Help! Need Solutions for Red Weepy Skin!

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w30bob

Hi gang,

Update time. So I changed my barrier this morning, but before I did, I sat down and re-read that peristomal skin article I gave a link to. This time, paying attention to the order of things. After re-reading everything... I might just be overthinking this whole thing. Not that I've ever done THAT before.

So in summary, the article lists the most common causes of peristomal skin irritation, and they are:

Mechanical Trauma

Irritant Dermatitis

Infectious Dermatitis

Allergic Reactions

Pyoderma Gangrenosum

So, okay... let me walk through those. The first one I've always pretty much skipped over, looking for a better reason than that. And that might have been my undoing. But I'll come back to that.

Irritant Dermatitis is primarily caused by leakage. Simple enough... I'm not having any leaks... and believe me, I check. Also, when I do have a leak, my skin in that area turns a deep dark red... not pink or light red. So this ain't my poison.

Infectious Dermatitis is primarily where I focused my efforts previously. This includes fungal infections and folliculitis. Never saw an issue with the hair follicles, but did get some relief a few months back by using an anti-fungal... so this one is in play.

Allergic Reactions. This is also where I thought my problem might be coming from. The way the redness just peeked past the barrier seemed to indicate it was caused by the bandage material. So this one is in play.

Pyoderma Gangrenosum. From what I see in pics, it doesn't appear this is my problem. But this is serious shit, and if it spreads to my bowel, I'd be in some serious deep crap. So rather than trust my gut, I'm engaging my Gastro and Derm Team to make sure I can rule this one out. Stay tuned for that.

And that's pretty much it. So I've been treating it like it's either an infection or an allergy... and nothing is working. So what does that tell me... well, maybe it's neither of those. I won't say for sure it's not... and may continue treating like it is... but sometimes if it quacks like a duck and walks like a duck... it could be a goose.

Which brings me back to the very first topic, which I continue to overlook. Mechanical Trauma. So I thought about that for a second. My skin is pretty tough, but having adhesive applied and pulled off, being shaved, and then covered tightly every other day might just be taking its toll. I mean it DOES do better when I uncover parts and just let it breathe in between changes. So could it be I've simply been overlooking the obvious? Well, maybe I guess.

I've got a few days before my Gastro gets back from vacay, and I don't see the Derm Docs for another week or two... so I got some time to think about it. Today I put some ice on the whole area, which felt great, and was about to apply a protectant sheet... but decided against it. I've got to sort out the whole how to deal with the extra thickness and how far from the stoma I should cut the hole (so my ring still functions properly without being too tall)... and standing over the skin with the clock ticking isn't the place for that. So I dried everything real good and went back to the Marathon protectant... as I had some good progress with it. Maybe I just didn't keep at it long enough. So... for those concerned... I'm doing okay. As long as SOMETHING still sticks to me... I'm good. So the saga continues... and with your help, we'll eventually crack this tough nut. And hopefully, someone else might find the info useful.

Oh, I should note... the other reason I'm not leaning toward that wonderful Pyoderma Gangrenosum as the culprit is because having that this long without treating it should have landed me in really, really big trouble by now... and I'm not even seeing the slightest of ulcerations, a hallmark of this nasty crap. But like I said... I'll have it checked anyway, as it's too serious to ignore.

Everyone, have a fantastic day!!

Bob

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Dixie1

Hi Bob,

I've been reading your posts about red weepy skin around your stoma. I am not sure if someone has already mentioned this, I may have missed it and I apologize.

Have you ever heard of Karaya powder made by Hollister? Adapt also has a paste. Years ago, there used to be Karaya rings that were great but are no longer manufactured. Why stop making a product that people used with great success? It makes as much sense as the captain of the Titanic thinking they just lightly bumped into something in the night.

I will say if skin is weepy, it is a healing agent. BUT, oh yes, there is a BUT. It stings like no one's business! Like have a shot handy and bite the literal bullet and put it on.

Karaya is a natural element. Gum karaya or gum sterculia, also known as Indian gum tragacanth, is a vegetable gum produced as an exudate by trees of the genus Sterculia. Chemically, Karaya is an acid polysaccharide composed of sugars and galactose, rhammose, and galacturonic. It is used in food products as a binder, like frostings, but I don't think Duncan Hines Devil's food icing is what you're looking for!

I also have red weepy skin, and this is the only thing that has ever worked for me. As I say, the rings were great but no longer made. However, the powder can be mixed to make a paste, but you have to work fast as it acts like contact cement. Until you get the right quantities, it takes a bit of experimenting.

