Skin Sensitivity with Barrier Use: Does it Toughen or Diminish?

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Past Member
Jul 21, 2020 7:24 pm

I've had my ileostomy for 1 year. I couldn't imagine not using an adhesive remover wipe, but I see a lot that don't.
Does the skin around the ring/barrier get tougher or less sensitive?

Past Member
Jul 21, 2020 8:05 pm

Hi Tmn,

I use the adhesive remover wipes for two reasons: 1) to reduce the adhesive on my skin 2) the little packet has liquid in it, when I'm peeling the bag away from my skin it pulls so I pour out the liquid on that stuck adhesive and it melts it instantly.

For reason 2) alone it's worth it for me.

That's my take on it...mountain

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lovely
Jul 21, 2020 8:31 pm

If you use skin prep, the adhesive remover wipes help remove the residue from that. The skin prep leaves a coating on your skin to help the skin not get so irritated. Best wishes and stay safe.

NJ Bain
Jul 21, 2020 8:37 pm

Tmn86,

I haven't noticed my skin getting any tougher. But I don't use adhesive remover. I just use a soapy washcloth and push between the barrier and my skin with it. I know others just peel it off, but the soapy washcloth makes it come right off with no residue. Then I just wash the peristomal skin with soap and rinse, pat dry or blow dry, and then I apply another skin prep before putting on a new pouch. Everyone is different, but that works best for me. Hope this helps.

Bain

Penguins7
Jul 21, 2020 9:08 pm

I used to use the wipes until I discovered the Hollister adhesive remover (Adapt 7731) in a spray can. It works so well as the wafer just falls off. Then I use a 4x4 pad with water to clean the skin around the stoma. I change out every day, and my skin has been flawless for 8 years. Plus, it is 3.4 ozs. so it's okay to take on airplanes. Good luck, and I hope this helps. Stay well. Penguins7

 
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w30bob
Jul 22, 2020 12:40 am

Hi tmn,

Well.......as usual....it all depends. Hollister makes 4 types of barriers with different levels of adhesion, or "sticky-ness". Depending on which one you use might influence your use of a remover. If you use stoma powder that also reduces adhesion. So it really depends on how well what you use actually sticks to you. If you have any broken or bleeding skin......it would be advised to use the adhesive remover (the ouchless kind). If your skin is healthy you shouldn't need any. There are also a variety of removers, as folks have discussed above. I don't see a downside to using one, other than cost. As for the skin getting tougher........as Bain said....not really. If you've had skin irritation in the past and used a topical steroid to keep things calm and under control your skin will change over time. It will develop a sheen to it, indicating it's been permanently damaged by the steroid, but I wouldn't say it's any "tougher". I change my barrier almost every other day and I don't use an adhesive remover unless I've applied one of the 3M tapes around the barrier periphery to help stop the barrier edges from lifting when I'm in the pool. That tape literally melts into your skin (and does an incredible job of keeping things in place no matter how wet things get), so I use a remover just over the tape, when I change my barrier. It instantly soaks through the tape and makes the adhesive "gum up" so it can be easily removed. As usual, your mileage may vary!

Regards,

Bob

Past Member
Jul 22, 2020 1:44 am

Thank you all!

MBT
Jul 22, 2020 5:48 am

Throwing in my two cents. In the case of fragile peristomal skin, history of liver issues, or peristomal varices (superficial, fragile veins), then using adhesive remover wipes/spray is recommended in the first case and a necessity in the last two to prevent major bleeding. Otherwise, the choice of moist washcloth vs adhesive remover is mostly down to preference.

ron in mich
Jul 22, 2020 1:06 pm

Hi all, I had my first ostomy a long time ago and my original surgeon told me about how to remove the wafer. As mentioned earlier, I should pull or work the skin away from the wafer. He said that as I got older, the skin changes. Now, since I had resection surgery 2 years ago and my stoma moved to the left side, the skin feels different where the old stoma was.

iMacG5
Jul 22, 2020 3:28 pm

I also have a couple cents to add. I suggest pushing the skin away (into the body) from the wafer rather than pulling the wafer off. The purpose of this method is to avoid stretching the outermost layer of the skin.

