Red Weepy Skin.......chapter 12

Hi Gang,

  A while back I wrote about my success with Marathon skin protectant for my red weepy skin.  Well........that crap came back to visit me again, and is now gone again.....for now.  Here's what I'm learning. 

  The red weeping skin is fairly common in Dermatology, but not well understood or treated.  It's usually labelled Contact Dermtitis or Eczema (and sometimes cellulitis if the Doc likes throwing big words at you), with the difference being what it looks like when it's really far progressed and getting ugly.  Those are also 'catch-all' labels Dermatologists like to put on skin problems they can't easily explain......so you hear them a lot.  

   In my particular case I'm not sure which I have, if I have either.  I was thinking I had the Contact Derm, and it was some reaction my skin had to the bandage portion of my Hollister barrier.  Now I don't think that anymore, and the reason is if I was having an allergic reaction to the product then I'd expect all the skin under the bandage to be red........and that's just not the case.  My skin under the barrier gets red wherever the hell it wants to, but never all over.  It's also not leak or weepage related, as I've looked very closely and my barrier ring stays sealed to my stoma.  Back a few months it was recommended I try an anti-fungal, and I did.  And it worked great!!  And it continued to work great for a few months.  And then without me changing anything in my barrier change routine.....the damn red weepy skin started coming back.

  That's when I started using the Marathon skin protectant, which is like Krazy Glue, and it literally seals the skin from the barrier bandage material.  That worked great initially too.  But I noticed at some point that when I peeled the previous layer of Marathon off (yes, I know you can leave it on and apply a new layer over the old, but as someone who understands painting.......that's never a good foundation), primarily to see what my skin looked like under it.........I noticed the skin wasn't really healing.  It was pretty much just staying the same, but protected by the Marathon.  So I figured it was time to go back to the drawing board, or go see Professor Whoopee (a reference to Tennessee Tuxedo and Chumlee that you younger folks probably won't get.......go Google it).  Ok, so it wasn't an allergic reaction and I tried the anti-fungal thing, which left me with only 2 other options ...a bacterial or viral infection.  Now I don't appear to have any symptoms of a viral infection that I can tell......but you never know.  

  So ok, between viral and bacterial.......I'd rather have bacterial.  I don't have a good arsenal of drugs handy to really mess with a viral infection.......so I started with bacterial, as common household antibiotics are everywhere.  Let's see....I got Neosprin, Bacitracin, triple antibiotic stuff........and I also have my favorite anti-inflammatory steroid Betamethasone!  So time to get busy!

  But then a funny thing happened.........after about a week (3 barrier changes) of just hitting it with the Beta (and nothing else) my skin completely cleared up!  Huh! Ok, so the problem hasn't cured itself.....it's still there....but the Beta knocks down the inflammation well enough that I don't see it re-appear 2 days later.  Which is good, as it gives me some more time to ponder my dilema. 

  But the point to this post is that this red, weepy skin that many of us seem to get.........is a tough nut to crack.  I mean if the Professionals can't figure it out....how the hell are we supposed to??  So I'd like to hear from you fine folks regarding what your experiences are with this crap.........and what you do....or have done.....to rid yourself of it, whatever it's called.  It sure would be nice to have a list of things to try to give the next ostomate who posts a question about how to deal with red, weepy skin under their barrier.  So what says y'all??

thanks,

bob 

Bob you have probally already looked up the salve that c57557555 was talking about. If you haven't here is a link about it. I don't know what the shipping price is about but the cost at Walgreens is $9.99 best wishes and stay safe,

https://www.walgreens.com/store/c/calmoseptine-ointment-to-prevent-%26-heal-skin-irritations/ID=prod3285901-product

Maybe try changing  your equipment more often.. if I try to get more then a couple days out of my bag wear my skin becomes red and weepy. My cure for the past couple of years has been cleaning the area with Head and Shoulder classic shampoo, apply the Butt paste diaper rash cream , remove any excess cream then apply Hollister Karaya  5 power so my bag will stick. The rash clears up very fast. Take Care!