I take some Amphogel or Pepto Bismol on a cotton ball, coat the area around the stoma first, and then gently start applying the powder. It has a nice fine nozzle, so you get a nice even amount in a precise way.

I've never consulted a dermatologist, and any stomal therapist I've encountered all must have gotten an A+ for the best "uhm try to look like you know what they're talking about" face in school.

I tend to go it alone to figure out any issues that have come my way.

I hope this might help.

:)

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w30bob







Hi Dixie1,

Thanks for the reply. I have heard of Karaya.........Maried turned me on to it when I wrote this topic. I ordered some.........or at least I think I did.........so I'll go check and see what's what. It sure won't hurt to try it. You're not missing anything by not contacting a Derm Doc. I was going to write a new post about it........but never got around to it. I should have known something was amiss when the lady on the phone who booked my appointment called the Derm Doc 'Kenny' instead of Dr So and So. When I showed up for my appointment I brought a couple copies of a PowerPoint presentation I put together about my skin irritation problem. It showed my most recent pics of my skin issue (from the morning before), as well as pics from the past few years....showing what my skin should look like.........and also included a list of all the possible skin conditions it could be, as well as all the things I've tried that showed it was none of them.

So I get there and I fill out the 7 pages of new patient paperwork......so much for the digital age.......and take a seat. After 10 minutes or so the Doc's assistant shows me to my room and asks me what the problem is. So I hand her a copy of the presentation and say.........you read this.......and I'm going to go take a pee. Be back in a minute and we can talk. So I go and come back and she's got that weird look on her face. She asks me a couple questions, like is it painful, bla, bla, bla. Then she gets up to leave and says the Doc will be right in. So a few minutes go buy and in pops the Doc. I say Doc, but he's really a PA. So here I am, with a pretty 'different' skin condition........and I get to see the PA. Ok...it's gonna be one of THOSE appointments. So he introduces himself as........you guessed it.........'Kenny'.....and I hand him a PowerPoint presentation. He looks at it, makes a few 'uh huh' sounds.....and then looks me right in the eye and says........wow, this looks bad. He then says.........I don't know what I can do about that stoma Mr. B.......it looks bad. And I say.........Kenny.......the stoma isn't the problem........the stoma is fine. It's the bright red weepy skin AROUND the stoma that's the problem! And he goes......OH! By this point I had lost all hope of this turning out to be an appointment where I actually learned something........so I just sat back in the chair and figured I'm just along for the ride on this one. So I direct ol' Kenny..........who looks about 16 years old, with a bad case of acne.........imagine.......I'm seeing a Dermatologist with acne! That pretty much says it all, doesn't it??? So I direct Kenny's attention to the list of things my skin irritation could be........and what I've tried. He reads it out loud and then gives me that 'deer in the headlights look' that I'm getting used to seeing when I see Dermatologists......or their underlings. So he kind of shrugged his shoulders and said.......'wow, I don't know'.......'have you tried Hydrocortisone?'. I seriously considered reaching out and slapping his acne-ridden face with my open palm..........but thought better of it. That would just get me into a discussion with our local Sheriff, whom I know fairly well.......and would consume a lot of time......so I decided against it.

So at this point I knew for sure I was wasting my valuable time. It's true that it was worth the 25 copay to see that look on his face when he had no answers, but now it was time to get going. I had lots of chores to do back at the ranch.......and that new KFC chicken sandwich I'd promised myself I'd try was calling my name. So my new buddy Kenny handed me a few tubes of some new topical steroid and wished me good luck.........and off I went. And so went another epic failure of the Dermatological industry to even slightly impress me with their understanding of skin problems.

And thus was my most recent encounter with Dermatology. When I got back I sent the Ostomy Nurse at Georgetown hospital in DC some pics of my skin irritation and told her what was going on. She got back to me a couple hours later and said she was impressed by not only what she saw, but by all the things I've tried to alleviate the irritation that failed. She asked me a few more questions, that I sent back answers to........and now I'm waiting for her reply. It is sort of disheartening when the Ostomy Nurse......whom you hope has pretty much seen it all when it comes to peristomal skin issues........gives you the same 'deer in the headlights' look that the 16-year-old Dermatology PA just gave you......even if it's by email. But unlike him, this Ostomy Nurse wants to get to the bottom of what ails me. So the saga continues.

Stay tuned to hear how this plays out......and I will go check on that Karaya!!! And then I'm going to sit down and write up my bill for Kenny.........for teaching him everything he now knows about peristomal skin problems. And I'm a VERY expensive teacher!!

