Seeking Advice for Treating Raw Skin Around Stoma

My skin is raw around the stoma due to many breakages. I got new wafers which work great but can't clear up my skin. Any suggestions?

I have found using a wipe, powder, rewipe, more powder and a third pass of the wipe will clear the area in a day -- be sure the bags are the correct fit -- you may need the convex rather than flat bond that some suppliers offer -- such as Sensura Mio. Good luck.

Hi, my name is Marsha, and I've had my ileostomy for well over 50 years. Skin irritation around the stoma is an ongoing issue.

Because my stoma is now almost flat to my skin, I switched to a moldable, convex wafer... I've always gotten 5-7 days wear out of a wafer, even taking showers and going swimming. Too much hot water will loosen the wafer (Convatec) and turn it to mush, so I avoid baths and hot tubs for extended times. Regarding skin care, I never use soap (and don't take off the wafer in the shower). The oils from soap or shampoo/conditioner can inhibit adherence. I use hot water first to clean and open the pores, and then cold water to close the pores (and stop any itching). I use stoma wipes to clean the skin, even the raw part around the stoma. It does sting a bit. Then I use Stomahesive powder on the skin and around the stoma, brushing off the excess. The opening on the moldable wafers (rather than the cut-to-size flat wafers) can be stretched and fitted around the stoma, actually forming a collar. It's possible to get more powder in between the skin and wafer, or use some Stomahesive paste in addition. It's more about trial and error to see what works well for you. I went to the regional conference in the spring and have samples of many newer items, but have not tried them yet. Just a little anxiety, despite my 50 years of experience. It's always difficult to try something new. Best of luck to you. Write if you have more questions.

Thanks Marsha, what stoma wipes are you referring to? I do use the stomahesive powder which helps but have to change wafer every day to get the raw skin cleared up. I used to have quite a few breaks and of course it made my skin raw so am now using the moldable wafers but have to get my skin cleared up!

In the beginning (I am now 4 months post-op), I was having major problems with my skin irritation around the stoma. Part of the problem was the leakage, which was really irritating the area. We changed the wafer to a convex type and then within a day or so of using Adapt stoma powder and the skin barrier wipes, my skin was healed....to me, it was a miracle. Now when I change the wafer (twice a week), we put just the skin barrier on...let it dry and then put on the wafer. Once or twice we have followed the skin barrier application with the stoma powder (during the summer I had some minor irritation)....it works. Good luck.

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Thank you!

Hi Nonnie,

I've been using Smith and Nephew Skin Prep for as long as I can remember. There is now a "non-sting" version, but I prefer the original. I like the "sting". The prep helps toughen the skin under the wafer and is also a "healing agent" for the irritated area.

My question to you is, "How irritated is the area?" Is it just the ring around the stoma... or does it continue under the wafer? For me, there is ALWAYS some irritation around the stoma, so I just continue the same skin care. If your skin gets irritated under the wafer too, it's not always from the leak. When you remove a wafer that's partly attached to the skin, it can cause irritation and even pull off some healthy layers of skin. If you don't already use them, try "Unisolve," which lets you remove the wafer (and any adhesive residue) easily from your skin. But be sure to wash the skin well after removing the wafer. It leaves an oily residue that impairs adhesion of the new wafer. If the skin around the stoma is really irritated (that it looks infected), mix a little Neosporin with stomahesive powder and try to press the mixture close to the stoma. Or try to get some on the area when the new wafer is in place.

I've had issues of Pyoderma Gangarosum (Ulcerative Colitis on the skin), so for me, a simple irritation can become a deep hole the size of a dime. That is a nightmare, but there were products out there to help me heal the area, even under the wafer. You don't need to be too concerned with a slight irritation around the stoma as long as it doesn't spread.

Best of luck,

Marsha

Thanks for the tip, Marsha

I use the same brand wipes and they do not sting my skin but they are also the only ones I am not reactive to. The Convex Sensura Mio was the breakthrough for me -- the bag fits right and no leakage unless I am careless in waiting too long! I used to have blistering but no longer as long as I am careful to fit it and if something starts to irritate, I just use the powder with the wipe and it heals right up....

Good luck!!

Try using karaya powder. Sprinkle it on the surface of the raw skin then apply the wafer.

X_

Nonniestar--When I first started using an ostomy appliance, I developed sores around the stoma from a combination of leakage and just plain sensitive skin. I found that Anacept was a terrific gel to help heal the skin, but it is a prescription item and your doc (PCP or surgeon) will need to prescribe it for you. Also, check with your insurance because it can be costly if not covered. Once things got under control, I began changing daily, after showering. I only use a barrier wipe, no moldable wafer, and the Sensura Mio pouch. If my skin gets irritated, the powder will usually help the problem, but I have found the Anacept to be the best solution.

Peace

Nancy

Doesn't the powder keep the wafer from sticking? I can't wrap my head around that! Powder will usually not let any type of tape-like adhesive stick.

Hey Pam, please read Ewesful's post above.  She describes the method called "crusting".  You're right about powder compromising the adhesion but the crusting method works.

Mike

Geez, I thought I remember reading that a light coating of milk of magnesia, if left to dry, would help make your skin heal as well as be okay for putting your pouch over it.

Anyone else remember something of this nature being posted before?

I have used witch hazel to clean around my stoma, then use a barrier wipe, and have not had any problems with irritation or sores.

Hi all, I use calamine lotion around my stoma and that helps my skin to heal if I get a sore spot.

Hi, regarding your post about "powder" interfering with the wafer sticking. Stoma adhesive powder is now like body powder. It has a healing property, and in addition, helps the wafer seal irritated areas. The formula actually blends with the wafer. I use a two-piece system, so after I get the wafer on, I "squirt" some of the powder between the stoma and the wafer, just to seal up a potential gap. Then I attach the pouch. BTW, the "powder" is also good on any other skin cut or irritation on the body. It forms a seal or crust and allows the skin to heal.

Best of luck

Marsha