Hello Bob.
Thank you so much for sharing your problems with weepy skin and some of the things you have tried to resolve this irritating problem.
From time to time, I have had this problem around my stoma but it has always healed up without much intervention from me. However, having looked at the pictures on the Hollister post on treating skin problems, I now realise that the skin around my stoma has never been right!
That aside, I do have problems elsewhere with itchy, sore and irritating skin so, I will be reading all your replies with interest to see if there are any ‘solutions’ to this problem.
I suspect that some of us are simply prone to this sort of irritation and there is little that we can do to ‘cure’ it, but maybe there are a few things that can be done to ‘manage’ it.
In my case. almost anything rubbing on my skin will cause irritation, particularly creases in clothing such as socks, vests, shirts, etc. Pants are a constant cause of irritation around the waistline where the elastic rubs against the skin with more pressure.
Now, my own contemplation of this problem takes me back to when I was working in engineering and the oily ‘suds’ made my hands red-raw and weepy. The doctor pronounced that I was ‘in a dermatoid state’. Meaning that the skin was susceptible to irritation (in my case to the oil/petroleum -based liquids).
Things like elastic in clothing can also be petroleum based and are designed to press tightly against the skin, so it would make sense that, if I am sensitised to this, then it will cause this sort of irritation.
I don’t know what the skin barriers for stomas are made from, but it would not surprise me if they were petroleum based and, if so, may be the cause of my irritations. Since I have been using my own DIY baseplates, I have had no serious problems with this type of irritation. However, I still have problems with anything elastic. This is especially so after garments have been washed a few times and tiny bits of elastic poke through the weave of the material to come in contact with the skin.
I have tried almost every ointment and remedy on the market to contain this irritation but, as yet the most effective thing has been to simply put a layer of fabric between the offending irritant and my skin. Wet wipes and dry wipes are handy in this regard, but they have a habit of moving about and exposing the skin to that which I am trying to protect it from.
Hence, I will be an avid reader of the replies to this post to see if anyone can come up with solutions to these problems both around the stoma and elsewhere.
Best wishes
Bill

Hi Bill,

  Great info, as usual, and thanks for sharing.  You jogged my memory in terms of things rubbing against my barrier. The lower portion of my barrier is normally covered by the waist in my pants (my stoma is above my waistline, but just barely, so my pants waist sits right up against the bottom of the bag flange (2-piece barrier/bag)..........nice job stoma location markers!). And any serious physical activity causes friction which tends to irritate the skin under that part of the barrier, making that skin red and weepy.  Not much I can do about that when I have to wear pants with a firm waistband, other than to get them off as soon as I can and let that area breathe.  But irritation is something to avoid if at all possible......thanks for that!

  I did fail to mention in my post what it is that I'm doing now to help prevent or deal with the red weepy skin I currently have....or had.  I've used 3M Micropore tape in the past on the edge of my barriers whenever I expected to sweat a lot or go swimming, as that tape is unreal at sticking to things like skin and ostomy barriers.  So what I've been doing over the past week or two has been slowly cutting away portions of the bandage section on the barrier and replacing what I remove with Mircropore tape, once I put my barrier on against my skin.  Each change I've cut a bit more bandage off, and I'm at the point now where I cut it all off except for about a 1/4" (6 or 7mm for you Metric System folks), to give the Micropore something to stick to on the barrier. And so far the skin under the Micropore looks fantastic!  Now this might not work for everyone due to how well what's left of your barrier adheres to your skin, but for me I've found that I actually don't need any of the bandage section of the barrier to hold my barrier in place.  The adhesion between the barrier ring I use between my skin and barrier is strong enough to maintain the seal and not come off under normal conditions.  But I never know when I'm going to be in an 'abnormal' condition.....so I always wear a belt and want some additional security.......hence the Micropore tape replicating the original barrier bandage section. And I don't replace the whole bandage section, I just use one width of Micropore around the periphery of the barrier........and I'm good.  And of course wearing the belt helps keep constant pressure on it.....so that's what I'm doing now. 

