Need help with stoma skin lesion - allergic reaction to barrier wipes?

It burns and stings, and hurts.... It's like my body is opening up next to my stoma. I don't know what to put on it. I tried a barrier wipe, but my skin broke out with an itchy rash. It seems like I have an allergic reaction or burning from anything I try to use. This morning, I changed my appliance (1-piece system) and put antibiotic cream in the wound, but I can feel that my appliance is not sticking in that spot and leakage is occurring. Ugh. Any ideas?

Hey darlz, was it a no-sting barrier wipe? I know there are lots of forums about natural stuff to put on the wound. If it's leaking, maybe it's the wrong size. Did you get a stoma measuring round thing in the box? If you did, check the hole. You might need a smaller size hole leaking on your skin, number 1 no-no. I have had a huge ulcer and a new site to prove that, not nice. Or get the nurse to check if you're using the right size. It needs to fit snug. xxxxxxxxxxx mooza xxxxxxxxx

Maybe you need to use an antibiotic powder rather than a cream, like Mooza said it's important to have a snug fit to avoid the burning from your output. I use a Cavilon barrier I spray on rather than wipe because the wipes tend to hurt more. Do you use barrier rings? Under the plate, this would help. I use Adapt barrier rings to make sure I have a good seal; they also protect the skin.

Trish

Good idea, Trish. I use the 1-piece shallow base plate from Coloplast and the 3344E no-sting barrier wipes. I also sometimes use the stoma adhesive powder 25510. It's great. Sorry, my spelling still sucks. xx

Hi, I use Osteoguard Lavender Protective Wipes, and the stoma adhesive powder as mine seems to retract too. I use Convect Flange One Piece Dansac Nova. I too always make sure I have a snug fit around the stoma. I find the lavender wipes very healing and calming on the skin. Hope things get better soon... tc Ambies xx

Have you tried stoma powder? I get the sores as well and they sting and itch and burn and drive me crazy. When I am changing my appliance, I clean the area well with a wet cloth (no soap) and then sprinkle the stoma powder around the affected area, then wipe off excess with a kleenex and then use the barrier wipe. Then the Convex style wafer since my stoma seems to want to retreat back into my body and not stick out like a lot of people's. I also use the paste on the convex wafer. Remember, you are likely getting the sores from stool that has leaked out and gotten on the skin, so you want to make sure you are cutting/fitting your wafer to the right size so this does not happen.
Good luck, I know how much it hurts to have the rash/sores. Sometimes I don't want to walk or move at all.

I agree with what's been posted so far. The stoma powder works wonders. Wipe off the excess and wipe with the barrier wipe. I've found out for those hard to heal sores, you can put a small dab of Silvasorb gel on the sore spot and it will heal very fast. It's imperative that you get a good collar seal around the stoma to prevent leakage to your skin. I use a Hollister barrier ring as well as a convex appliance. This gives me a great seal around the stoma. Good luck. Bob

Everyone has such good advice on this site! I have sensitive skin, have had several bouts of rash, which was diagnosed as a fungal rash. I now use powder to dry my skin when changing the wafer, then a spray-on barrier (Hollister) and let it dry well before applying the wafer. I haven't had a rash in a year since following this procedure. If this doesn't help, you'll need to see a doctor to get a prescription for an antifungal medication. If you have an ostomy nurse, call and get some help from them. Or get a referral for a nurse from your surgeon if you don't have one. The nurses at Hollister, and I'm sure the other ostomy supply companies, can give you some ideas as well. I wish I'd heard about this site years ago! I've had to figure out so many problems by trial and error! You guys are good!

Hi:
Had the same issue - as some have suggested, check if you need a new size.
Also, try:
On clean dry skin:
Calamine (thin coat, dry well with a hair dryer on cool)
Plain Maalox
More expensive but really works: Convatec makes DuoDerm extra thin (ref. # 187957) cut out rounded pieces and apply over the worst of sores - the Hollister 14803 flange does stick to this product.
Also, investigate if you are allergic to/sensitive to the flexible flanges - that was my major problem. Now that I use a harder (have to cut out the opening) flange, I have less irritation under the flange. My issue is my opening is only 3/16" and no flange is that small - so no "snug" fit.
Good luck!

I don't want to alarm you, but maybe you should see a stoma nurse who specializes in wound care, or a dermatologist-- that happened to me and it turned out to be the start of an ulcer next to the stoma (it's called pyoderma gangrenosum)... It started off just looking like my stoma was kind of separating from my skin a bit, and then it turned into a red sore. It's best to treat it early if that is what it is, and better safe than sorry.

For anything wet, including pyoderma, I used some "Aquacell" which is material that soaks up moisture, and then I put some Coloplast barrier film over that, then the wafer on top of it all. I just cut out the Aquacell to cover the moist, red area, and then cut out the Coloplast barrier film a tiny bit bigger than that. My ostomy nurse showed me this trick, and it worked very well for me. If I didn't do this, my wafer would last an hour because the moisture would cause it to fall off- if I did use all that extra stuff, I could get 4 days or so... Good luck.

I just joined and with every post I read I am amazed at all the openess and great advice here. After almost 20 years of trial and error I wish I had joined earlier.

