This topic is about managing severe skin reactions around the stoma, which can be a challenging issue for those with an ileostomy. The person sharing their experience has been dealing with sensitive skin that reacts badly to adhesives, causing it to break down, weep, and bleed. They are looking for effective solutions to manage these reactions. Here are some helpful tips and insights shared by others:

1. After showering without the appliance, gently wash and dry the skin. Apply a topical steroid solution like Betnovate around the stoma, let it dry, then use a skin-barrier wipe before reapplying the appliance. This method reportedly helped eliminate burning and weeping within two weeks.

2. Avoid showering with the pouch on, as wet adhesives can worsen skin breakdown.

3. For bleeding areas, use calcium-alginate dressings such as "Calcicare" or "Restore." Clean the wound with saline, cover with the dressing, and then apply the appliance. These dressings can be replaced through the pouch opening with tweezers.

4. Try an acid-neutralizing rinse by dabbing liquid Maalox around the stoma, then air- or blow-dry before attaching the pouch. This has helped some users with chronic irritation.

5. Consider products formulated for sensitive skin, like the Hollister Karaya line or CyMed pouches with MicroSkin. You can request free samples, though insurance might require a physician's approval due to higher costs.

6. Use the powder or "crusting" technique to prevent fungal issues. After cleansing, apply ostomy or Nystatin powder, let it sit, and optionally alternate with a skin-barrier wipe before attaching the wafer.

7. No-sting skin barriers like 3M Cavilon Barrier Film can form a breathable protective layer without affecting adhesive strength. These are often covered by insurance.

8. If possible, have "leave it open" rest days by fasting and leaving the stoma uncovered to air-dry, which can help accelerate healing.

9. Itching under the wafer can be an early warning sign of skin breakdown, so change the appliance promptly if you notice this.

10. Try samples from different brands until you find a leak-free system. Many companies offer free samples upon request.

11. Domeboro astringent soaks can be used after removing the pouch and showering with water only. Apply the solution with cotton, cool-blow-dry, and then reapply the pouch. This has been reported to help prevent and cure severe rashes and pustules.

12. Hydrofera, a hydrophilic antibiotic foam, was mentioned as a possible option to explore.

These suggestions include a variety of approaches such as steroid creams, specialty dressings, antacid rinses, and more, all aimed at reducing skin trauma and preventing irritation.