This topic is about whether exfoliating the skin around a stoma is necessary for maintaining long-term skin health. The person who started the discussion rarely experiences leaks or skin issues but is concerned about the skin being covered by non-breathable barriers all the time. They wonder if dead skin cells might build up and cause problems. Currently, they gently exfoliate the area about once a month with a mild facial exfoliant and feel that their skin looks healthier as a result.

Here are some insights and advice shared by others:

1. Daily Cleaning vs. Periodic Exfoliation
- Many people with long-term ileostomies or colostomies do not deliberately exfoliate. They find that using plain water or a mild soapy washcloth during each appliance change is enough. The process of removing the wafer naturally removes dead skin cells.
- Some individuals with eczema or darker peristomal skin are curious about trying gentle exfoliation but have not yet shared their experiences.

2. Cleansing Routines and Products
- Common routines include removing the pouch, cleaning with mild soap (like Ivory or Softsoap gel) or just water, and then blotting or air-drying before applying skin prep and a new wafer.
- Adhesive-remover products mentioned include Convatec Sensi-Care Release spray, AllKare adhesive-remover wipes, and Uni-Solve adhesive-remover wipes. Users often rinse with water or use a moist wipe to remove any oily residue before applying a new wafer.
- One person maintains healthy skin by washing daily with Head & Shoulders Classic shampoo and applying Boudreaux Butt Paste weekly to manage a persistent rash.

3. Showering with or without the Appliance
- Many people shower with the pouch on, as a two-piece pouch dries quickly or can be dried with a hair-dryer.
- Some prefer to shower without the pouch only when changing the appliance or right after irrigating to avoid accidental output.
- Standard shower gels and shampoos are generally used without causing stinging or damage to the stoma. It's important to rinse thoroughly to prevent residue from affecting wafer adhesion.
- Some apply an adhesive remover after showering to ensure no soap film remains.

4. Adhesion and Irritated Skin Problems
- Overusing powders, prep sprays, or multiple products can sometimes irritate the skin and reduce adhesion. Simplifying the routine may help.
- Ensuring the skin is completely dry and warm before applying the wafer can improve adhesion. Using a Y-shaped barrier strip can offer extra security during active periods or travel.
- If leaks persist and the skin becomes red, it might be due to a product allergy or moisture-related breakdown. Consider changing brands or consulting a stoma nurse for a pouching system refit.

5. Output Consistency
- Very liquid output can undermine wafers for some users, while others find it easier and leak-free. Adjusting medication or diet to thicken output can be tried, but the best consistency varies for each individual.