Inflamed skin - seeking advice!

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judgelori
Nov 06, 2019 4:09 am

So, I'm wondering if this looks bad compared to what others may have gone through
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. My skin goes through periods of red and irritated and then perfectly fine. Tonight, it's mad. Inflamed and sore. Any thoughts? Sorry about the pic but it was the only way I knew to get my point across.

lovely
Nov 06, 2019 4:36 am

Looks like you really do have a problem. What kind of products do you use when you change everything? Do you use like a stoma powder or skin prep wipes? Have you talked to a doctor or stoma nurse.

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judgelori
Nov 06, 2019 5:29 am

I use the Mio Sensura2 piece bags and I have been trying different barrier rings to see if that is an issue. I have Bravo ones, Hollister ones, and Eakin ones... I don't use too many products... I do have skin protectant wipes that I used tonight.... I have stoma powder but don't really know how I'm supposed to use it.... and I have some Marathon that I've used before when it's been worse than this....

I have had to change my bag a couple of times in the last few days due to leaks... once Sunday, once Monday, and again tonight. So that has contributed to the irritated skin.... I usually only change every other day or every third day...

So, that's where I am at... only been at this since February so I'm still learning what works and what doesn't....

I have an appointment with my ostomy nurse but not for 2 weeks... it will be cleared up by the time I get to see her. Same thing happened last time.... I made an appointment when it got irritated but by the time I got to see her, it was cleared up.

Thanks... Lori

Angelicamarie
Nov 06, 2019 5:36 am

Judgelori... wow... seek emergency care. Don't take the chance by waiting....

Angelicamarie

lovely
Nov 06, 2019 6:53 am

If you can't see a doctor or nurse soon, take the picture with you. I have also been told you can call Hollister and speak to their ostomy nurse. They can recommend suggestions to help and can send some samples. You can sprinkle the stoma powder on and just tap the skin to shake some off and dab the skin barrier over that. There is also a lot of videos on YouTube you can watch. Here is a link to one, but there are more you can look up on YouTube. https://www.youtube.com/watch?v=X6zrh9ErLAQ But I suggest you see your doctor or nurse. Hope this helps.

 

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w30bob
Nov 06, 2019 8:34 am

Lori,

That looks perfectly normal to me, considering the recent leakage you describe. My skin gets much redder if exposed to a leak. If what you're showing is as bad as it gets, I'd be happy as hell. Many folks on here have way worse skin that gets blood red and weeps constantly... Your ostomy nurse will tell you to use stoma powder before you use the skin protectant wipe and to change your barrier more frequently for a short time to let your skin get back to normal. I'm surprised more people don't post pics on here. If you guys think Lori's skin is bad, I can post pics that will make you say OMG!

Regards,

Bob

newyorktorque
Nov 06, 2019 9:01 am

Hi Lori. It definitely looks like you've got some irritation there. I am always having some skin issue myself and have scheduled an appointment with the nurse and arrive with a Murphy's Law stoma skin. I recently had to change to a bigger cut-to-fit bag. As a result, I now have some 'baby' skin that's going to be exposed to adhesive, whereby it has not been before. As I suspected, I get the irritation from removing the bag off that fresh skin. Since it's not an infection, I smear a thin layer of nystatin on it and let it sit and sink in. Then I will wash it off with a washcloth, dry, and put on a new bag.

judgelori
Nov 06, 2019 12:19 pm

Thanks, guys!!! I was hoping that on the grand scale, this wasn't too bad. It's been a little worse than this before but mostly around the stoma. This is the first time I've had the large red ring around where the wafer is. Just hoping I'm not developing an allergy to the wafer. I've really liked these. I was so itchy with the Hollister ones that I changed to these Mio ones and love them. I'll keep pampering the skin. Thanks for the advice. I'll keep y'all posted on how it goes!!

Lori

judgelori
Nov 06, 2019 1:53 pm

Can you tell me more about what Nystatin is? Is it prescription? Over the counter? Order through Byram? Not sure what that is.