This might be just another way of saying what’s already been mentioned.
Definitely use adhesive remover rather than excoriating the skin.

Mike

Past Member
Jul 22, 2020 3:43 pm

Hi Mike,
Never thought about pushing instead of pulling. Good point. ..mountain.

lovely
Jul 22, 2020 6:59 pm

Mike, that is the way I remove my wafer. It is much easier than trying to just pull it off. I just hold the edge of the wafer and push the skin down away from it. Much easier on the skin. Best wishes and stay safe

w30bob
Jul 23, 2020 12:20 am

This is kind of funny, kind of stupid........but hearing you guys mention how well your barrier sticks reminds me of what I learned the other day. When I got my ostomy back in 2014, the ostomy nurse told me to always use ostomy powder and an adhesive wipe or two. I never thought much about it, but in the back of my mind, I realized I was basically putting talc on my skin, wetting it, and then expecting my barrier to stick to that. And it did, but the adhesion was nothing like what you guys are describing above. Meaning it didn't stick well enough to ever pull off any skin. And over the years, I've pretty much always used the ostomy powder and the adhesive wipes......because ostomy nurses know what the heck they're talking about.......with most of them being old and wise....errr...."well seasoned" in their trade........so I never really questioned it. This summer with the heat and me working outside, I asked you guys about tape for the edge of the barrier.......and got great replies. And then the other morning, instead of changing my barrier like a robot......I took the time to think each step through. When I got to the "apply Stoma Powder" step, I stopped. I asked myself why the heck am I doing this? So I got out my tablet and Googled "what is Stoma Powder?". And it said it's used to absorb any moisture if your skin is weeping or wounded, before putting on a barrier. Moisture? Wounded skin? I don't have any of those things. So why am I doing this??? So I didn't put the Stoma Powder on or use the adhesive wipe. Well............two days later, I go to change my barrier. Holy crap Batman........that bitch was stuck to me like glue!! So NOW I see what you guys are talking about......and the Stoma Powder will stay neatly in my emergency kit........for use during an emergency! I'm pretty sure I can safely get at least one more day between barrier changes now. Not sure how my skin will like that.......but I'm going to find out. I guess sometimes when you just do things just because........and don't think them through......we're susceptible to make mistakes like that. I wonder what else I do every day without thinking about why I do it.....and probably shouldn't. Live and learn I guess.

Regards,

Bob

Penguins7
Jul 23, 2020 12:03 pm

Hey Bob, you are correct that the stoma powder is for absorbing moisture so you are better off without it. The other product available from ConvaTec is DuoDerm extra thin spots. It is like a bandage you can cut to size and put over a sore area. I would recommend the powder and then the DuoDerm over top as this will allow the spot to heal in time.

These stay at home times have allowed me the opportunity to experiment with some different products because if I have a blowout I am at home. I enjoy reading your insightful posts and like the added sense of humor. Stay well. Penguins7

Past Member
Jul 23, 2020 2:40 pm

I've had my ostomy for over 30 years. When I first had it, adhesive remover wasn't available.....it was for nurses for removing dressings. I remember nurses being naughty but nice lol, using it to remove my bag as well. At the time, it was so much easier. It's only in the last 20ish years that it's been available to us in the UK. Anyway, for me, it's one of the best ostomy products to become available in my 30+ years of having an ostomy. I'm one of the lucky ones. My bags stick to me as if they're welded to my skin, so it's a pain in the ass to remove without adhesive remover. I only use adhesive remover spray. Just a few squirts is enough to remove the base. 1 x 50ml can lasts me about 30 changes. When you speak to people that have had ostomies for 40/50+ years, you hear a lot of them say that their skin is very delicate and they have lots of problems under the flange. Now, I always ask ostomy nurses at events if they think it's because adhesive remover wasn't available until recent years and all the abuse their skin has taken from the pulling, damaging the skin over the years. Most go with my thoughts on it.

Past Member
Jul 23, 2020 6:33 pm

Hi Panther, 
Thanks, very good insight. Nothing trumps experience.  ...mountain. 