  Again, would love to hear from anyone else with suggestions that worked in the past, work now.......or just didn't work at all.  That last bit of info could save a lot of people a lot of trouble as they scramble to try to find something to deal with this very irritating (pun intended) problem!!

regards,

bob

Since this is chapter 12 .. have you tired going to a Ostomy Wound Care nurse? Their arsenal of products /suggestions is much larger then anything we can offer. They are professionals and may save you a lot of pain and time safeguarding your skin.

Bob, when I get irritated skin it's usually at under my stoma and I need a mirror to see it clearly. What I do is cut a piece of stomahesive from a 4 x 4 wafer as no apply it over the irritated skin. I then put an Eakin Seal and then my gasket. Another thing that worked goes back to when I was in the hospital many moons ago when I first had ileostomy surgery. The nurse used Malox on the skin and let it dry She then applied the gasket and used scanpore tape to secure it. I don't know how she ever did it so good cause I can't do that myself but it did work awesome. I hope something works but I'm sure it is damned frustrating. Wishing you well!

Hi Maried,

  Great suggestion.........but yes, I have.  I've seen the ostomy nurses at Hopkins, Washington Hosptial Center and Georgetown Hospital.  I've even seen some of the Docs who treat the President.  And each time I've come away shakin' my head as to why I wasted my time.  They're certainly nice enough people, no problem there, but once pushed out of their comfort zone.........it's not a pretty site.  I've even taken their advice and seen the Dermatological Team that's a conglomerate of all the DC hospitals' Derm docs located in Chevy Chase.  That was the biggest joke of all.  Again, nice folks......but I think I taught them more than they taught me.  Except I didn't get paid. 

  The ostomy nurses I've dealt with were incredibly caring individuals, who really take to heart our well being.  Kudos to them all!  But I tend to think they are a very focused group in what it is they treat, and the way they treat.  I would have thought they'd seen it all by now..........and they probably have.......but how to treat some things is still a crapshoot.  And their arsenal is rather limited in relation to what other Docs have available.  So if you have an ostomy problem that's seen frequently I guess it's easy for them to deal with.  Some of the more uncommon stuff.......that's a different story.  But I do urge others to follow your suggestion and not hesitate to see an ostomy nurse if you need help.  They genuinely enjoy helping folks with ostomy issues......so make them happy and go see them!!

regards,

bob 

Hi WI,

  Yeah, there are a bewildering number of products like you describe........and I need to get off my ass and look into them.  My problem is my short attention span.  I worry about this crap the morning I change my barrier, and tell myself I need to do some research immediately and order some samples. But the second my new barrier is in place my attention goes to my next project, and well..........you know how it goes.  So far my skin is doing awesome (knock on wood) by cutting the bandage portion off my barrier and using the 3M tape instead.  Which gives me another excuse to look into it some other time.  I know, I know......some people never learn.  I'm definitely THAT guy!  Thanks for the reply!!

regards,

bob

Hi Bob

i believe I have the solution for the red weepy skin.    It is a rash from being wet. So the thing to do is buy the smallest little hairdryer you can. (800 to 1000 watts.)

Absolutely every time you shower or bath or hot tub or anything else that gets your appliance wet you must use the dryer to get it bone dry.  Magically your troubles will disappear, I know because I went through it, like you i tried all kinds of stuff to no avail.   Then it dawned on me that the area was primarily on the perimeter of my appliance when it first started and the light came on.  So I bought a small hair dryer years ago and I have NEVER had a problem since.

Note: It also is used to heat my appliance before I attach it to my skin, which makes for a better seal.

I have a urostoma and use the two piece Hollister appliance.

I have a number of other things I can tell about how I do look after my stoma etc.    Is anyone interested?

Jim

Ahhh.....Jimbo.......I wish it were that easy!!  I do use a hairdryer while changing my barrier, and I also use it to heat up both my skin and the barrier/ring before I apply and after.  In terms of getting wet......I usually shower every other day and remove my barrier while showering.  In the summer I shower every day or jump in the pool.......depending on how I feel.  But I've even gone for  4 days without showering to get 2 barrier changes in and see if it affected the skin........but nope.  I think you're right in that moisture will cause problems..........it's just not the problem I have.  Or had, and will have again at some point.  So for me the mystery continues...........but what fun would it be having an ostomy if there was no mystery and suspense.  Or was that misery and suspense?  I forget.  But thanks for the great post......I'm sure it will help others.  