Thanks,

Lori

ron in mich
Nov 06, 2019 2:19 pm

Hi Lori, do you use flanges with convexity to force the stoma out more? I know Coloplast has varying degrees of convex wafers, and I believe Convatec also has them. Maybe call and get samples to try.

judgelori
Nov 06, 2019 3:00 pm


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Yes...these are the flanges I use.    
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newyorktorque
Nov 06, 2019 5:51 pm

Hi Lori. Nystatin cream (or powder) is an Rx prescribed by your physician. I was referring to the cream. I see you're using Coloplast now. I love Coloplast for the flexibility and have used a number of their one-piece bags. GL

warrior
Nov 07, 2019 12:03 am

Yes, I too agree with Bob. I do believe that redness is from the leak, and it's nothing to worry about. But for peace of mind since this is new for you, go see a doctor. The leak will cause irritation. You cleaned up well. Other than what I can see as skin folds, I really wouldn't worry too much about this. Also, are you using a spray adhesive remover? That is a must. And also, sometimes irritations can occur using them. My stoma is about 1 inch and 3/8 round, and the area around it I keep clean using warm water over the sink or laundry tub. Gotta have a flexible faucet. I use normal soap, shave around the area because hair will cause leaks too, and fan it dry with cardboard. Spray a barrier on, fan it again, allow it to dry, then apply a wafer and the "C" strips to secure the appliance. The strips are the deal. You should not leak using them. Are you familiar with them? Accordion-style wafers help prevent leaks too, and the new Mio type that looks like a starfish looks very promising to stop leaks. You will find the easy way to do things and learn a lot about things here. I just joined this August 2019, but I have had the stoma since 12/16. I flew solo a long time before I landed here. Lucky me too. Keep us posted. Good luck.

iMacG5
Nov 07, 2019 2:42 am


Hi NYt.  I think it would be advantageous to discuss your skin prep with a WOCN or a skin care specialist.  I'm not sure it's a good idea to apply antibiotics or antifungals to healthy skin.  A liquid barrier wipe might give your baby skin the protection it needs without killing some good stuff in your skin.  Just removing the nystatin with a washcloth can cause some skin damage.

 These are just my thoughts and I'm not trained in medicine.  Please let us know how you make out.

Respectfully,

Mike

iMacG5
Nov 07, 2019 2:59 am

Hey Your Honor, thanks for the photo.  It's worth at least a thousand words.

Bob's reply is so "dead on".  People like us can get our skin in terrible condition if we don't know what's going on.  Any unprotected skin will get damaged by leakage.  Fixing damaged skin can be very difficult in addition to the discomfort or flat out pain.  We need to do all we can to protect our skin.  Just removing our wafer could be damaging if we PULL the wafer and stretch the skin.  I try to PUSH my skin back into my body to separate it from the wafer to prevent that stretching.  Frequent changes mean frequently subjecting our skin to possible trauma.  I know it can be a mess but we just read, listen and learn.  In time we become experts; with oursevelves, at least.

Hope it all works out well for you quickly,

Mike

Baw
Nov 07, 2019 7:47 am

I agree with Bob. My skin has looked much worse from time to time and I have had quite a bit of bleeding during that same period. I keep it from happening now by keeping it clean and if it does come in contact with fecal matter, I make sure to wash it well. I always clean it with water on a cotton pad after cleaning with adhesive remover to make sure it is really clean. I don't use soap but have been known to put a mild medicinal ointment like Neosporin on the area because it kills bacteria. I really find that keeping it clean is key.

w30bob
Nov 07, 2019 8:58 am

Hi Lori,

Looks like you're getting lots of good info from folks. Tony's right in that it's all about the learning curve. As the years progress, you'll see a lot of stuff and better understand what works for you and what doesn't. If you ask 5 people how they prep their skin and apply their barrier, you'll get 5 different answers. That's why you want to get friendly with any local ostomy nurses near you. I find those folks will go out of their way to help you, and if you understand your skin, the two of you can pretty much figure out a way to deal with any ostomy problem. The fact that they see so many ostomy issues really helps to zero in on your issue and get it solved.