MBT
Jul 23, 2020 9:41 pm

Must've been an old-school ostomy nurse. 

w30bob
Jul 24, 2020 5:47 am

Well........she was old!  I think the real cause was because I was only in the hospital a couple days after and while there my barrier was only changed (maybe) twice......and it was changed by them, not me.  So the only practical experience I got changing a barrier was when I got home and was by myself. I would hope that nowadays new ostomy patients are provided more guidance (maybe videos) that cover most of what can go wrong with stomas, before they leave the hospital.  

Regards 

Bob

lovely
Jul 24, 2020 5:18 pm

My experience at the hospital was about like Bob's. A nurse came in to show me how to change it and I had company. They said they would step out but she said she would come back later, I never saw her again. I had to learn on my own. I have learned a lot from this site and looking at videos online. Best wishes and stay safe.

Past Member
Jul 24, 2020 8:43 pm

I use a spray remover by Convatec which is amazing, lets me easily lift away the edges of the flange then I push my skin in away from the rest of it around the stoma. I use wipes next to get the remaining goo off of my skin and make a smooth surface for the new flange. I had been using a barrier wipe each time I changed because that's how the nurse in the hospital taught me but found out about six months ago that newer flanges aren't made to use with barrier wipes, it decreases their longevity on the skin. Mine had been getting gooey every time I showered with the barrier wipes and after I stopped them, no more goo and my flange can last through showers and pools about 5 days.

iMacG5
Jul 26, 2020 3:01 am

  
Hi Sangria.  You referred to the barrier wipes you stpped using.  Are they what's also called "no sting barrier film"?

Thanks,

Mike

MBT
Jul 27, 2020 2:48 am

Sadly, this is common. I am sorry you, Bob, and so many of us did not get the training we needed. It makes places like this community special and essential bridges along with other ostomy resources.

w30bob
Jul 27, 2020 3:36 am

Hi NWAO,

You're right.   But as I mentioned on here a while back (before you got here).......it would also have been nice if when I/we left the hospital they handed us a sheet of paper with a list of websites (this one included) that had ostomy info.   I didn't find this site until 4 years after I got my frontbutt.......and I found it by accident one day while looking for something else. Just sayin'.

Regards,

Bob 

ron in mich
Jul 27, 2020 1:26 pm

Hi all, when I had my first surgery 30 some years ago for an ileostomy, I was given a book on colostomies. About day 3, I think it was, I was taken into the bathroom and told to do a change of the wafer and pouch, with the nurse suggesting what to do and how to clean it. I did that once more and then was released to go home.

w30bob
Jul 27, 2020 2:21 pm

Hi Ron,

Yes!  That's what should be done for everyone.  I sure hope it is that way today.  Especially now that they give out ostomies like candy in the OR.  It really is an area where a little info goes a long way, and can stop a lot of problems before they start.  Glad to hear someone used a hospital that had their act together.  

Regards,

Bob

Past Member
Jul 27, 2020 4:14 pm

I think it's the same thing. It's what you would use for crusting if you needed to. I do still use it if I happen to get any skin issues that I have to crust with. Mine are Convatec AllKare protective barrier wipes.

MBT
Jul 28, 2020 3:00 am

My ostomy nurse group has asked me to compile a list of my recommended ostomy resources and products...the ones not found in textbooks & journals. I am working on the list. MeetAnOstomate will be on it.

w30bob
Jul 28, 2020 3:53 am

Very cool. Can you share the list with us when it's done?

Regards,

Bob

MBT
Jul 29, 2020 4:41 am

I'd be glad to!

Melanie

LetsGoGolfing
Aug 23, 2020 1:10 pm

I liked the comment about having an old school nurse lol. I've had an ileostomy for 20+ years and appreciate hearing how to best handle fragile skin around the stoma. I stopped using adhesive remover wipes because after repeated use I'd get a rash, especially after shaving the hair that grows between changes. I use warm water, gentle pH balanced liquid soap (like medical soap, nothing like hand soap) and take time to carefully remove the adhesive ring, etc. Any tips you can share would be fantastic. My ileostomy was older than the stoma nurse I had at a recent check-up, so that was worth a laugh.