Skin Rash Under Ostomy Appliance: Seeking Advice

I have recently been struggling with skin breakdown under my ostomy appliance. I have had my ileostomy for 40 years and just recently started having problems. It is a battle I am unfamiliar with until recently. Any suggestions?

I would contact an ostomy nurse. They are experts about peristomal skin. All ostomy product manufacturers have ostomy nurses on staff to answer questions about using their products and skin care.

Hope you find an answer.

Dan

What type of skin breakdown are you having? Red rash? Ulcers?

Hi Far, when I have skin issues, I spread some ostomy paste on the sore spot and let it dry. Then I put my wafer on, and that seems to help heal it for me.

Have you changed any of your ostomy items or has any of your ostomy items been changed recently by the manufacturer? Might be a reaction if anything new is touching your skin. Otherwise, in my opinion, getting air to the skin for as long as possible is about the best thing along with the normal crusting techniques.

I agree with Alex, have you made any changes at all?

It is possible to develop an allergy to something at any age, so it could be that suddenly you have become allergic to something you are using. Might be a little trial and error involved. When I get skin problems, I start wearing a barrier ring and this clears it up, then back to my normal routine. The Salts rings are infused with aloe and are very kind to the skin. To start though, I would do as others suggested, just try the crusting technique and maybe that will do it.

Terry

There is a powder you can ask about. It's supposed to dry up the area. Dust on and dust the remainder off. Maybe let it sit for a bit before putting wafer back on. The powder makes it hard to stick so just a light dust. I did it once when I had a small spot and it seemed to work. But ask your stoma nurse first.

Hi, how are you? I have a skin rash and have suffered with it for the last 5 1/2 years.

I found that keeping it extremely clean along with using a bit of hydrogen peroxide manages to keep it down to a minimum, but the only way to really do that is to have a bag change every 3 days. In my opinion, it's a matter of cleanliness.

I've had my ileostomy for 52 years. When I have skin problems, I use compound tincture of benzoin. It does burn a little, but it works for me.

Similar experience, after 8 years developed rash that didn't clear. Ostomy nurse suggested eliminating an adhesive wipe from routine. Instead use water and soft paper towel for cleanup and made sure area is DRY, before applying the barrier ring. Added Brava Elastic Barrier Strips for insurance. That's been 5 years ago and the rash hasn't reappeared and can now go 5-7 days between appliance changes.

Have you had antibiotics for any reason recently? If so, it could be a yeast/candida infection. I usually find a tiny amount of athlete's foot powder helps, but severe cases may need oral fluconazole.

You can switch from the powder part of the crusting technique to a silver powder which will help it heal. If you crust twice, use the original powder the second time as the silver powder is expensive and at the second application, won't be against your skin. I used AG+ silver powder, I added a photo of the bottle. Hope this helps.

You can do the following if you have a rashy-red area around the stoma. I wouldn't do this if you have open ulcer-type sores. Get a tube of Boudreaux's Butt Paste. It's the red tube which contains 40% zinc and it's used for babies' diaper rash. Apply it to the rashy area and let it sit for at least 5 minutes and up to 10 minutes. Then wipe off and apply adhesive spray or wipe. Let that dry for a couple of minutes and then apply barrier and wafer as usual. The zinc kills whatever is causing the rash. The butt paste is available in the baby section of any drug store or on Amazon for about $7. (Don't get the yellow or green tubes. Only the red one.)

I commiserate with you. I have had mine for almost 50 years and in the last month my skin has become blistered. The last time I changed, I used calamine lotion and let it dry and then used a very large karaya wafer by Adapt from Hollister. The number ID on it is 7806. I've had it for years and never used it. After I used it, my skin wasn't itching and burning after I applied the bag. I hope it has helped to heal it. I only change every 6-7 days. So, I'll see in a couple of days how it looks. If it worked, I hope I can still get this karaya wafer again.

My stoma nurse says it can be that you develop a sensitivity to the bag you're using - in which case you can try other bags. I suspect it can happen if the manufacturer changes an ingredient in the wafer/adhesive.
I had a lot of trouble changing bags so I was reluctant to start on that route. What worked for me was, after washing with water and a plain wipe, I wipe the skin with Brava Skin Cleanser Wipes. These leave a surface that protects the skin. Waft that till it's dry and then wipe round with Stocare Protect Wipes. Waft this dry and then put my bag on. Once my skin was clear (red bumps with slight skin break) I tried without these products but the rash came back. I tried different combinations but this seems to work well for me.
I had a more significant open wound - from external trauma (regular prodding from kitchen cupboard door handles I was leaning against + poking the same point with the corner of a file as I did some Zoom classes). This took a while to heal. The stoma nurse used a steroid transparent tape over the wound that allowed the plate to stick. The point here is that the stoma nurses know lots of products that we don't normally have to use. So I would say that the first thing to do is to get a stoma nurse to take a look to get a diagnosis.

Same here. I had mine for 12 years and no problem. Now I have a red rash under it. I think they might have changed the adhesive.

Hi Alex, would you describe your crusting technique? Norman

Put some powder on, blow off the excess. Dab with a barrier wipe, let it dry. You can do it a couple of times if need be; I've only done one layer.

Very good solutions. I'm going to get the butt paste. The explanation of crusting techniques was helpful. I was just putting powder on and blowing it off; I didn't think to use a barrier wipe to moisten the powder. I'm going to get the silver powder too. Silver works really well.

Thanks, everyone!