I'm about 2 hours from both Hopkins in Baltimore and Georgetown in DC, without much ostomy nurse help in between. So I always meet with the ostomy nurses from both places whenever I'm at their hospitals for follow-ups with my Gastros, whether I'm having skin issues or not. I take pics of my skin/stoma at every barrier change because I can't remove my barrier during the day when in a doctor's office (due to my pretty much constant output) and email them to the nurses a few days before any office visits. Taking a few pics each time has really helped solve some skin issues that had everybody else completely stumped... including the whole Dermatology team at Georgetown. I was able to stitch together pics of my skin right after removing my barrier for a number of prior months to make a poor man's time-lapse and figure out what the heck was going on. Not saying you should do the same, just letting you know there are things you can do to help narrow down options when dealing with stoma skin issues.

I've used the Nystatin cream (I didn't know it came as a powder... thanks for that Torquey) but found it too greasy to get off easily. But it may work just fine for you, as your skin isn't too far gone that any rubbing to remove it won't cause your skin to bleed. A quick note on leakage... it's the cause of the majority of skin problems around your stoma. That was told to me early on, and I've found it to be true. And "weepage/seepage" around the stoma seal is very common. In my case, it was causing the skin at the base of my stoma to get bright red, but it didn't look like anything was leaking when I looked at the barrier after each removal. So over time, it just looked like the red skin was slowly expanding away from my stoma. This had everyone stumped because there's no real reason for the red skin at the stoma base to ever grow or spread out. And looking at a few pics didn't tell the story because of how slowly the red ring of skin was growing/expanding. After trying lots of creams and meds, which did nothing, I thought of making that time-lapse of stoma pics over the last 6 months or so. And when I did, it became obvious what was going on, and simply sealing my barrier better around my stoma caused the redness to stop growing and start to recede. So sometimes you just need to think out of the box.

Ok, I'm pretty sure I just won the award for the longest post of all time... so I better go get my solid 2 hours of sleep before I have to get up and go to work. Let us know how you make out with your skin.

Regards,

Bob



lovely
Nov 08, 2019 4:10 am

Hi Bob, I was just wondering if you are still using the Okeefe salve for your skin problems, and is it still helping.

myyear54
Nov 08, 2019 1:15 pm

May sound stupid, but I found relief for irritation using O'Keefe's Working Man's Hand Cream. Was cleared with my doctor. Just said not to put it directly on stoma. Is greaseless, and with a rinse off, doesn't interfere with adhesion. For 6 or 8 bucks, it is worth a try. Doug

w30bob
Nov 08, 2019 3:28 pm

Hi Lovely,

Actually, yes, I am still using the O'Keeffe's (not sure about that spelling and too lazy to go find the tube) and I'm very satisfied with it. I use it more to moisturize my skin under the bandage part of the barrier/wafer than for adhesion, but I don't even rinse it off. I just rub it in real good until it disappears, then hit it with my hair dryer on low heat and low flow for 10 seconds or so and I'm good to go. I'm tempted to use it on my feet, which are in pretty rough shape. It really does work as people claim. Yesterday I got my box of Skin-Tac wipes from Amazon, so I'll be trying those next. So stay tuned, but O'Keeffe's gets a big thumbs up from me!! Oh for myear54....just FYI......Walmart sells it for a little more than half what you stated. I think my tube was 4 or 4 and change, and there's a smaller cheaper tub as well.

Regards,

Bob

lovely
Nov 08, 2019 6:27 pm

Thanks Bob, I think I will get a small tube tomorrow to try out. I don't have a big skin problem, just some redness out from the stoma. My problem is where the skin and the stoma meet. It stays red and weepy. I have an antibiotic cream my regular doctor gave me that I put right around the stoma. Then I put stoma powder over that with a skin prep over that. It still looks red and weepy. Maybe that is just me, it may be the way it should be. Like I said earlier, I was not given any help. So anyway, thanks for responding.

