This topic is about dealing with a sudden and severe rash that appeared under a long-term colostomy barrier. After 15 years without any skin issues, the person experienced itching and discovered a rash after removing the wafer. They used stoma powder but were concerned about the new barrier not sticking and needed a quick remedy from a local pharmacy to ease the burning sensation so they could attend an appointment.

Here are some helpful insights and advice:

1. Reinforcement & Hold
- Use medical tape, Hypafix, or any transparent adhesive roll around the wafer to secure the seal. Place the wafer on top of the tape.
- Apply barrier strip extensions or a Brava Protective Sheet over inflamed areas to protect the skin while it heals.

2. Skin Protection / Barrier Films
- Use Marathon skin protectant or any fast-drying barrier film wipe or spray to create a protective layer before applying rings or wafers. These are often available at pharmacies.
- Try the "crusting" method by dabbing a Cavilon swab, sprinkling stoma powder, and repeating the layers for extra protection.

3. Treating Rash & Broken Skin
- For fungal issues, apply an antifungal cream like Clotrimazole 1%, let it sit for about 10 minutes, wipe off the excess, and then apply the wafer. Prescription niacin powder may also be recommended for fungal issues.
- For bacterial issues, use a proper topical antibiotic. It's important to correctly diagnose whether the rash is fungal or bacterial to guide treatment.
- Domeboro soaks can help dry and calm irritated skin. Soak a paper towel in the solution and lay it on the rash.
- Using original, non-fragrance Head & Shoulders shampoo as a skin cleanser can reduce the rash. Some people combine it with Boudreaux’s Butt Paste diaper rash cream, wipe off the excess, and then dust with Hollister Karaya 5 Powder before applying the appliance.

4. Other Helpful Products & Tips
- Hydrocolloid Gel Adhesive Pads can be cut and placed over small denuded areas.
- Protect barrier rings from harsh soaps or sanitizers inside the pouch, as they can break down and cause leaks.