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Nov 20, 2020

Quick Relief for Red, Weeping Skin?

This topic is about finding quick relief for red, irritated, and weeping skin around a stoma, which can happen due to leakage and poor sealing of the ostomy appliance. The person experiencing this issue is looking for ways to soothe the skin quickly and reduce the need for frequent changes of the barrier. Here are some helpful suggestions and insights:

1. Skin-prep and barrier films:
- Use "No-Sting Skin Prep" by Smith & Nephew.
- Try 3M Cavilon No-Sting Barrier Film spray as a preventative measure.
- Consider using compound tincture of benzoin for irritated skin.
- Thorawoks or "TheraWorx" foam can be an alternative to standard barrier wipes and may help ease itching.

2. Powders, creams, and topicals:
- The classic "crusting" method involves layering ostomy powder with a protectant wipe.
- Lotrimin antifungal powder can be used before crusting to prevent or clear yeast-type rashes.
- Calamine lotion is noted by several people as soothing.
- Zinc-oxide diaper-rash cream, also known as "butt cream," forms a healing barrier but requires crusting over it before applying the appliance.
- Crushed prednisone tablets can be dabbed on raw skin, as shared by another member.
- Egg whites have been mentioned anecdotally as a remedy.

3. Appliance fit and sealing tricks:
- Check the wafer’s adhesive after removal; if one area is more eroded, add a sliver of barrier ring only in that spot.
- Use extra bits of barrier ring to build up dips or uneven skin.
- Some find paste works better than rings, such as Hollister Adapt paste (alcohol-based) or Coloplast Brava alcohol-free paste. Apply a 2–3 mm bead around the cut-out, press repeatedly, then warm with a heating pad for about an hour to set.
- Others have the opposite experience, finding that paste liquefies with high-volume liquid output, while rings last longer.
- Consider Eakin seals for a longer-lasting fill of crevices.
- Try using half a ring on the output side only, then apply a custom hernia belt to create more clearance for effluent flow.
- The newly released Ostoform Seal with a "flow-assist" flexible plastic diverter can redirect output away from the skin.

4. Professional help:
- Consult a certified Enterostomal Therapist (ET), who may be an RN or another trained professional. Large centers like the Cleveland Clinic have them and can evaluate appliance fit, skin care, and possible stoma revision.

5. Surgical or long-term options:
- If the stoma retracts or exits at an angle, discuss reshaping, lengthening, or relocating the stoma with a colorectal surgeon. Some members have eventually needed revision or moved the stoma to the opposite side.
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