a small piece and roll it between fingers). Tamp down the edges of the flange with the swab. If you wish, before tamping, you can add back in some or all of the still-clean paste which you had removed, to fill in while the new bead of paste is expanding.
I hope these ideas might help some of the members of this forum. I can provide more details if anyone wants a more precise description.
Thanks archr. I’m a month in and having issues, I will try your techniques! Thanks for sharing.
Hi Lara, That technique (placing the barrier ring directly onto the skin) works well for me, too. I make sure the skin is completely dry; if it looks a little irritated I use the tiniest amount of stoma powder that I brush off lightly wish a tissue before applying the ring. I use Hollister CeraRing. LL