EvaJean
Nov 08, 2019 11:13 pm

I have heard the advice that less is more, so I have tried the minimalist route, but my skin was not happy about it and would get red like yours. This is my list of products that keep my skin irritation-free. Brava adhesive remover wipes, Viva paper towels with just water for washing around the stoma, Coloplast Sween Cream, Brava skin barrier wipes, Hollister Adapt CeraRings (I don't put the cream or the barrier wipe right around the stoma where the Hollister ring will be.), Sensura Mio click barrier. I think it can be helpful to hear what works for other people. I hope you can find what works best for you soon!

judgelori
Nov 10, 2019 4:20 pm

I think it looks a lot better, y'all... there is hope in sight!!! Lol... has a couple days where I leaked and had to change my pouch daily. But I managed to keep the last one on for 3 days, so it appears to have helped. Just gotta get that area directly around my stoma happy. I am a work in progress, in more ways than one.. lol... thanks for all of the advice.
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lovely
Nov 10, 2019 7:51 pm

Hi Judge Lor, it does look a lot better. Hope you will be able to continue to keep it under control.

newyorktorque
Nov 10, 2019 11:40 pm

WTG Lori. Looks like you're on the mend.

judgelori
Nov 11, 2019 2:44 am


Thanks. I realized that I had nystatin powder that the doc had given me a while back so I started using it...crusting with a skin prep wipe. That and not having to change my pouch for a couple days helped a lot. I was pleased this morning when I changed it. I treated the area right around my stoma with some marathon. Hoping that helps by the next change. Thanks for your advice and encouragement. What a process this is....lol... Lori

judgelori
Nov 11, 2019 2:46 am

Thanks for your help and encouragement....hoping I can keep my skin healthy from now on....

Maried
Nov 11, 2019 2:57 am

As an old timer ostomy... this is what I now use to clear up any irritation due to moisture/leakage. Clean the stoma area with Head and Shoulders shampoo, the classic one, and then apply Butt Paste (diaper rash cream). Remove any extra, then apply Karaya 5 Hollister powder. I had a terrible wet rash and found this information on another ostomy site. Even when my skin is clear, I add the Butt Paste once a week and clean the area with Head and Shoulders Classic every other day. My skin has been pretty healthy.

Puppyluv56
Nov 12, 2019 2:15 am

Wow,

That looks painful. As much as I like the Coloplast two-piece, I find the Convatec flange much nicer for my skin! It has a fabric-like outer band that is adhesive as well as the inner portion that is normal, and my skin has never had any issues.
Puppyluv

Jodyskip
Nov 13, 2019 4:26 am

I have a urostomy since 2017. I had issues with skin itching and red, some white tissue (from leaking).
It took me 3 tries to find an ostomy nurse that helped me.
I am using Marlen product now.

Agua Tack Hydrocolloid Ultra Max
Shallow Convex One Piece
#72522. 7/8" precut or
#72500 cut to fit

I use Viva paper towels moistened with warm water, push on skin at edge of wafer to remove wafer from skin.
Wash skin with water and vinegar (4:1) solution, pat skin no rubbing.
Pat skin dry with cloth

Around stoma

Sprinkle Stomahesive powder, brush off extra with tissue

Apply by patting Cavilon no sting barrier film over powdered skin

Use hair dryer or small fan to dry

Apply new wafer, use hand to help it adhere (for 1-2 minutes), to make sure it attaches well.

I change wafer every 3-4 days

Agua Tack Hydrocolloid (I sweat easily and this seems kinder to my skin) rarely do I leak.

The convex shape helps to prevent urine getting on skin

Hope this gives you some ideas, it sounds complicated but only takes me 3-5 minutes