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Red Weepy Skin Around Stoma PART 2, the saga continues

Posted by w30bob, on Mon Dec 16, 2019 11:34 am

Hi Gang,

 Ok, so I've been "studying" what's going on with my red weepy skin around my stoma.  Bottom line is the ostomy powder/barrier wipe thing isn't working.  I've been applying 3 rounds of stoma powder/barrier wipe/warm air drying.  I can keep going, but it just builds up a wet mushy layer of wet stoma powder.  And nothing will stick to that.  So that routine isn't working for me.  When I look at my freshly peeled off barrier I can see it's wet under the ring.  It doesn't appear to be output contents, just that weepy liquid secretion that I assume continues under the ring after I put it on.  The skin in that area gets red because it doesn't like being wet all the time, so that makes sense.  I've noticed over the course of this ostomy adventure that when the skin is exposed to output contents under the ring the skin turns a bright fire red (ie, alarming) color.  Mine isn't that red, so I'm pretty confident it's not output I'm seeing under the ring, the weepy liquid not going away. 

  So the issue is how to stop the skin from secreting, and I keep coming up blank on that. I talked to a wound nurse about it, and as I suspected the way to stop the weeping is to expose the skin to the air so the weepy liquid can form a crust and the skin can heal in a clean environment, as nature intends.  Now the one thing I did differently today when I was preparing my skin for my new barrier/ring was to apply liquid Nystatin first.  I let that soak in and dry, then hit it with Betamethasone, and then started the powder/wipes crusting mess.  After all that I held a piece of paper towel over the whole thing and a nice ring of wetness appeared thru the paper.  So the ostomy powder/wipe thingy isn't able to handle the amount of weepy-ness and it soaks right thru.  I plan on changing my barrier again tomorrow to see what's what.  Maybe I'll just cover the whole mess with New Skin and hope for the best.  Ok, no....I won't do that.  Just seeing if you're still paying attention.   I plan to call NuHope to see about getting a non-adhesive barrier to try.  I was thinking about one of those skin protectant products, i.e., a layer of material that you put on your skin to which you then apply your barrier, but don't see what that will buy me.  So shout back with your thoughts and questions.........and I'll keep you posted if I make any breakthroughs.

regards,

bob

 

Reply by xnine, on Mon Dec 16, 2019 3:38 pm

Is your bad skin just around the stoma or under the ring or the barrier? I would try some diaper rash ointment. Are you allergic to anything?

Reply by Tickpol , on Mon Dec 16, 2019 4:17 pm

I had a similar issue a while back now that I understand your circumstance.  I cut off the fabric adhesive and relied on the ring and the belt to hold it in place.  I then used absorbent bandages that I changed every other hour.  In a few hours I got the crusties appearing. It took a couple of days for my skin to recover using this method.  I was lucky in that it happened on days I was working from home. I was also lucky in that the weeping skin was just under the fabric adhesive and not the ring.  It was about that time that I also started putting the stomahesive in the syringe so I could put it exactly where I wanted it and didn't have to fuss with it gooking up everything in sight. 

 

Dave

Reply by Uro2011, on Mon Dec 16, 2019 4:45 pm

Try a product called Marathon. It's not cheap but forms an instant dry crust barrier and gives your skin underneath time to heal. I had the same problem and this stuff saved me. Put it on and blow dry it a bit to dry it quickly. If your skin is really bad change your pouch every few days while putting this stuff on to help it heal fully. It's called Marathon Liquid skin protectant. 

Reply by Bellily, on Mon Dec 16, 2019 7:42 pm

yeah, the marathon.. the big guns and it's what the kind wocn nurse recommended for me.  could you chat up your wound nurse to give you some?  just to break the cycle of weepy skin.  i haven't gotten any yet because my insurer is freaking out about all the stuff i've been ordering to keep my sitch in check.. plus, i'd have to pay 15 bucks copay for a 1x use thingie full.  i did check online and there are some cheaper sources there.

my ostomy adventures have convinced me that similar products from different brands are not the same.  the adhesives in hollister and coloplast flanges make my skin weepy, convatec doesn't.  barriers and pastes look the same but one will make my skin freak out and the other doesn't.  for me the coloplast strip paste has been best for dealing with weepies, with convatec powder (not too much crusting, less is more).  of course all of this is out the window presently with the funnel stoma 24/7 poopy skin situation. 

less is more.  you've heard that, you know that: the various creams and such can complicate things.  if your skin has said "ahh" before with a clean flange and not much else on, it can do it again.  way back when, when my skin was only occasionally angry, the magical time between changes was about 2-3 days - that gave enough time for everything to "rest" a bit before bringing on another round of rubbing/cleaning/barriering/etc and things healed up. 