Thanks again Dixie!!!

Regards,

Bob

w30bob

Hi c,

Yeah, I hear you regarding the vitamin deficiencies, as well as that of zinc.   I do supplement all of those things, and have my micronutrients checked twice a year.   At last check, I was fine across the board.   I'm due again, so will see if I'm deficient in anything now.   Thanks for the heads-up!

Regards,

Bob

NewlifeVictoria

Hello all my beautiful friends.

How's everything? Are you all doing okay?
We can only try and try again!

I'm not really good with sharing stuff, and I don't want to tell somebody something and it not work, but I hope you feel better soon!

I wonder what everyone uses? I don't really use anything but water (actually, I use electrolytes essential water, and that's when I'm sitting with it as I do often, and it's how I watched the medication come out before. It took a long time to do this, but I have found it is what it is, and we have to take care of it/ourselves!

I get irritated around the stoma a little but real close to it and use the Nystop (but not much because it will help the flange come apart), and it works well. And I will say that I don't think using a bunch of stuff helps anything! Just how I feel about it! I don't want to really use a lot of different stuff, and I think sitting with it for a while works too...for me!

I also have problems with prolapsed and scar tissue and (had (blockage). I think it's all good and helpful, but when you're all healed up, does it matter with scar tissue? I was told no, but I'm 2013 from colostomy and ileostomy now and been through a lot as you all know me...septic shock was horrible from a knick of bowel, well, and did I say many prayers!

Try nothing, maybe you change it a lot, maybe pull on your skin like that isn't good. I change every 3-5 days or even sooner, but I think a combination of too much is too much. I think anyway it's been my experience with this happy place. And you have to give it love.

I hope that this just makes you think to stop everything and not change every other day anyway. For you, Bob, you know what I'm saying... I know you do. Good luck.

I'm thinking you're thinking? Haha jk.

How can you sit with your stoma? Well, just ask.

Have a wonderful time-- LOL.

I'm trying to make something out of nothing, and it seems to work in my head because it's been too much like all of us here!!
The weight gain too...omg.



By the way, I try not to read the internet and just try on my own and my skin. I do have other issues.

But try it. Definitely can't hurt!

 
Stories of Living Life to the Fullest from Ostomy Advocates I Hollister
Past Member

Hi Bob, I am sorry that your skin is so red and sore. These are a couple of things I do for my son. When his skin is red, I put a wafer under the base plate and another on top of the base plate just to make sure that nothing is leaking while his skin repairs. Another thing we do is put colloidal silver on the sore skin, and he lays down with nothing on his stoma for a while. Lots of tissues on hand to catch any output before it touches his skin. Occasionally, he will lay outside in the fresh air and sunshine too. (Not for long).

w30bob

Hi guys,

Thanks for all the help and tips.......lots to think about and try. After talking to my local, but useless dermatologist.........and the ostomy nurse at G-Town......there hasn't been any definitive cause found yet for the red and weepy blues. My skin is getting better, still red but not weeping as much. I'm doing a couple things to get it to calm down, and the problem with that is you never know which one thing you're doing is what's making it better. It could also be a combination of things. But what I do now is after I pull my barrier and the Micropore tape......I clean it all up with just the Coloplast adhesive remover wipe and water (on paper towel). Then I shave it quickly, so as not to irritate the skin any further, and then I put an ice pack on the whole thing for 5 minutes. I'd do it for longer, but I get really bored staring out the window over the sink. I found a gel-pack with a hole in the center that exactly matches my stoma.....I think it's for a knee or elbow. So I made up a Velcro belt for it so all I do is pull it out of the freezer and slap it on. Feels good too! Then I basically throw the kitchen sink at my red weepy skin.......I start with the anti-fungals, then the anti-allergy stuff and finish up with the topical steroids. The other thing I changed is I now fully cut off the bandage portion of the Hollister barrier......and I use two rings to completely cover the rest of the Hollister barrier. So my skin is now only touching ring material around my stoma and I use Micropore tape around the periphery to hold the barrier to my skin......instead of the bandage portion.

I've done this twice now. And the first time I pulled the barrier (after wearing it for 2 days) everything looked pristine on the barrier (i.e., no leaks) and adhesion was better than with a single ring and the bandage portion of the barrier. So I may have stumbled onto a way to extend my barrier wear time at least another day. Which is what I did this time around. This morning would have been my second day with it, the day I'd usually change it.......but it looked and felt so good I said screw it and jumped in the pool. I'll change it tomorrow morning and see what's what.

