The topic is about finding ways to heal irritated skin around a stoma, known as peristomal skin. This can be a common issue for those with an ostomy, and the person seeking advice is experiencing irritation despite regular care from a home-care nurse. Here are some helpful tips and insights shared by others:

1. Consult a qualified stoma or WOC nurse, or a surgeon, to accurately diagnose the cause of the irritation. It's important not to rely solely on visiting nurses who may provide only basic care.

2. Ensure the opening of the appliance is cut correctly, leaving about a 1 mm gap around the stoma. This helps prevent any output from coming into contact with the skin.

3. When cleansing, using warm water is sufficient if the area is cleaned thoroughly. Some people prefer using a mild soap, while others use an adhesive-remover wipe after water to remove any residue.

4. A recommended skin-protection routine includes:
- Cleaning with warm water (and optionally using an adhesive-remover wipe).
- Patting the area completely dry.
- Applying a barrier spray like 3M Cavilon and allowing it to dry fully.
- Dusting irritated spots with stoma or ostomy powder, then "crusting" it by adding another light coat of barrier spray.
- Adding a washer or ring before applying the wafer or flange, then attaching the bag.

5. Consider using products like:
- Stoma powder (generic).
- Marathon (Medline) liquid skin protectant, which is effective but can be expensive; ask your nurse for samples.
- 3M Cavilon barrier spray or wipes.
- General "skin prep" wipes; some people also use diaper-rash lotion for stubborn irritation.

6. Make sure the skin is completely dry before applying any wafer or barrier to improve adhesion and minimize further damage.

7. If your output is liquid, consider using a barrier or stoma ring first to absorb moisture and reduce leaks.

8. For very watery output, add thickening crystals or powder to the pouch to slow the flow and reduce skin contact.

9. Change the appliance sooner if you feel tingling or itching, as this may indicate that output is undermining the seal.

10. If irritation appears suddenly after long-term success, the adhesive in the wafer might be the issue. Try a different brand or product line.

11. Communicate any pain or persistent problems to your healthcare providers immediately, and insist on receiving education in self-changing and skin care.