Reply by britathrt60, on Tue Dec 17, 2019 1:12 am

Jeez Bob I feel so bad for you..hope you can find something that helps soon...

take care

Ange

Reply by w30bob, on Tue Dec 17, 2019 1:43 am

Hi Gang,

 Xnine......so the way this works is the weepy wetness starts at the inner edge of the barrier right at the stoma.  Any skin that see constant wetness turns red.  Over time more and more skin sees the wetness and turns red.  So if you watch a  time-lapse video of my barrier changes every other day you'd see a small ring of red skin right where the stoma sticks thru.  Then as time went on you'd see that thin red ring start to get bigger (wider) and wider.  It's different than a leak. When I did have leakage some time ago the progression of the red ring of skin was the same, but the color of the skin was a much brighter, deeper red......the same color as the stoma.  With the skin weeping (and not leaking output) the skin is red, but not bright blood red.  Now the allergy question.  My skin does react allergically to the bandage portion of the Hollister barrier, but not to the material they use for the inner section of the barrier which hugs the stoma.  This the same material they make their Adapt rings out of.  I say I'm not allergic to that material because over the past 5 years of using the same barriers and rings this is only the second time I'm having a problem with my skin weeping under this material.  I have had an allergic reaction under the bandage portion, which the Betamethasone tamps down and the Flonase easily keeps at bay..........so two different issues.  

 Tick-ster............my issue with the weepy skin IS under my barrier/ring, not under the outer bandage part. But when I was having an allergic reaction I did what you said........I'd cut out the section of the bandage portion of the barrier to let the air get to the skin, and that did clear that area up pretty quickly.  

 Uro.......thanks for the suggestion........I ordered a 5 pack of the Marathon from a guy on Ebay and it will be here by Friday.  Amazon couldn't get it here until after Xmas.  Prime my ass.  Anyway, checked out the Marathon website and it looks to be just what the doctor ordered! Thanks again.

  Bellily......saw your post........sorry to hear the nipple thing didn't work out, but good to hear your surgeon is moving you to the front of the line.  Let us know how the revision goes.  Yes, I hear you regarding different brands having different formulations.  Trade secrets I guess.  Yup....less is more.  

  Ange........don't feel bad......this is just a minor inconvenience at this point. If this is the best Mother Nature can throw at me...........tell her I barely noticed.  On second thought don't make her any more pissed off than she already is, we haven't seen eye to eye in years.  

;O)

thanks Gang,

bob

 

Reply by Bill, on Tue Dec 17, 2019 2:37 am

Hello Bob.
Thank you so much for your detailed descriptions of the problems you have been grappling with, as this gives me ideas for what I might try if I had similar issues. I also like your logical approach to each situation as it arises, so that if something doesn’t work you can move on to try something else.
When I had problems with sore skin, I quickly realised it was probably due to excessive sweating, and the only ways to realistically deal with that was to either let the air get to it or to have some way of soaking it up as it was happening.
This is yet another reason I started making my own baseplates, that I can stick the manufactured devices onto. It means that I can take them off and put them back on again at whatever intervals I like, without worrying that I am using too many of the manufactured stuff. I can also keep replacing whatever it is that I choose to put between my baseplate and the skin. Sometimes this is straightforward medical adhesive (if I need a strong and safe bond). Other times I use absorbent tissue which tend to stay put remarkably well. However, my baseplates are kept in place with two belts, so I don’t have problems with them falling off. They do not stay in place if there is nothing to hold them there, as the moisture & mucus makes them slippery. I also have a 90% bend that I use to guide the output away from the stoma area. This is somewhat cumbersome, but it works well in the evening and overnight, when I am not concerned about other people seeing me. When the bend is not attached, there is a small collar which it attaches to, and that also helps to keep the output away from the stoma area.
The reason I’m sharing this information with you is that easily removable baseplates enable me to experiment with all sorts of stuff that would not be possible when using normal flanges.
In the past, I have tried to devise a pipe to insert into the stoma so that nothing gets near the outside. Unfortunately, none of my efforts in that direction have proved to be entirely satisfactory as the peristalsis tends to block the pipes before the output has a chance to exit.
I agree with what most people have been saying about various products being useful for some people and not others, so we must develop ways where we can experiment without making things significantly worse.
From my perspective, as I get older, things do not heal up as fast as they used to, and I am very quick to stop using stuff that I appear to be sensitive to.
I did try the O’keef’s cream, but it was no use around the stoma area. However, it has been great for preventing the skin cracking around my fingernails, so thanks for that!
I hope you manage to find something soon that works for you.
Best wishes
Bill

