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 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!!
Best of luck to you, Lori!
The “4 to 7 day" recommendation is ideal, but many people can’t push their appliance that long without developing problems. If I go more than 5 days consistently, I’ll have skin trouble guaranteed!
I hope the barrier ring works for you. You may need to try different brands to see which one works best for you. The Brava Protective Rings by Coloplast have been really good and don’t break down or “melt" as often as other brands.
Thank you so much for the advice! I looked into the Brava Protective Rings by Coloplast. I saw your video on it and it said in the comments you could only get it in the UK and Canada. Is it available in the US now? Should I order directly from Coloplast? Also, I have been showering with the bag (not brave enough to go the other way just yet :) ) and I was wondering if that breaks down the barrier ring faster? My ostomy is active and I have not really figured out a time yet when it settles down…but that is probably more about what I am eating/drinking than the stoma itself. If the skin is aggravated, should I be letting it “breathe"?
You may want to contact Coloplast to see if any of their US dealers sell them. I saw that a company called Medline has them, but I don’t know much about them as a supplier.
Showering with your appliance is fine. If you notice that the edges of your wafer peels, you can use a wafer extender or medical tape, but it shouldn’t peel very much.
Don’t worry about your stoma being active – if you aren’t comfortable then keep the bag on :) I do tend to “air out" my stoma on occasion, and there’s no harm in doing it, and I believe it can help with raw/aggravated skin.
Hey there! I reached out to the Ostomy nurse (through my surgeon/hospital system) and spent some time with her this past week. She was a wealth of information. She told me that my stoma sits in a crease when I sit up directly. As a result, she said I needed to use a convex cut to push the skin down and the stoma up. She also said I needed to wear a belt all the time to help further with pushing the skin down. I am now using Hollister Premier One-Piece Soft Convex Cut-to-fit Beige Drainable Pouch With Remois Technology. In addition she said I need to change the wafer/bag every two days. What a difference it has made in a short time! I wish I had consulted her two weeks ago. According to the nurse, there is something within the wafer itself that is supposed to help with skin issues as well. We will see. Thank you for all of your advice! She also agreed with you in regards to the barrier rings and thought that could help me further now that I have the right fitting wafer. Thanks for fighting the good fight out here in Ostomy land. :) You are appreciated!
Lori, I have been where you are just a month or so ago. I also have a temporary ileostomy and am about 3 months out now. My takedown was supposed to be in March but the surgeon has pushed it back to May because I have a loop ileostomy and, after an exam and explaining what they have to do in the surgery, he said he wanted more time because I wasn’t healed enough yet. I was devastated. And the soonest they could do it was the day before my birthday. So happy birthday to me! But as many assured me, it is better to wait then for them to get in there and not be able to reattach me and have to go back through my abdominal incision (I have severe sepsis from a perforated intestine from a hysterectomy days before and had to be cut all the way open and my ileostomy was a result of that). So anyway-back to the point :) I have terrible trouble with breakdown and I too have an active stoma. I used the Chloroplast rings and found they broke down quite fast for me so I switched to a thick Hollister ring that seems to be more ‘waxy’ and it has worked great. I order all my supplies through Amazon. When I did have skin irritation I tried a technique I found on here using a product called Domeboro. I only had to do the soak once and it worked! I also was petrified of taking a shower without my bag on. But one day I just did it. And my stoma was active and I just let the poo rinse off and cleaned out the shower after. It will get easier and better. I know how emotionally hard it can be and just wanted to reassure you it will get better. Eric had been a great help to me, as well as these forums and videos. Keep your chin up. There is hope!
Sarah,
Thank you so much for your very kind and encouraging words! I always need to hear them! I am so sorry that you could not do your reversal sooner. I am so hopeful that mine will be quick but if not, I will just have to deal with it. Now that I have the right wafer and am in less pain/discomfort with it I think I can manage emotionally if I had to go longer. I know what you mean about birthdays! I had my colon removed/ J pouch surgery at 22 years old the day before my 23rd birthday. :) I am now 40 and just had surgery for a fistula repair…thus the ostomy while it heals. That surgery was on Valentines day! ha ha. I have to think it brings us good luck! Thankfully this last surgery was planned and I had several months to get ready for it mentally and physically. I cannot image emotionally all you have been through. You are a trooper! Even through this bad experience you are able to help others like me. I will keep you in my prayers and I hope May gets here quickly for you!
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.
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! 🤪
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!
Hey Sarah,
I agree with your nurse and you might want to try changing maybe every 2-3 days for a few weeks to see if that improves things.
Generally speaking, I don’t use the stoma powder unless the skin is weepy (if it’s just red or irritated, the stoma powder won’t help with much).
Best of luck to you!
So what product would you suggest?
I would stick with your current appliance and barrier ring, but change them a day sooner than normal. Unless you’re having specific trouble with the particular supplies you’re using, I see no reason to change them for anything else.
You’ll probably find that once your skin has healed and is back to normal, you’ll be able to wear your appliance longer again. Damaged skin makes it very difficult to wear an appliance for very long, and many times the irritation leads to weepy skin, then problems with the adhesive sticking.
Update me in a few weeks and hopefully your skin will be happy again :)
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?
Hi Reva, changing too often or not often enough can both cause problems. I personally don’t wear my appliance for longer than two or three days if the skin is raw and sore. I find that keeping it on longer causes more skin erosion and removing it more often than that just irritates my skin. I do find that my skin will heal very quickly (a few days) if given the right conditions, so if you have ongoing trouble, I’d suggest having a stoma nurse look at it for an assessment.
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!
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
Hey Sally,
Is that “calamine lotion" (the pink stuff)? If so, I’ll correct your post :)
I used calamine lotion several times under my nurses recommendation. It was a while ago, but I did have some success with it! Glad it works for you!
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.
Yes, diaper rash cream (which usually contains zinc oxide) can help with skin irritation, but it’s often difficult to get an adhesive to stick on top of it. Do you do anything special before applying your wafer?
Marathon is something I’ve used in the past – it is VERY expensive, but also quite unique in what it can do.
I will likely do other videos on other ways to help with broken/irritated skin :)
How do you use the Marathon liquid skin protectant with irritated skin around a stoma?
So, Marathon comes in this little applicator that’s almost like applying lipstick. The liquid that comes out is spread thinly over the affected areas and when it dries it forms like a plastic layer on the skin to help protect it.
I just purchased the marathon skin protectant and was wondering if it stings when you apply it. My skin is blistered around the stoma and very painful. I have been using stoma powder without much success. I am hoping the skin protectant is much better!
Hey Chris,
Marathon shouldn’t be applied to broken skin, so I’m not surprised that it hurts. Blistered skin should be investigated. If it’s just caused by regular exposure to your output, it can heal quickly once you fit your appliance properly.
Thanks for your advice! I adjusted the appliance today and used a lot of stoma powder! Hopefully I’ll be on the mend soon!