This topic is about dealing with a painful skin irritation around an ileostomy stoma, which has become ulcer-like and is getting worse due to contact with the wafer. The person experiencing this issue is looking for practical advice to help heal and protect the affected skin. Here are some suggestions that might be helpful:

1. Try refining the crusting technique:
- Clean the skin around the stoma with water only, avoiding soap. You can use an adhesive remover if needed.
- Make sure the area is completely dry by gently patting it.
- Lightly dust the sore area with ostomy powder, then apply a liquid skin barrier over the powder. Let it dry until it looks crusty.
- Repeat the powder and barrier application once more, allow it to dry, and then apply a new wafer.
- After securing the wafer, lightly dust some ostomy powder inside the pouch to help control moisture.

2. Consult a stoma nurse about using Healen Tape to cover and protect the ulcerated area under the wafer.

3. Consider using Marathon Skin Protectant, which is a polymer-based barrier sold in single-use ampoules. It creates a strong, breathable film that can help dry and protect the damaged skin. Although it can be expensive, many users report quick improvements.

4. If these methods do not provide relief, try cutting a small window or hole in the wafer directly over the ulcer. This allows the sore to breathe while the rest of the wafer adheres normally, reducing pressure and moisture on the wound.