Reply by newnormal, on Tue Dec 17, 2019 4:17 pm

I don't know if anyone has suggested this so far but diaper cream with zinc works well for me. Let it sit on the skin for a while and then thoroughly wash it off before applying the barrier. Also, I like to apply Bard Natural Care Gel(it contains aloe and hyaluronic acid) when I change my appliance, I put it on first before any barrier spray or powder. Head and Shoulders shampoo has been recommeneded to me as well, it works because it contains zinc. 

You scared me with the New Skin! :D

Reply by renomar, on Tue Dec 17, 2019 4:40 pm

Wound Honey promotes fast healing. Just don't use to much at one time.

A strong barrier adhesive works well. (Liquid SkinTac)

Flush bag often after emptying with cold water in a hairdresser coloring bottle that has a long tip. Just make sure you hold the top of the bag securely while flushing and squeeze the bag often while flushing to remove remaining contents around the stoma area on bottom.  Very refreshing !

 

Reply by newyorktorque, on Tue Dec 17, 2019 6:16 pm

I have used marathon in the past and it did work.  It dries quick (no rinsing).  I dont know if anyone else has mentioned this but I just tried something recommened on another site "cortisone 10" max strength.  It comes in different formats but the one I purchased comes in a liquid contained in a stick.   Its like a cross between a mini bingo dauber and a kiddie sized roll on deodorant.  It too dries without rinsing.  I had to switch to a bigger size bag as I put on some weight, my stoma got bigger and now I have more skin covered than before.  So the skin that was previously exposed and now 'bagged' went on an irritational revolt.  I only used it today so the jury is not in yet.  I'm looking to avoid creams and things that I have to rinse...too time intensive for high output ileos.

 

Reply by vdahl, on Tue Dec 17, 2019 6:45 pm

Hi Bob,

Not for nothing but I occasionally have an issue with the skin around my stoma. I kept trying things like airdrying, crusting, skin products "guaranteed to dry up weepy skin" and the list goes on. I was visiting with an ostomy nurse that suggested maybe starting over from scratch. I gently clean the skin with surgical soap and rinse it with colidal silver (my husband makes it for me) then prep the skin with only one layer of the powder and a towelette. I had to quit using the 3M cavalon, sort of an alergic reaction. It started getting better right away but I still changed everything every other day, but I went back to rinsing with warm tap water. We moved from WA to AZ in June and shortly thereafter, I started getting irritated again. If I tried to go an extra day without changi it, I had a real mess!!! The itching and stinging was driving me nuts!!! (true, it's a short drive :) )

I started reading some things about the contaminants in the water, wondering if it had anything to do with the irritation. My husband started making the colidal silver again and sure enough it's clearing up again. I'm sure you've heard from plenty of people that know better than I but I just wanted to share my story. I still can't extend the wear time but I'm healing well and a lot more comfortable.

Sure hope you find a solution that works for you! Vicki

Reply by w30bob, on Tue Dec 17, 2019 11:15 pm

Hi guys,

  I'm noting all you suggestions and will try them!  New......I was only half kidding about using New Skin!  It is a frontline wound solution, so why not?  It's just Krazy Glue with a plasticizer added for flexibility. I also picked up a tube of silicone RTV from work today to play with. I put a few blobs on my skin and will see in 2 days how hard it is to remove.  Ya know, the more I look into stoma skin problems.......the more I think people with these problems are in the majority, not the minority as I was led to believe.

Thanks,

Bob

Reply by Nobagjerz, on Wed Dec 18, 2019 3:28 pm

Hi bob.jerz from the west side of Baltimore. I rinse my porch with water 💦 and arm and hammer bacon soda.along with using a zinc oxide cream on a cotton ball with a set of forceps to wipe down the red rings. I also go with out wearing my pouch for a few days.until the red ring goes away.good luck 

Reply by w30bob, on Wed Dec 18, 2019 10:07 pm

Hi nobag,

  Sure wish I could leave the bag off for a few days to let the skin heal.  But as I said above.......I'll try all the suggestion, so I'll add yours to the list.  Thanks. I changed my barrier this morning and noticed the Nystatin I used last change seems to be helping. When I got done "crusting" I checked to see if there was any weeping and instead of the whole circumference of my stoma still weeping only about 1/4 of it was weeping......so that's progress. So I applied the Nystatin again and will see if it continues to reduce the weeping or not on Friday.

