This topic is about dealing with itchy skin under the tape of an ileostomy appliance. The person experiencing this issue has had an ileostomy for nearly three years and is noticing persistent itching specifically under the perimeter tape of a Hollister appliance. There are no leaks or irritation under the flange itself, and they are using a fungal powder with each change. They are considering whether they might have developed an allergy to the tape and are looking for solutions. Here are some helpful suggestions and insights:

1. Allergic reaction to tape or adhesive:
- It's possible to develop tape allergies even years after surgery.
- Contact the manufacturer to inquire about any ingredient changes and request samples of "tapeless" wafers, which Hollister offers.
- Consider switching brands or alternating between 1-piece and 2-piece systems to see if the problem resolves.

2. Remove or interrupt the offending tape:
- You can cut the perimeter tape off the wafer entirely or make small cuts where the irritation begins.
- Use a gentler tape to secure the flange, such as paper tapes like Scanpoor by BARD, Nexcare, or generic paper tape, which are less likely to cause reactions.

3. Use different skin-prep or barrier products:
- Some people react to certain barrier wipes, but Smith & Nephew barrier wipes are often better tolerated.
- Tincture of benzoin can be applied to the skin as a protective barrier before taping.
- Sween Cream, designed to be used under a wafer, can soothe the skin and help with adhesion.

4. Powders and the "crusting" technique:
- Anti-fungal or ostomy powders, like Convatec Ostomy Powder or karaya powder, can protect the skin and improve adhesion when used sparingly and "crusted" with a barrier wipe.
- Baby powder should only be used on the surrounding skin, not under the wafer, as it can affect adhesion.

5. Moisture and heat management:
- Warm weather and perspiration can worsen itching. Dust baby powder around (not under) the wafer or use ostomy powder after the wafer is in place to absorb moisture.
- Ensure the tape is thoroughly dried after showering to prevent dampness, which can lead to itchy skin.

6. Medications and topical aids:
- Oral antihistamines like Reactine Extra Strength can provide quick relief from adhesive-related itching.
- Calamine lotion, allowed to dry before applying a new wafer, can calm flare-ups without affecting adhesion.

7. Alternative or temporary adhesives:
- Consider using only paper tape, plant-based options, or homemade Knox gelatin paste to give the skin a break. Gelatin holds well but needs monitoring as it can break down with stoma output.

8. Seek professional help if needed:
- An allergist can perform patch testing to confirm specific adhesive allergies.
- Ostomy or WOC nurses can provide sample wafers, tapes, and creams tailored to individual sensitivities.