I still think the best 'medicine' would be to let the air get at it........but that's just not practical in my case. I did look into the Nu-Hope Adhesiveless barrier......which is basically a large silicone O-Ring held in place by a belt. But unfortunately they only come in circular O-Rings......and my stoma is a big fat oval. So my search is on for OVAL silicone O-Rings!! But most importantly.....things aren't getting any worse......and they may be getting better.......so we'll see.

That's good news, as I just got that letter in the mail saying my favorite gastro was leaving G-Town and her last appointment was last week. So much for my scheduled tele-appointment with her this coming Monday! And now I've got to train another one.........all over again!!! Got to love the medical profession!!

Again, thanks for all the help and suggestions!

Regards,

Bob

Axl

It's good to hear you have finally made some progress. It's no fun when things just won't work for you. You have extended your change time too. Good for you.

w30bob

Hi c,

Thanks for the concern. I'm not in the military... I work for the military as a civilian. But I do work on a Naval Air Station. The Pyoderma Gangrenosum is certainly something to be concerned about. I've checked and it doesn't appear that's what ails me right now. Interestingly, my skin is getting better. Not quite as red and not very weepy anymore... it just appears irritated. And no signs of the ulcerations normally associated with Pyo Gangren. What seems to be working... and I don't want to put the cart before the horse, but recently I've been wearing my barrier longer between changes... because using 2 rings allows me to do that. So I believe my skin is irritated from the continual contact I have with it from changing my barrier every other day... and just never giving it time to heal from that trauma. There's a caveat, but I'll get to that in a sec. So what I have found... is that by using 2 rings instead of one, and completely covering the Hollister material on the backside of the barrier... my skin is healing. Is the ring material what's helping... can't say for sure. But right now I cut the full bandage section off the barrier, cover the rest of it with ring material, and then hold it all on with Micropore tape. And that shit is amazing. What I do know... is that I can now reliably extend my barrier change interval by a day... and even then when I pull it off it looks perfectly sealed. So I believe I can easily go another day longer, which would double my wear time from every other to every 4th day. So I did make some progress in that regard.

That caveat I was talking about... not to alarm anyone... or even suggest a connection... but I went back and looked at the photos I take each time I change my barrier. I still want to do some more looking... but what sort of jumps out at me is that my skin was pretty decent for the past 5 or 6 years, all the while using the same Hollister products. And I've had no meds changes in that time or any even minor illnesses. The only thing I can see that changed... is... are you ready for this... I got the J&J vaccine for COVID on May 1st of this year. And that's about when my peristomal skin issues started. Again, not saying they're related... I need to research this more and really check my pics... but I remember hearing about blood clots in women with the J&J vaccine, which turned out to be rare... but I doubt they did any vaccine testing on ostomates and irritation can be confused with blood flow issues. So I'm paying attention to this, and my skin slowly getting better could be an indication of something related to the vaccine's half-life. So time will tell if there is any connection... but I can say with some positivity that all my previous skin issues were minor and cleared up with one of the things I'm currently using. The fact that none of those things are having any effect is strange. And in terms of the Pyo Gangrene... I've had bloodwork done and both CRP and white count are normal... so doubtful it's Pyo.

Will report back when I learn more... thanks for everyone's concern.

;0)

Bob

sunshine141052

Hi, regarding weeping skin around the stoma, my stoma nurse advised a scalp lotion used for irritation of the scalp and it worked first time for me. Hope this helps.

cathleenhenry

Have you tried the Ceraplus line by Hollister? It has ceramides to protect the skin.

w30bob

Hi guys...........thanks for the continued replies!!!

Cath, yes I've always used Hollister products. I'm not sure I buy into each manufacturer's hype about their products.........but I'm hesitant to change to another brand until I understand what the actual issue is. Otherwise it complicates results when I try different things and get different outcomes.

As an overall update.......I've now used just about everything......or I should say products that attack each of the possible problems that I could be having.....and I'm still not seeing an obvious solution. That really only leaves mechanical trauma from me dicking with it every other day. So I'm trying ways to keep my barrier in place with the least amounts of adhesive or tape. This is looking a little promising. I can't use Nu-Hope's adhesiveless barrier because their "O-rings" only come in circles.......and I need an oval. So I'm looking into having silicone oval "O-rings" made. That will take some time. I am in the process of talking to my regular ostomy nurse..........but that's not going to bear any fruit.....it's just a technicality so when the docs suggest I see an ostomy nurse I can say I already did. But I guess the good news is it hasn't gotten any worse, which means I can keep a barrier on as needed.

Thanks again for the support!!

