This topic is about dealing with a rash and red ring under an ostomy wafer, and whether it might be caused by an adhesive reaction, a fungal infection, or a leak. Here are some helpful insights and advice shared by others who have experienced similar issues:

1. **Possible Causes**
- Many believe the rash pattern suggests an adhesive reaction rather than a leak, as output-related damage would typically appear under the barrier ring, not just under the wafer tape.
- A deep scar or crease can prevent the wafer from sealing properly, and using paste or a convex wafer might help.

2. **Crusting Technique for Irritated Skin**
- The recommended sequence is: apply a barrier wipe, lightly dust with powder, blot with a wipe, and repeat up to three times, ending with a barrier wipe to ensure adhesion.
- Remove excess powder, as too much can prevent sticking.
- You can find instructional videos online for this method.
- Barrier wipes are best used when the skin is actually irritated.

3. **Antifungal vs. Adhesive Allergy**
- Antifungal powder with No-Sting wipes can help if the issue is yeast-related, but won't solve an adhesive allergy.
- Some people use a few drops of nasal steroid liquid on the rash, let it dry, and then apply the crusting technique.

4. **Cleaning and Minimal Products**
- One person found better adhesion by avoiding all powders and wipes, cleaning only with warm water and tissues.
- Using extra adhesive-removal spray can help if adhesive buildup is suspected to cause the rash.

5. **Flange/Barrier Extenders**
- Products like Adapt Flange Extenders and Coloplast Extenders are curved strips of tape that help secure the wafer, especially over scars or during heavy activity. They might cause a mild temporary rash but are known to stick well.

6. **Alternate Appliances for Sensitive Skin**
- Consider trying Sensura Mio flanges with vitamin-E adhesive, Convatec or Hollister convex systems, and Eakin Cohesive Seals for better leak protection. You can request samples from these companies.
- Slight convexity often provides a better seal near scars.
- Some people change their appliance every three days to allow the skin to breathe.

7. **Filling Gaps and Scars**
- Stoma paste or moldable rings can fill gaps where the wafer lifts near a wound.
- For persistent blow-outs due to a low, oval stoma, some have found that an elective stoma revision can eliminate leaks.

8. **Wear-Time and Showers**
- Many can shower with the appliance on, and Convatec convex flanges reportedly stay on longer after showers. Typical wear-time is 4-5 days, but change immediately at the first sign of seepage.

9. **General Reminders**
- It's important to contact a WOC (ostomy) nurse for an in-person assessment of your skin, wafer fit, and product selection.
- If you've undergone radiation, chemotherapy, or experienced weight changes, it's a good idea to periodically re-evaluate your fit and supplies.