Keep 'em coming folks!!!

regards,

bob

I know Convatec makes a 2-piece pouch system that is entirely Stomahesive...no tape edges. It is non-accordion making it less flexible. I'm sure they would send you samples!

Hi MBT......thanks for that!  I'll check it out the next time it rains (or the next time I can't be outside).  I'm SOOO lazy when it comes to looking for ostomy products........I just can't get excited about it.  Woes me.  But thanks for the good input, as usual.  

;0)

bob

Hi Bob, I sufferred from a nasty rash and red, weepy skin in the first months of having an ileostomy. It really stung, especially if any output got on it. However, one morning I woke up and was in the half asleep/half awake state, when I heard the words Calomine Lotion. Well, that would be my mum, who worked in pharmacy all her life, and passed away at the age of 103. As kids, we always had calomine lotion in the house. Pooh-pooh the message all you like but the fact is I tried it, a light wipe of calomine on clean skin at every bag change and I haven't looked back. My skin has been just fine since 2017. The zinc is anti-inflammatory, and very soothing. One cotton pad, one dab of calomine, and work around from the outside to the inside. Lightly blow dry with a hairdryer before you apply the new bag. The bag stays stuck, too. I change bags 2-3 times a week. 

Thank you for the info on 3M micropore - I live by the beach in Western Australia, but I've been nervous about going in the ocean. Sounds like it will be worth a trial next summer.

Hi Perilune,

 Thanks for the info.  I've tried Calomine in the past, but maybe applied it too heavily...........as nothing stuck to it.  But I'll try it again with a lighter application and see what happens.  Sometimes it's all about the process and not the product.  I appreciate the info.  By the way, I was in the pool all weekend and the Micropore still looks pristine.  It's amazing stuff.  3M also makes other surgical tapes that have more and less adhesion........so if for any reason the Micropore doesn't do the job........you have other choices too.  Thanks again!

regards,

bob

Hi Perilune,

 Well...........I hit a couple stores today, including CVS and Walgreens and couldn't find a Calamine Lotion with Zinc in it.  Seems they all only have a couple percent Calomine and 1% HCL.  That's it.  I did find one anti-itch product with a percent of Zinc Oxide in it........but it had no Calamine.  So can you tell me the brand name of your Calamine Lotion that has Zinc in it?  Looking forward to trying it.  

thanks,

bob

Boudreaux Butt Paste has 16% zinc oxide.

Hi Bob, I purchased mine years ago at a local pharmacy, what you call a drug store, I guess. It lasts for ages. It contains Calamine B.P. 15% and Zinc Oxide 5%. It is made by Sanofi-Aventis Australia Pty Ltd, 12-24 Talavera Road, Macquarie Park NSW 2133 Australia. However I believe it is also available from the Ostomy Association here. So that's where I'll get my next bottle when this one runs out. Good luck! Jean

Hi Guys,

 Right after I posted I found that "Calamine" by definition contains zinc........but they don't specifically call out those ingredients on the package.  How much zinc is anyone's guess......but it's supposedly in there.  I was going to post immediately, but other than Ritz's announcement, the forum has been kind of tame lately.......so I figured I'd let you guys run with it.  It's gonna be hard to look the cashier in the eye as he's ringing up my Butt Paste........but such is life!!

;0)

bob

Ok, just tried some calamine lotion this morning.  Ivarest actually, but same difference.  Felt nice and cool while it was doing it's thing, but only left it on for 5 min and then wiped it off.  It's a bit of a pain wiping off with plain water.....meaning it takes a few wipes and I don't want to irritate that skin.  But it came off and we'll see what I get.  My skin right now isn't bad at all.....just a bit pink.....not red and weepy......but I'll see if there's any difference after I use the calamine a few times.  Can't hurt........although I've said that a few times in the past and had to eat my words.  

