This topic is about dealing with eczema that has developed under the wafer of an ostomy appliance. After many years of using the same appliance without issues, the person is now experiencing skin irritation and is considering whether switching to a different type of appliance, such as a 2-piece system, might help. Here are some suggestions and insights shared by others:

1. Consider trying wafers or adhesives from different manufacturers. Sometimes, skin can become sensitive to a product after years of use. It's a good idea to request free samples before making a switch.

2. Experiences from two-piece system users:
- One user found that the Hollister New Image two-piece system, combined with Welland Hydroframe half-moon frames, helped keep the edges secure and seemed to calm the eczema.
- Another user had success with the Convatec SUR-FIT Natura Moldable Technology Durahesive Skin Barrier with Hydrocolloid Flexible Collar, which provided good adhesion without causing skin issues.

3. For topical treatments, non-steroidal creams that have been helpful include:
- "Moo Goo Eczema and Psoriasis Cream"
- "Ego QV Cream" and "Ego QV Lotion" from Ego Pharmaceuticals
Apply a thin layer of cream, then dust with Stomahesive Powder before placing the wafer.

4. Medicinal treatments that dry quickly and maintain adhesion:
- Nystatin (liquid) combined with Betamethasone valerate foam can be effective for inflamed or weeping areas, though it can be costly. It's best to limit steroid use to short periods.
- An asthma steroid inhaler spray, prescribed by a stoma nurse, can be used once daily to clear the rash in a few days and can be applied at the first sign of a flare-up.

5. For mechanical adjustments to address isolated irritated spots:
- If the irritation is near the outer edge of the wafer, consider cutting that part of the barrier away to allow the skin to breathe.
- If the irritation is close to the stoma, cover the spot with a flattened piece of barrier-ring material.

These suggestions aim to help manage eczema under the wafer and improve comfort and skin health.