Skin rashes can be caused by several different things. Most commonly, it's a leak from under the barrier. When you have an ostomy and thus a much shorter bowel where you're losing a lot of absorption, our waste is much more acidic - thus it can and will cause irritation to the skin if allowed to touch it for a length of time. Second, frequent changes in your barrier are rough on the skin. Thirdly - everyone's skin is different, and can get an allergic reaction to the adhesive on certain brands. Not every ostomy manufacturer uses the same adhesives and chemicals in the manufacturing of their supplies. I've heard of people having terrible allergies to certain brands, and have to try 4 or 5 different manufacturers before finding one that agrees with their skin.
When I get a rash or skin problem, what I do is plan ahead for my change - don't eat or drink anything for several hours before going to bed - then when I get up in the morning, I watch my output - when it slows to pretty much nil, and I'm getting nothing but air, then I know my system/bowel is pretty clear. I go through my normal routine of washing the skin, then I apply an ointment especially made for skin rashes. I work it around, then I grab a small towel just in case I get a hiccup of output, then I go sit back or lie down and relax for at least 20 minutes to let the skin breathe and give the chance for the ointment to sit on the skin. When I'm ready to finish my appliance change - I go back to the bathroom and wash the skin again to remove all the residue from the ointment that would prevent the new barrier from sticking, I then sprinkle some stoma powder on the red area - this will keep the red area dry when I place the new barrier around my stoma - if the rash is really bad I will place a small piece just big enough to cover of solid gauze material my ostomy nurse would always give me - this helps the skin to breathe and also keeps the barrier adhesive off the red skin, and 9 times out of 10 when I did my next appliance change in 5 days or so, the skin would be all better.
