Topic Explanation:
The forum topic is about a person seeking advice for painful stoma skin. The individual has been experiencing extreme irritation and pain at the bottom of their stoma despite trying various remedies and changing their pouch more frequently. They are seeking suggestions and solutions from others who may have experienced similar issues.

Replies and Insights:
- Use antifungal (jock itch) powder spray to treat fungal-related skin irritation. It may take 3-6 weeks to see the effects.
- Ensure the stoma output is not sitting on the skin, as this can contribute to irritation.
- Consult a stoma nurse or professional for personalized advice and potential prescription of Nystatin powder or Canestan cream for fungal issues.
- Consider using barrier rings and no-sting skin prep to protect the skin and improve adhesion of the pouch.
- Let the skin air out for a while when changing the pouch to aid in healing and consider using chamomile lotion or Domeboro Solution to soothe the skin.
- Avoid using Neosporin on the skin around the stoma, as it can interfere with pouch adhesion and worsen irritation.
- Ensure the stoma hole is cut to the right size and fits snugly against the stoma to prevent output from getting onto the skin.
- Consider trying different stoma appliances or products with Ceramide infused into the flange to protect the skin.
- If experiencing discomfort and irritation, getting the right size barrier cut and ensuring it is dry and positioned perfectly can help.
- Consider using compound tincture of benzoin for skin irritation and antifungal lotion or cream (not ointment) for fungal problems.

These insights and advice from the forum participants provide various options and strategies for managing and treating painful stoma skin, including addressing fungal issues, protecting the skin, and improving pouch adhesion.