Issues with Covotec Moldable System and Skin Irritation

I've had my ileostomy since January and have been adjusting just fine.

I started to get a lot of itching about 3 weeks ago and soreness. I saw my surgeon, and she advised antifungal powder. I've been using that and the ostomy powder and forming a crust. It's not really getting better. For some reason, I started having leaks last week and just had another tonight. Thankfully, both times I was in a place where I could address it. I use the Covotec 2-piece Natura Moldable system. I feel like it's starting not to work for me. I don't use the Eakin because it adhered so much to my skin I couldn't get it off. I use barrier strips too.

Anyone experience trouble with the Covotec Moldable system? Just curious.

Thanks!

G-Day pianowooster, 

It sounds like you need to try another make. I know we are all different, and ones that are good for some are not for others.

I use Hollister 2-piece and settled on this make after trying so many others. Talk with your stoma nurse and get your skin repaired, and then try other brands. But you really should be using a sealing washer as well under your wafer.

Regards, IGGIE

I use Hollister brand.

I use Hollister brand. Those Eakin rings really stuck to me too, which aggravated my skin. I am a redhead, so my skin is very sensitive. My routine is to remove my appliance, shower, and if my skin is really sore, I mix 1% cortisone cream and Canesten cream and lay down for about 20 minutes, which allows the skin to absorb, wash it off with Cetaphil, apply Brava barrier cream, rub it in, and use a damp paper towel to make sure there is no excess, dry thoroughly. At this point, I apply stoma powder (also antifungal powder if needed), I use Cavilon skin protection, and then my barrier ring. One thing that really helped me was to make sure my template showed no skin around the stoma. At first, I was leaving a bit of space, which caused turtlenecking of the ring that ended up exposing my skin to acidic output. I know it seems like a lot, but it really made a big difference. Don't overuse cortisone as it thins the skin. As for the itch, Benadryl works wonders, and an ice pack also quells the itch. If you're really puffy and swollen, Anusol helps too (models use it for eye bags). Also, I put Hollister Adapt lubricant and hydrogen peroxide in my bag, which helps with odor. Once my bag is on, I press everything for 30 seconds to make sure it's well sealed. Trial and error will eventually get a routine that suits you.

You have quite the chemistry lab experiment going on with all that stuff you use. 😬

Living with Your Ostomy | Hollister

I use the Coloplast SenSura Mio on both of my stomas.

I've had success with the Adapt barrier ring. It is not as sticky as the Eakin seal. You really need a barrier ring to help protect your skin.

I've not tried this myself, but I've seen calamine lotion recommended for itchy skin.

Hi Pianowooster, sudden leaks mean something suddenly changed. Remeasure your stoma; it usually shrinks in the first five weeks or so, but maybe it's different now. Maybe try a convex wafer if you're not using one already.

I've had 2 leaks in the past week, and it thankfully happened while on the toilet. I do rinse my bag with a squeeze bottle. I'm not sure if that has anything to do with it. I have to rinse it because my output is so thick. I use a two-piece Hollister system and use the barrier ring and powder. I'm so frustrated.

Reach out to ostomy suppliers like Coloplast. They will send you samples until you find what works best for you. My advisor at Coloplast worked with me for 6 months or better until I found what worked best. Please reach out to them! Take care!

You should also try different systems. Call for samples.

Does your stoma stick out an inch? If not, try a convex wafer.

With a colostomy and thick output, you may wish to consider closed-end bags. You'd replace the bag when it fills instead of rinsing.

Hi piano,

I have a urine pouch but can advise as far as the yeast because I had that once too. I ended up having to see a dermatologist. The stoma nurse did not work for me either because I was given the same advice as you. It was biopsied and came back as fungal. The dermatologist put me on a prescription cream called ketoconazole, but that wasn't a good fit because my pouch would not stick. Another thing I was given was a 14-day dose of Diflucan pills. I took a 200 mg pill per day. I think more than anything, the Diflucan pills worked.

I use Hollister 2-piece, and it works great for me. Hardly ever a leak. I also use a ring. If you don't use a ring, try using a ring to prevent leaks.

A lot of good advice here by experienced folks on this site; they're so helpful and compassionate! I've been living with my ileostomy since Thanksgiving last year, and I've come a long way since I got out of the hospital! One thing I learned from them and from personal experience is that everybody is different and unique, so what works for one may not work for you. But try the different products until you find one that works for you, then stick with it until you need to change again for whatever reason.

I definitely had leakage issues if I didn't use a barrier ring. I've had the best luck with Hollister Adapt Rings; for some reason, the other brands didn't work as well for me. I also use an adhesive remover during my changes (non-alcoholic ones designed for peristomal skin). That makes removal less damaging to the skin and helps remove the ring if it's still being sticky. I found that if my cutout was too large (you have to be sure your cutout is as close as possible around your stoma without impeding it), or I didn't place the wafer around my stoma "just right," the fluid output would make the skin around my stoma itchy during output. Stoma powder and Cavilon barrier spray work great for me (don't let your supplier substitute with some no-name brand; Cavilon is the gold standard. Use a different vendor if they won't give it to you; I had to for this reason). Coloplast's barrier spray is also acceptable, but Cavilon is the best (for me) IMO.

Work with an ostomy nurse if you have access to one. They've been great for me and have access to all different types of products you can look at and then ask for samples to try (from the vendors, all of whom are great at providing samples to try).

Ileostomy stomas will always have more liquid output, thus are more prone to leakage because the liquid will eat away at the barrier seal, and you have to find the balance of food, meds, and ostomy products that work for you. I have a partially flush stoma that barely sticks out above my skin on one side and is flush on the other half, so I have to use a convex bag (Coloplast light convex, 2-piece) with a barrier ring (Adapt) to get a good seal, along with stoma powder (I found any brand seems to work for me) and barrier spray (Cavilon) to make it all work together, in addition to food changes and taking loperamide. Let me tell you, it was a process to figure all these combinations out! Good luck!

Yes, it takes time and a lot of patience, but you find what works best for you! A lot of good information here! We've all been there, done that...lots of good folks here!

Yeah, you're right. Mind you, I don't leave it on for more than 20 minutes as it absorbs in that time. My skin was so sore at the start that, between me and the stoma nurse, this system works well for me. It's not necessary to use it every time, as the Brava barrier cream is amazing. Another thing I found was that if I showered and got my appliance wet, or I got really sweaty, the skin problem happened, so in those instances, I change the appliance.

If it happens when you get it wet or when sweating, it could be a fungal infection. See your stoma nurse. Plus, you are using so many chemicals, more than the norm; it could be one of those causing a problem. Talk to a dermatologist.

Regards, IGGIE

Absolutely! I discussed it with the stoma nurse, and she's the one who helped me develop a regime that keeps my skin clear and itch-free. If you have ever seen a video from Stealth Belt, they recommend changing your appliance more often rather than trying to keep it going for days. Luckily, the province covers 75% of most ostomy supplies, and anything the province doesn't cover, my pensioner's plan covers 80%. I consider myself extremely lucky to be a Canadian with excellent healthcare.

G-Day Kyle,

Trying to wear your bag too long is number one for getting problems. I change every Monday and every Friday.

In Canada, you have the SALTS products. I use their Salts Seal/Washer; it has aloe infused into it, and it's fantastic for your skin. They will send you a sample for free. Just tell them the size of your stoma.

Regards, IGGIE

Thanks for the advice. I generally change my appliance every 3 or 4 days. I can't use aloe because I have a latex allergy. It's amazing how many plants other than rubber trees contain aloe.