Ostomy itching - Need help with solutions!

Hi everyone,

I am having a terrible time with itching under the wafer.

I wear a convex barrier ring, and have been able to go 6-7 days. Now, the same day I change, it starts to itch. I have talked to an ostomy nurse, and she gave me a few options. The first one was to try a flat ring snug up to my stoma with the convex on top of that. Today when I took it off, it was worse underneath. She said to try the Head and Shoulders and/or some Flonase spray. Still itching. I do have a small redness, maybe 1/16th, around the base of the stoma, which I think a lot of the itching is coming from. She said to put a little stoma powder around the red part and brush it off. Today it looked worse, I think because of the flat ring.

The rest of my skin under the barrier is perfectly fine. I thought if I was sensitive to the barrier, my skin would be red and broken out under the whole barrier.

If anyone has any other ideas, I would gratefully appreciate them. The itching is driving me crazy. I figured nurses are great, but it takes someone walking in your shoes to really understand and know what works.

Thanks to everyone, at the end of my rope.

Elaine

Hi, Elaine!

A few questions, please, to help us understand what shoes you're wearing...)

- What kind of ostomy do you have? The type of output you have may be a factor.

- How long have you been an ostomate?

- Have you always used a barrier ring? Have you ever tried stoma paste instead of a barrier ring?

Based upon what you have relayed so far, I'm wondering if your barrier ring is not totally adhered to that 1/16" of skin directly around your stoma, and the skin is being irritated by your output...?

In my experience as an ileostomate, when my output touches my skin near the stoma it does itch fiercely! That itching isn't localized to just the skin exposed to the output: the nerves in my skin near, but NOT underneath my appliance itches, too! (I know: strange.)

Not all ostomates have the same experiences, but I'm sure a few of us are willing to share ideas on what may be going on in your situation. I hope we can help!

Let us know when you're able, Elaine! :)

Lily17

Hi Elaine,

The same thing happened to me many, many years ago shortly after I got my ostomy. I believe it's some kind of yeast infection and requires a prescription for a medicated powder that you apply to your stoma before putting your appliance on. Shortly after I started using it, it cleared it up pretty fast. I'm not sure if this is what's going on with your stoma, but you may want to ask your doctor about it, even though I would think an ostomy nurse would have heard about this same situation before. The name of the powder is listed below for reference:

Nystop Topical Powder, by Paddock Laboratories, Inc.

I hope this information was of some help to you :)

Take care,

Greg

Hi Elaine. Could you tell us how far above your skin is your stoma? If it is close to your skin, like 1/2 inch or less, then it can certainly irritate your skin and cause itchiness. Even with a convex disc, it's just a temporary fix. The more days you leave your pouch on, the more it will irritate your skin. In 1990, I had an ostomy nurse look at my stoma that was too close to my skin. My barrier would melt from the output, and I had to change my pouch every second day. She said it would be best to see a gastroenterologist for another opinion. The gastroenterologist recommended a surgeon to me to lift out the stoma a bit higher so that anything that came out of the stoma would fall more into the pouch. It was a minor revision that made huge results.

I would try seals to get a nice snug tight fit around your stoma. There are many different makes of them. Your ostomy nurse might be able to get you some free samples to try to see if they make a difference.

Hi Lily,

Thank you for your reply. I have had my ileostomy for 8 years. I usually have output that is fairly thick, sometimes gets thinner depending on what I eat.

I have mostly used a ring, now the convex because of the stoma changing from sticking out about an inch to flush with my skin. I had a hernia and prolapse repair about 1 1/2 years ago.

I am trying one of those paste sticks from Coloplast. I take a small piece and roll it in my hand then wrap it to fill in that little space. How do you get the ring or barrier to stick to the small red area around the base of the stoma?

I think you are right when you say the itching is coming from around the base of the stoma, then feeling like it itches around the outside.

Any other ideas PLEASE let me know.

Thanks

Elaine

Hi Greg,

Thanks for your reply.

I do have the powder you are referring to, but didn't think it looked that bad. I have used it when I have had red, broken out areas in the past, but you might have a good idea to try it again to see if it helps.

Thanks,

Elaine.

Hi Supreme,

My stoma is out about 1" but of course it does change and goes flush with my skin sometimes. The ring always seemed to take care of it, but now not so much.

I am seeing a GI doc and the surgeon later this month, but I hope it will not require any intervention. My surgeon is quite conservative, so I'm not sure if they will want to do anything. However, I could go 7 days with no problem, now it is hours after a change.

Any other ideas would be appreciated.

Thanks.

Elaine.

Elaine, it sounds like the same thing that happened to me. I think it's the right thing to do. Let us know how your GI handles it. Good luck!

Michael

Hello Elaine

I have an ileostomy and have discovered that my skin in general is sensitive to adhesive and I have a few allergies. So a lot of gluey things like tape, stoma powder, and a lot of wafers are irritating. Hollister wafers seem to be the least irritating but that's a personal problem.

