This topic is about someone who is experiencing severe skin irritation around their ileostomy, which is almost flush with the skin. They are trying to figure out if the irritation is due to an allergic reaction or leakage. Despite consulting with ostomy nurses, the issue persists, causing both physical and emotional distress. Here are some insights and advice that might help:

1. **Identify the Cause: Leakage or Allergy**
- Check the removed ring or wafer. If you find output underneath, it might be a sealing issue (fecal erosive dermatitis). If the skin is red where the ring was, it could be an allergic reaction.
- Some people cannot tolerate Eakin seals. Consider trying Hollister Adapt CeraRing, Coloplast Brava Protective Ring, or not using rings at all.

2. **Enhance the Seal for a Flush or Recessed Stoma**
- Use a firm convex barrier or wafer. Brands like Hollister, Coloplast, Convatec, and Nu-Hope Labs offer convex options. Convatec ActiveLife One-Piece is noted for flat stomas.
- Warm the ring and wafer with a hairdryer, apply snugly, hold hand-heat on for 30–60 seconds, and use an ostomy belt to maintain pressure, but not too tightly.
- Place the barrier ring on the wafer opening instead of directly on the skin to prevent undermining.

3. **Soothe and Heal Damaged Skin**
- Use Domeboro soaks (aluminum acetate astringent powder packets) for 15 minutes before each change to reduce pain and weeping.
- Shower without a pouch, cleanse with mild soap like Ivory or white Dial after using adhesive-remover wipes, and rinse well to remove residue.
- Try the "crusting" technique: apply a light layer of stoma powder, blow off excess, dab liquid skin-barrier, and repeat 1–2 layers before applying the wafer.
- Some find topical Milk of Magnesia or pure witch-hazel calming for rashy skin.

4. **Product Suggestions and Samples**
- Hollister: CeraRing, Adapt Rings, 2-piece convex wafers, Adhesive Remover Spray.
- Coloplast: Brava Protective Sheet and Rings; you can call Coloplast for free samples.
- Convatec: ActiveLife One-Piece Convex pouch.
- Nu-Hope Labs: custom convex and specialty barriers for challenging stomas.

5. **If Allergy is Suspected**
- Eliminate one product at a time (ring, powder, barrier wipe, remover) to identify the cause.
- Some users report rashes from Eakin seals and/or Coloplast adhesive rings but tolerate Hollister or no ring at all.

6. **Frequency and Positioning**
- Change the system proactively before it leaks until the skin heals; daily changes might be necessary for now.
- Avoid sleeping on your back; side-lying or using a recliner can reduce pressure and prevent leaks.

7. **Surgical Consultation**
- Many suggest that a flush or recessed stoma often needs surgical revision, as output can undermine any appliance.
- If your current surgeon refuses, consider seeking another opinion; a minor local revision can usually be done quickly.

These suggestions aim to help manage the skin irritation and improve the overall experience with the ileostomy.