Bob

Bill

 



Hello c57557555.

Thanks for your comments and suggestions. As far as I am aware I have never had any form of epilepsy, but low blood pressure and iron deficiency would explain most of the dizziness and collapses I have experienced over the years.

It has not really bothered me much, once I had a reasonable explanation for it, and the medics don't seem to have a cure for it, so one has to think these things through for ones's self.

Best wishes

Bill    

Ebony&Ivory

I recently tried a convex wafer even though my skin is smooth and even. I normally change my appliance every other day but am going 4 days now. It has decreased the leaking around my stoma and I'm completely healed up.

E I

Frank

Just posted this to another person. It's a wound care product that I use to clear a similar issue from leaks and continued appliance failures at the suggestion of a wound care nurse. It's magic for me.

Try ConvaTec DuoDERM Extra Thin CGF Dressings 4 X 4 Inches 187955 10, about 28 boxes of 10 on Amazon. A wound care nurse advised me to try them, and it cleared up 2+ years of dealing with skin problems due to leaks from an uneven area around the stoma. I take each pad and cut it into 8 strips, 1 x 2 inches each. I use 4 strips to picture frame the skin around the stoma problem area. I still use them at every change. The wear time on the appliance has gone from unpredictable to a comfortable 5 days with few exceptions.

bilingualadr

Hi Bob,

First of all, I understand your frustration. I myself have been through open sore hell to the point that I had more sores than skin under my flange. But with what I have found that works for me and with the help of my very "woke" dermatologist as well as a colorectal surgeon who was willing to prescribe off-label as well as other approaches, I have now not had sores for a few years:))))))

So here we go. From what you are saying, your skin is only "red and weepy", not open sores. Either way, if it is weepy, you can do the following. Buy yourself some DOMBORO solution packets (or generic version) at your local drug store.

Take HALF a small packet and mix it with HALF a cup of lukewarm water to dissolve. Once you have your flange off, soak a surgical sponge or gauze in the solution, squeeze lightly, and lay it over the angry skin. Keep it saturated and leave it on for at least 20 minutes. I have found that 20 minutes is necessary to see improvement. This is an astringent solution that helps dry out the weepiness and even open sores. It is a bit tricky to manage output during this, but it can be done:) Then allow it to air dry or help along with a hairdryer on low.

I would also say that you may be on the right track with thinking you may have an allergic reaction to something you are using. I actually use Nu-Hope pouches, and when the weather is hot, I can have some irritation under the outer edge of my foam flange. It was recommended to me to use the Coloplast medicated barrier wipe only on that area, and that seems to work for me. I use NOTHING else. Sometimes too much product is simply the problem. Or the way you clean your skin. I only remove my flange gently with the help of the Coloplast silicone adhesive remover spray and then the related wipe. It leaves my skin soft and clean. I do not use soap, water, or anything else because it is unnecessary. I then apply the mentioned medicated barrier wipe only around the outer area where the flange will sit, give a last dry with a hairdryer on low, and apply my one-piece pouch. Done. Hope this helps you be at peace with your precious skin.

Ebony&Ivory

Bilingualadr, I agree with you that less is more. I've found that I have fewer issues when I use fewer products.

In desperation, when my skin was really bad, I tried multiple products but never together.

As it's turned out, most of the problems I was having were allergies.

I've never heard of a medicated wipe. I'm going to check that out.

My ostomy nurse did suggest Domboro once. I don't remember the outcome, but it must have been okay. I would remember if it was bad.

Thanks for sharing!

E & I

w30bob

Hi Sunshine!  

Yes, I have tried Head & Shoulders shampoo a couple times. I see the Derm tomorrow, so this should be interesting. Thanks for the suggestions though!!

Regards,

Bob

w30bob

Hi Cath!

Yes, I've been using Hollister products since I got my front-ass, and did start using the Ceramide-infused barriers and rings when they became available.   It may, in fact, be what I'm allergic to... if I'm allergic to it.   It's a long story, but after I see the Derm Doc tomorrow, I'll summarize for everyone where I think I'm at.    

Thanks,

Bob

w30bob

Hi E..........That's awesome!! Glad to hear it!  

Regards,

Bob

Ebony&Ivory

Bob, I just came across your post again and am wondering how your skin problem is going. I hope things have gotten better.

E, I

JamesArnod
Reply to Maried

I 100% agree, any moisture under the barrier will eventually cause a rash. I shower every morning and use a small hair dryer (not likely to burn myself with a small 1000-watt dryer). I had a lot of problems before I started with the hair dryer and zero after that.

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