;0)

bob

Bob, why did you wipe it off? I just wipe a light layer of my quite liquid calamine around the area covering all the skin that will be covered by my appliance. Then I dry it with the hair dryer and then stick the bag on. My calamine is a lotion. What are you using, that you needed to wipe it off? I would not be able to wipe mine off as, once it dries, it is just a very fine layer of chalky pink. I would have to wash it off. I am a bit curious...  So, basically, once I have put the bag on, there will always be a fine layer of calamine between my skin and the bag, which seems to offer excellent protection to the skin, and I have never had a rash since I started using it.  

I like the simple life. 2-3 bag changes a week. The bag comes off easily, into the shower, get the skin nice and clean, and then get out of the shower, get dry, wipe on the calamine with a cotton ball or cotton pad, blow dry, and whack the new bag on. I don't think you can get simpler than that. I don't need any other products. So my stoma takes up very little of my time and attention and that has been the case for nearly four years now. My only complication is a hernia, from coughing a couple of years ago when I got the flu.

Jean

I will, however, try the 3M product for extra security for swimming. Here in Australia we get most products free, subsidised by the government. We just pay postage and membership fees. There are between 3-4,000 ostomates in Western Australia. I feel very lucky when I read that ostomates in the USA have to pay for supplies, which is hard when it is a lifelong situation. 

Hi Perilune,

  I wiped it off because you're not supposed to leave calamine lotion on for very long........per the directions, as it can irritate the skin.  It also dries rock hard and can be very difficult to remove from sensitive skin later.  On the opposite side of the spectrum I'll be working outside in the heat, and perspiration will break it down reducing adhesion..........and I just don't have time for leaks or issues right now.   Sounds like a good winter-time thing......but I figure some time on my skin is better than no time.  Your routine does sound simple..........it would be nice to get there. We'll see.  I'll let you know how it goes!

thanks,

bob

I'm so sorry skin issues are such a troubling issue for so many ostomates. There doesnt seem to be any one magic treatment that works for everyone- here are some of the things that I have heard and found could work. 

For cleaning raw skin and helping treat weepy, water logged skin-

1.domboro soak(powder packets from drug store that mix with water) used to help dry out weepy skin like from poison ivy.

2.Homemade version we often recommendis 1/2 white vinegar/1/2 water on soak for a few minutes-doesnt burn Im told and works like an astringent to help dry theweepy skin out. It is recommended for ostomates who have pseudovericular lesions  (overgrowth tissue from constant leaking) 

3. If you truly think it is fungal or bacterial- you can get VASHE (hypochlorous acid) on amazon and has a cooling sensations and kills bacteria. We use is in wound care a lot

For itchy skin - your right that short courses of topical steroids can really calm down skin (don't use too long as it can thin the skin)

There is olux foam (clobetasol foam) that can sit for a few minutes and then wipe off-works really good for the ostomates I've had try it

Cordran tape- it is a steroid infused tape that should be able to stay in place under wafer depending on how close it is to the stoma

If heat/moisture is an issue - there are antipersperant wipes on amazon that can help with sweat causing poor adhesion- they last 7 days
Marathon and cavilon advanced have been helpful to some - they are also expesive and I tried both from rep and broke out with itchy rash from both of them.
i've read on the forums about the topical flonase and showering with head and shoulders but don;t have any experience if these work

End result-just like Bob says -you have to be perisitant and share any knowledge to be able to learn from each other.

Thanks for all the advise I am sure it will help some folks out.

I know this will sound weird, but I found a solution to the red weepy sin!  I'm 67 and have had atopic eczema since I was an infant.  I was getting the red weepies under bandages I use to help fortify the bonds on my bag and the adhesive ring around the wafer.  Solution?  FLONASE!!!  I spray it on my fingers and then around the affected area.  My skin has been BEAUTIFUL for months now!!!  Just make sure the area is dry before putting on your appliance.

Hi she,

  Yup........I did that for awhile.  Then it just stopped working.........or another problem took over.  But when it worked, it did work well.  It means there's an allergic reaction to something and Flonase is a synthetic glucocorticoid steroid.  Got to love them steroids.  Enjoy it for as long as it lasts!!!.......hopefully for a very long time!!!

;0)

bob