I agree that the best thing to do is to get the issue diagnosed properly before you end up with a worse problem to deal with.

My issue ended up being an allergic reaction to oranges (after eating them for decades). What worked for me was a combination of changing the wipes I used and switching to a one piece convex (Convatec). I also tried a few different skin barriers till I settled on Hollister skin conditioning cream. I also use Adapt paste to help with a tight seal. My stoma is just a touch larger than 7/8 so I buy the 7/8 but use my fingers to ply it open. Because the actual stoma where it meets the skin is actually smaller than the rest of the stoma this helps get a perfectly tight fit. The convex helps the opening settle in air tight along with the paste which protects the skin.

The other suggestion I'd have is to use the thin film that was mentioned (coloplast product).
One other thing, once you find out what the issue is try non alcoholic wipes to clean your skin. There about a half dozen different options out there. Once you get the right combination working 'd have one last suggeston. I know it sounds simple but...when you're changing appliances don't be in such a rush to put the new one on. A little time to breath does wonders for the skin. Allowed to breath the skin actually heals better.

After all these years my skin is as close to normal as possible and I use Cottonelle moist wipes w/ aloe and E and let it dry and then apply the skin barrier and while it's drying I apply the paste to the opening of the appliance and spread it around the opening and then after one last check apply the appliance. I press it briefly in place until I feel it's tight and that's it. I get 6-9 days consistently depending on activity level etc...

Good luck.

Life is Good!

Michael

I have had exactly the same thing as you! A really sore, weepy wound right next to my stoma! It carried on for 3 months and nothing I did helped, until I started using steroid cream applied onto a small piece of silver-based cotton dressing (Aquacel). I would place this directly onto the sore area, cream side down, then use some Comfeel cut out into a half-moon shape to go over the dressing that was on my skin. This kept the cream on the wound but allowed the bag to stick properly as bags stick to Comfeel. I changed my bag every day and sometimes every 2nd, and it slowly but surely started to heal. It's been 4 months now and my skin is healed up, but if it gets too moist it breaks down again, so I just start with the cream/dressing (Aquacel)/Comfeel combo. I hope this helps.

PS.. My skin problem was also pyoderma gangrenosum, not very nice at all and very hard to heal, and the sooner you get onto it, the better. For this, the powder doesn't work, you need something more like an AB cream. It took 3 months just to diagnose as doctors try to eliminate first, took a very good wound specialist to recognize it.

As noted in another reply above, you may have a type of pyoderma gangrenosum (PG); when it's around your stoma, it's called peristomal PG. If you have Crohn's disease, it may well be the peristomal PG. It is very hard to deal with and difficult to get to heal. I have had bouts of it off and on for the 30 years I've had an ileostomy. I've tried every wound care product on the planet. Here's how I get it to heal:

I clean the ulcer with a little peroxide, although it might sting a little if the ulcer is really angry. Then I paint the ulcer with betadine using a Q-Tip, and then I dry it with a hair dryer. Then I put a soft dry dressing over the ulcer, that is cut to fit around my stoma. I find that I have to change it daily until it starts to heal in earnest. I use a little stomahesive powder next to my stoma if the wound is right next to the stoma. If your pouch gets wet, as from showering, you have to change the pouch and do the treatment again soon. In my experience, if the wound is wet, it will not heal and will worsen. I use a Hollister pouch with the synthetic Karaya ring and micropore tape. I'm lucky in that my insurance supplies me with all my ostomy supplies for free. You can go through a lot of pouches in getting the ulcer to heal.

One last thing: PG does not react well to trauma. Once you get it healed, try not to even get so much as a pulled hair or a tiny blood blister from removing your pouch too quickly and without adhesive remover. Even a sore, pulled hair can blossom into PG. I hope this helps. Cary

I use a sliver of material called silver. I put it in the wound with a Q-tip, then put stoma powder and spray over that x2. I also use a ring over the pouch opening with a little more coverage over the sore area to prevent stool, etc. from getting in there. They tell me it takes a long time to heal. Sorry, I wish it didn't, for you and for me. Best of luck.

You don't want to use a cream, use powder. You don't want to irrigate also. Just wipe out the end of the pouch and fasten it back up again. I also use 3M cloth tape around my appliance to prevent leakage and have not had leakage for months.

You can also get an antibiotic powder for the rash and wound.

Oh boy, do I know the pain and burning that can happen with open sores around the stoma. I have been suffering for two years and had two surgeries to remove what they call granuloma, which they say not everyone gets, but I get them and boy do they hurt. I finally found an ET nurse 5 weeks ago, and it was the best thing that happened to me in two years. They used silver nitrate on the sores and tried different appliances, and lo and behold, things right now are finally healing. What a long journey this has been, and I only hope it lasts for a while. Joyce

I also had granulomatous tissue cut from the bottom of my stoma. That was in 2010. It still gets red and sometimes bleeds. I was told not to use cream. I use Aquacel applied with a q-tip to the area then powder and spray over that. But my opening is in the lower right corner, instead of in the center, and it is hard to keep the area dry enough to do any healing. But if you are using cream on the Aquacel before applying it, I think I will try it and see how I do. You said you use a steroid cream; is that over the counter or do you need a certain prescription? Thanks.