I also experience itching underneath my wafer now and then and it's either because I'm leaking and the output is irritating my skin, or I am developing a yeast infection.

I immediately change the wafer and use any 2% miconazole antifungal powder (I use Micro-Guard because it's corn starch based so it absorbs moisture also. Costs about $10).

After cleaning and letting the area dry, I very lightly dust the entire area beyond where the wafer will end, then wipe the excess off with dry tissue. You should barely be able to see the powder if at all. You know powder will prevent the wafer from sticking. Then I dab, not wipe, the entire area with the skin barrier wipe. Make sure it's dry before putting the barrier on.

I use the Brava Skin Barrier wipe by Coloplast. It's silicone-based and doesn't irritate my skin.

If after a few changes the itching persists it's probably not fungus, I (and I mean I because my nurse said not to do this but it works for me) clean the peristomal area as usual then I take a gauze or paper towel and dampen it with rubbing alcohol and wipe the entire area as close as I can to my stoma without touching it. Yes, it stings but just for a few seconds. I wipe with water, let dry, apply the barrier wipe then the barrier.

Sometimes you have to try something unconventional.

I have to change my wafer every two days because I'm limited to products that don't irritate and for me the more stuff I use the more problems I have.

Sometimes less is better.

Hi, Elaine.

Regarding, "How do you get the ring to stick to the small red area around the base of the stoma?":

The "red area" you're referring to, Elaine - is that the inflamed skin surface next to the base of the stoma? Or, is it the exposed stomal tissue at the base of the stoma that meets the abdominal skin?

If it is the exposed stomal tissue, I don't know that anything will adhere to it, as it is constantly exuding fluids, exactly as the GI tract tissues are supposed to.

If it is inflamed skin surface...if it is so inflamed that you can't get a barrier ring to adhere to it, I recommend that you see your ostomy nurse or a dermatologist.

I hope you can find answers to overcome this issue, Elaine.

Lily17

Hi, Sissy

I have sensitive skin around my stoma, as well. You say you use Hollister appliances; have you tried Hollister's CeraPlus appliance? They are composed of materials that are supposed to be more gentle on skin. It's more expensive, but I've had terrible skin issues and I'm willing to pay more.

Be well!

Lily17

Hello Lily

Thank you for your input!

I have tried Cera Plus. I don't remember what the issue was at the time but I do plan to try it again. Having to change my wafer every other day is a drag.

Hopefully someone comes up with something new. I have some ideas I plan to present but I have some other things I have to do first.

All of us ostomates should think about giving our ideas to the manufacturers. Who knows better than us what might be the next big thing in ostomy care.

Sissy

Hi Greg,
I do have this powder, and never gave it a thought before you mentioned it. It didn't look like that kind of problem, not rashy, or red other than right around the base of the stoma. So I decided to try it. I used it a couple of days ago, so I have not changed it yet, but I think it is helping. I am still getting a little itching from time to time, but better. I will tell for sure when I change the barrier. Thank the good Lord for this improvement, and thank you for your suggestion.

Elaine

Your very welcome, Elaine. I'm glad to hear that it seems to be helping. I hope it continues to improve even more over the days.

Hi

Pretty new to this, 3 months post surgery. I have stupidly sensitive skin. At first, the Sensura Convex Mio worked well, added barrier rings to help seal the wafer when it began to lift around edges. First started getting redness at edge of barrier strips, now under wafer too. Particularly red after showering. I've been using the protective powder and Convex wipe. I've a feeling it has to do with dampness but I try to keep things dry.

Do I have to dump wafer, etc. and experiment again?

Thank you!

Alita

Hi Alita,

I use the Mio also. I used to use the flat barrier and added a Hollister convex ring. Now I am trying the Mio with a convex barrier.

I had leaking and itching around the edges of the tight side and bottom. I also have a red ring around the base of my stoma. Not sure what that is.

I had a hernia and prolapse repair about a year and a half ago. Now my stoma is going flat to my skin sometimes. This ring is helping but still have some output on the barrier when I take it off.

I thought I was getting sensitive to the barrier, but the itching is better. I started using a vitamin powdered zinc instead of the standard powders. I am not sure if it is the zinc or the barrier that is helping. My skin would be red under the barrier too, but more after I took a shower. I think the hot water made it red, but it went right away after coming out.

I did not want to change brands because the Mio pouch I like and the window. Coloplast is the only brand that has a pouch shorter than 12". My stoma is low, at least to me, so I did not want a 12" pouch.

Try the zinc and see if it helps. Use the skin barrier as usual.

Elaine

It could be the barrier wipe that you use. I was using one that I was allergic to. It would itch and break out something awful. I saw my ostomy nurse at the clinic and we found one that worked.

What is the name of the powder with the zinc you're using? I use the same bag and have the same issues.