This topic is about dealing with persistent skin irritation and poor adhesion around the stoma site, six months after having an ileostomy. The person is experiencing skin problems during every appliance change and is unsure about how to use the products they have. Here are some helpful tips and advice:

1. For mild, red, weepy areas, try the "crusting" technique:
- Clean the skin around the stoma with Cetaphil, then pat it dry and let it air-dry for about 30 minutes.
- Alternate layers by using a 3M Cavilon swab, then apply Hollister Stoma Powder, dab with the swab, and repeat this process 3-4 times.
- Brush off any excess powder, seal the area with 3M Cavilon No-Sting Barrier Spray, let it dry, and then apply a moldable barrier ring and wafer.

2. Consult a certified Wound, Ostomy, and Continence (WOC) nurse early on. They can help identify the exact cause of the irritation, whether it's fungal, allergic, moisture-related, or mechanical, and provide tailored treatment to save time and effort.

3. Use reference guides with photos and treatment options:
- "Abdominal Stomas and Their Skin Disorders" by Lyon & Smith is a useful book that can be found used for around $20.
- The Wound Ostomy Continence Nurses Society and Hollister offer a free online Peristomal Skin Assessment Guide.

4. Keep your appliance routine simple and consistent:
- Remove the pouch and gently clean the area with a damp paper towel, then use Witch Hazel. Shower with a residue-free soap like Dove.
- Dry the area thoroughly. For damp or weeping spots, dust with stoma or Nystatin/antifungal powder, and layer with a barrier wipe or spray using the "crusting" technique until the skin stays dry.
- Ensure the wafer opening fits the stoma precisely. Warm the wafer against your body before applying and use light hand pressure for better adhesion.

5. Consider product changes that have helped others with leakage-related irritation:
- The ConvaTec Natura SUR-FIT Moldable Skin Barrier with a convex flange automatically shrinks to fit the stoma snugly, eliminating the need for scissors.
- Pairing this with an Eakin Cohesive Slims barrier seal can provide an extra shield against leaks. Some people also reinforce the perimeter with medical adhesive tape.
- The Hollister Convex Pouch #8868 used with a larger Hollister Barrier Ring or a Coloplast Barrier Ring can help stop small leaks at the bottom edge.
- Stomahesive wafers from ConvaTec can protect and help heal irritated skin, as they have a Stomahesive backing built in.

6. General tips:
- Be aware that seasonal temperature and humidity changes can affect your skin and the wear time of your appliance.
- Thick output, often referred to as "pancaking," can overcome any barrier, so ensure you are drinking adequate fluids.
- If adhesives seem to be causing irritation, explore alternate brands or request samples. Manufacturers like Hollister, ConvaTec, and Coloplast can provide advice and send trial products upon request.