This topic is about someone who has had an ileostomy for 40 years without any major issues but is now facing sudden skin breakdown around the stoma. They are looking for advice on how to manage and resolve this new problem.

Here are some helpful suggestions:

1. Reach out to an ostomy nurse. Many major manufacturers have certified nurses who can help by reviewing photos, discussing your routine, and recommending products or prescriptions.

2. Consider possible causes:
- Have you recently changed any products in your routine, like wafers, seals, tapes, adhesive removers, or skin-prep products? Sometimes manufacturers change ingredients, which can cause reactions.
- You might be experiencing a delayed-onset contact allergy or sensitivity, which can happen at any age.
- If you've recently used antibiotics, it might have triggered a yeast or candida rash.

3. Try general skin-healing techniques:
- Use the "crusting" method: lightly dust ostomy powder on the skin, blow off the excess, dab with a barrier wipe, and let it dry. Repeat for 1–2 layers.
- Make sure your skin is completely dry and exposed to air for as long as possible before applying the wafer.
- Change your pouch more frequently, like every 3 days, to keep the area cleaner.

4. Consider products and treatments that others have found helpful:
- Barrier rings, such as Salts Aloe-infused rings, can protect and promote healing when placed directly on irritated skin.
- The Brava line by Coloplast offers Elastic Barrier Strips, Skin Cleanser Wipes, and Skin Protect Wipes to protect edges and create a clean surface.
- The Adapt Karaya wafer #7806 by Hollister is known for its soothing effect.
- Compound Tincture of Benzoin can be used as a topical adhesive/protectant, though it may sting on application.
- Ostomy paste can be applied to sore spots and allowed to dry before placing the wafer.
- Calamine lotion can be applied and allowed to dry before applying the wafer.
- Use hydrogen peroxide for cleaning, followed by a thorough rinse and dry, to reduce bacterial load.
- Silver-impregnated ostomy powder, like AG+ Silver Powder, can be used as the first layer of crusting for antimicrobial action.
- Standard ostomy powder or athlete’s foot powder can be used for suspected yeast infections. Severe yeast infections may require oral fluconazole, so consult your healthcare provider.
- Boudreaux's Butt Paste (red tube, 40% zinc oxide) can be smeared on the rash, left for 5–10 minutes, wiped off, and then the adhesive/barrier can be applied.
- Use Brava or other protective tapes over steroid or medical dressings for larger wounds.
- Consider removing accessory products that might irritate the skin, such as eliminating adhesive wipes and using only water and soft towels for cleaning.

5. Try troubleshooting steps:
- Eliminate or substitute one product at a time to identify any allergens.
- If you suspect adhesive changes, try a different brand or model of the bag.
- For ulcerated or open areas, avoid zinc paste and seek advice from a nurse for appropriate dressings.
- Use light dustings of drying powder, as too much can prevent wafer adhesion.