This topic is about dealing with persistent skin issues around an ileostomy, where the skin has not healed properly, leading to discomfort and irritation. The person has tried various methods to address the problem but is seeking further advice. Here are some helpful suggestions:

1. Fix the leak first:
- If output is sitting on the skin, it might be due to leakage between the wafer and the skin.
- Re-evaluate the fit of the pouch. A convex barrier combined with an ostomy belt might help create a better seal.
- Avoid using soaps with oils or perfumes before applying the pouch, as they can affect adhesion.

2. Try different systems and seek samples:
- Reach out to manufacturers' help-lines to request free samples and find a wafer or pouch that suits your skin type.
- SALTS products from the UK are recommended by some users for excellent skin protection.

3. Manage skin irritation directly:
- Apply a thin layer of liquid antacid like Mylanta on clean, dry skin, let it dry, then apply skin prep and the wafer.
- Use Duoderm over irritated areas, placing the flange on top to allow the skin to heal underneath.
- Use stoma powder followed by a protective wipe or film to create a dry, sealed surface.
- Some find baby powder helpful for drying weepy skin, while others use Savlon cream first, then normal powders or creams.
- Consider changing the appliance more frequently, such as every other day, until the skin improves.

4. Reduce "pancaking" (stool sitting on the stoma):
- Ensure you are drinking enough fluids, as dehydration can thicken ileostomy output and lead to pancaking.
- Check if recent antibiotic use might be affecting the consistency of the output.

5. Allow the skin to air-dry periodically:
- During changes, lie on a towel or waterproof mat and let the area air-dry for 20 to 60 minutes if the stoma is quiet. Many find this helps improve the skin condition.

6. Professional support:
- Schedule an assessment with a WOCN or stoma nurse for advice on fitting and product selection.
- Take a photo of the stoma and surrounding skin and email it to your surgeon or nurse for review, which can save an in-office bag change.
- Bring extra pouching supplies to medical appointments so clinicians can examine the skin directly if needed.

7. Additional product notes:
- Consider using barrier wipes instead of sprays if the spray ingredients are irritating.
- If allergic to certain wafers, some find relief by placing a protective wipe layer between the skin and the wafer.