Thanks,

Bob

Reply by iMacG5, on Wed Dec 18, 2019 11:44 pm

Hey Bob, I know Vicki had a problem with 3M Cavilon no sting barrier wipes but they seem to work very well for me.  We're so different in so many ways.  I think they're worth a try.

Thanks for the reminder Vicki.

Mike

Reply by vdahl, on Thu Dec 19, 2019 1:00 pm
iMacG5 wrote:

Hey Bob, I know Vicki had a problem with 3M Cavilon no sting barrier wipes but they seem to work very well for me.  We're so different in so many ways.  I think they're worth a try.

Thanks for the reminder Vicki.

Mike


Hi Mike,

You're absolutely right, our skin is nearly as unique as our finger prints! I certainly didn't mean to suggest that 3M Cavilon spray is inferior in any way. In fact, I used it faithfully for the first year I had an ostomy then suddenly I started responding differently. I'm told skin sensitivities can change, like allergies, with age.

I also want to tIry to see if the baking sodo would help. I also wonder if rinsing with warm epsom salts might help.

Thanks for taking the time! Vicki

Reply by iMacG5, on Thu Dec 19, 2019 3:50 pm

Hey Vicki, It's so important to know the possibilities and the options.  Thanks for the reminder.

Mike

Reply by Marilyn Flowers, on Sat Dec 28, 2019 4:53 pm

Happy New Year!

I just read through the posts on this topic.  I've been an ostomate for 56 years (but who is counting?). I frequently have a bit of weeping skin around my stoma. To minimize this I do the following.  When changing my appliance, I wash the area, let it dry, then apply a Smith & Nephew Skin-prep wipe and let it dry.

For the barrier I use Convatec sur-fit natura durahesive.  I cut the opening to fit my stoma and put an eakin's choesive slims on top. Before applying this to my body, I put a thin ring of Torbot bonding cement on my skin where the outside part of the barrier will be -- let it dry.  Apply barrier and use 3M micropore tape around outer edge to hold it all in place.

This generally lasts for 4-6 days.

Hope your situation improves.

Reply by w30bob, on Sat Dec 28, 2019 6:48 pm

Hi Gang,

  Wow, thanks for all the inputs!  I'm still using the Nystatin and it seems to be working, as the "weepiness" is lessening to the point where it's almost completely gone now.  Not sure where the Nystatin liquid came from, but found some in my closet in my box of old meds, etc.  Was probably prescribed for one of my animals at some point, but luckily it's the liquid type and the bottle is full.  I also got some Marathon via Amazon (possible rhyme alert for Bill).  I do notice that with the Nystatin when I peel off my barrier the bandage portion is fully adhered (good), but the actual ring and barrier material around my stoma (that have fused together) don't have much adhesion to the skin, as the barrier pulls right off after the bandage portion is pulled back.  But I'm not seeing any leakage under the ring, just less than optimal adhesion.  So for now it's working just fine, but I doubt I could get another day out of the barrier if I needed to.  Thanks again!

regards,

bob

Reply by Marilyn Flowers, on Sat Dec 28, 2019 7:05 pm
w30bob wrote:

Hi Gang,

  Wow, thanks for all the inputs!  I'm still using the Nystatin and it seems to be working, as the "weepiness" is lessening to the point where it's almost completely gone now.  Not sure where the Nystatin liquid came from, but found some in my closet in my box of old meds, etc.  Was probably prescribed for one of my animals at some point, but luckily it's the liquid type and the bottle is full.  I also got some Marathon via Amazon (possible rhyme alert for Bill).  I do notice that with the Nystatin when I peel off my barrier the bandage portion is fully adhered (good), but the actual ring and barrier material around my stoma (that have fused together) don't have much adhesion to the skin, as the barrier pulls right off after the bandage portion is pulled back.  But I'm not seeing any leakage under the ring, just less than optimal adhesion.  So for now it's working just fine, but I doubt I could get another day out of the barrier if I needed to.  Thanks again!

regards,

bob


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