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 have had a stoma since 09 Sept 2014 as a result of my own stupidity by not taking action when I first noticed the signs of cancer as in blood in the toilet. In the last 8 months I have been having a red weeping sore around the wound. I have been using Convatec 22771 with an Eakin Cohesive ring after spraying the area with Convatec sting free skin barrier. The pain on the skin became more than I wanted to deal with so after I cleaned up I took plastic wrap and cut it to about 4 inches wide, put it over the wound leaving a ballooned area and taped it to the skin after spraying with sting free. The plastic wrap fills up once or twice a day but I change it and clean up each time but I am able to get out and do things in public without odor. After 4 days the skin issues have been resolved and I can once again use a bag.
I am going to try some of the possible solutions that I have read here and will make a follow up comment if this helps my situation.
Wow, Jimmy! I’m glad you’re skin is back to normal, but I hope you can find a better solution to prevent that from happening again.
Hello Jimmy, I actually use tissue paper folded up and use press and seal (just next to plastic wrap in strores) over it so you avoid using tape on your skin . The press and seal sticks on your skin and tissue paper absorbs any fluid . When changing just wrap up everything in the press and seal and dis guard. Good luck.
I want to thank you for your web site and videos. My husband has a colostomy after surgery for colon cancer then a perforated colon with sepsis and months in the hospital so I am the one changing his appliance as he was/is too weak to do so. I have had to deal with several issues and an ever changing stoma. They found another colon leak so in a few weeks he will have surgery to reconnect his colostomy and then they will create an ileostomy. Your web site has been a tremendous help. I really appreciate it!!!
Hi Tammi,
Thank you so much for the praise and I’m glad you’ve been able to make use of this website! I hope that your husband has a better time with his upcoming ileostomy! Sending my wishes to you both!
Hey! Been following your blog since I got my temporary double barrel ileostomy back in November. Thank you so much for the wealth of information and tips. It’s been like having a second stoma nurse!
I just needed a tip on the size of my stoma. I’ve put weight on since having the stoma and It’s prolapsed a bit. The colon end of my stoma is rather bulbous and it makes changing my appliance hard, so i kind of have to wait until some peristalsis happens. My question is that I’ve noticed when i lay on my back, the actual circumference of my stoma hasn’t changed since surgery but when I’m upright (like anyone is for most of the day), the stoma kind of “fills out". I’m not sure what to do as I’ve been cutting my appliance to the size of it as it appears when it is larger, which is fine as it seels the gap between stoma and bag, but when I lay on my back at night, it shrinks. This has lead to irritated weepy skin and the powder isn’t helping much. I’ve ordered some protective sheets from Brava i hope will help.
Thanks!
Hi Tom,
Yes, that’s an interesting problem indeed.
I’ve had my stoma shrink from when I cut the hole and it can lead to some problems, but the edges of the hole tend to swell up and fill in any gaps.
If you find that this is becoming an ongoing problem, I’d suggest speaking with a stoma nurse to see if any adjustments should be made to your routine (you may need to add another product in the mix).
Best of luck!
For anyone having the same trouble as I am, I’ve found a solution that works for me. I now have to change my bag lying on my back so that the stoma retracts and is as flat to the skin as possible. This gets me a good seel around the edges of the stoma. The size has actually got a bit smaller since surgery as I’d expected but I was cutting a bigger hole to get the wafer over the stoma, which led to irritation and faster ware on my wafer.
It can get messy for me as my stoma is very active. Be patient for your stoma to be a bit quiet whilst you change. The extra time changing will save hassle for days. I tend to take a loperamide pill (aka imodium) before I intend to change (please don’t take too many of these if you are prone to blockages. My stoma nurse recommended 6-8 but my gastro nurse said that is well too many and said it should be only 1-2 when necessary).
My skin is healthier within days and I can now get a few more days (4-5) of wear on my appliance.
I’m not sure how this would work in emergency situations, but I’m hoping it won’t come to that. As soon as I feel any slight irritation, I make time to change at home.
Hope this finds its way to anyone else having a similar issue.
All the best!
Thanks for sharing what’s worked for you, Tom.
You mentioned that you have a prolapsed stoma and that laying down helps it to retract before an appliance change.
I know it sounds strange (and I promise it’s not an April fool’s joke), but have you ever tried putting regular sugar on your stoma to help it retract?
I know of people who’ve been told to do this by their stoma nurse, and it’s been published in various medical literature too:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604428/
I haven’t tried that yet no, i have heard of it though! It sounds crazy. I will be giving it a try next time i change for sure, though. If it helps me to be able to change my bag standing up it will be a godsend!
Sugar does work for prolapsed stomas.
Hi Laura,
It certainly does help! For those who are interested, check this out for more info on this:> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604428/
Hello to all,
I am a new permanent ileostomate(3 weeks). At the age of 54, I now am cured of my 20 years of having UC. I am so relieved and happy to have had the surgery and now will be involved with using stoma appliances and I am actually excited…There are soo many options and remedies that it truly puts my mind at ease and am very happy for this site.
I am currently using Coloplast products and their customer service is excellent. I have had no issues with getting samples. One of there recommended sites for ordering supplies is CanMedDirect.ca. There prices are actually very reasonable.
VO, in my opinion, your videos and advice are top notch!
To all, take care and all the best!
Hi Rob,
Glad you found the site!
IBD, including UC, can be insidious in nature, so continue to work with your GI doctor if you have any symptoms in the future (including “extraintestinal manifestations" like joint pains or mouth sores).
I use Canmeddirect and payless medical. Both offer great prices and fast service!
I have found SCIsupply is very good also.
This may be a weird one, but have you ever had sores and bleeding not on the skin at the base of the stoma, but around the shaft of the stoma itself. I have tried barrier rings molded up and around the stoma, doing the turtleneck thing, but the blood and (i guess clear inflammatory fluid) are REALLY doing a number on the survivability of the stoma cover (it doesn’t leak poop ever, but blood is what starts to leak out.
Would you recommend barrier ring, just stick with it for a while longer, or do you know of any tips for this situation? The stoma nurses at my hospital are usually great, but they just kind of shrugged about this one.
Hey Rich,
Hmm. I’d get a second opinion from another stoma nurse. While bleeding around the stoma can sometimes be normal, sores are not, and I’d prefer that it gets looked at to determine what exactly they are.
Once you know what’s causing them, you can proceed with how to better manage them.
Best of luck!
Hi Rich. I sometimes have several small points around the outside of my stoma that bleed, just as you describe, and blood is obvious in the bag when I empty it. My surgeon looked at it and pointed it out to me and told me to use silver nitrate sticks to chemically burn/cauterize those points. The areas where I touch the stick to turn gray and the bleeding stops. Those spots will heal. I discard the used stick carefully by wrapping the tip in a tissue before putting the stick in the garbage. Be sure kids or pets don’t get into that garbage and be sure to lock up the silver nitrate sticks. They are sort of dangerous for kids/pets. Every time I change the bag I look to see if more spots have sprung up on my stoma. I bought a tube full of 50 silver nitrate sticks from Shoppers Home Health Care for maybe $50 or something.