This topic is about dealing with persistent red, weepy, and painful skin around a stoma, known as peristomal skin issues. The person sharing their experience has tried many solutions, but the problem keeps coming back. Here are some insights and advice gathered from their journey and others' experiences:
1. Possible Allergy to Wafer Material:
- Consider switching to a different brand, like Coloplast Sensura Mio or trying Coloplast Brava protective sheets.
- Some people develop allergies to their current products over time.
2. Keeping Skin Dry and Managing Moisture:
- Use Boudreaux Butt Paste with Hollister Karaya 5 powder to help clear rashes.
- After showering or changing, use a hair-dryer on cool or low heat to dry the area.
- Apply hydrogen peroxide and then use a cool blow-dryer before placing the wafer.
- Use waterproof tape or picture-frame the wafer with strips of DuoDERM Extra Thin.
3. Barrier-Protectant Products:
- Try 3M Cavilon No-Sting Barrier Spray or Cavilon wipes/sheets.
- Coloplast medicated barrier wipes can also be helpful.
- Domeboro astringent soaks and colloidal silver can soothe the skin.
- Consider scalp preparations for any fungal or yeast issues.
4. Anti-fungal and Anti-Candida Measures:
- Use Nystop (nystatin) powder under the wafer and minimize other products to let it work.
- Ensure adequate levels of zinc, B-vitamins, and iron for better healing.
5. Mechanical and Pressure Solutions:
- Try convex wafers even if your skin is flat; it might improve wear time and healing.
- Test for allergies by applying a wafer patch elsewhere on the abdomen.
- Consider using a Nu-Hope adhesiveless silicone foam O-ring system if available.
6. Wound-Care Dressings:
- Use thin DuoDERM strips to frame irritated areas or a full Extra-Thin sheet under the wafer.
7. Soothing and First-Aid Measures:
- Use short ice-pack sessions to soothe the area.
- Apply zinc-oxide diaper-rash cream with Saran Wrap overnight for relief.
- Allow the area to air-dry between changes using a blow-dryer or tissues.
8. General Tips:
- Sometimes using fewer products can lead to better adhesion and fewer reactions.
- Adjust your change schedule; some find daily changes help, while others benefit from extending wear time.
- Keep a photo diary and consult with dermatology or gastroenterology teams to rule out other conditions.
For more detailed guidance, you can refer to resources like the Memorial Sloan Kettering guide and a peristomal skin journal review.
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