Red Weepy Skin at Stoma/Skin Junction - Need Solutions

Hi gang,

I know this has been discussed in the past, but can't find my notes. I just searched this site and all the discussions I found about red weepy skin were about the skin under the outer bandage portion of the barrier/wafer, not at the stoma/skin junction. I've been experiencing this lately, but only at my stoma/skin junction... my skin under the bandage portion of the barrier is fine. I took a real close look at my barrier when I took it off this morning and it's hard to tell if the weepy skin is what is causing the skin to turn red or if the weepy skin is allowing the barrier to leak some output (i.e., weep) that is causing the red skin. The only thing that has ever worked on red weepy skin at the stoma junction has been to change my barrier every day... but that gets expensive.

So remind me again how you guys solved the red weepy skin problem. And remember, I'm not talking about skin under the bandage portion of the barrier (which is most likely an allergic reaction). I'm talking about where the stoma meets the abdominal wall skin.

Thanks,

Bob

Hello Bob.

Thanks for the post and I hope 'we' get some good replies as this has bothered me from the start.

Mine feels as if the join between the skin and the colon is splitting apart and it's forever bleeding. I found that having a bigger circumference on the flange hole eased it a bit, which made me think that maybe the edge of the smaller flange was irritating it. I also found that the Dermacol  stoma collars ( made by Salts Heathcare) helped for a while and they are very comfortable to wear. I don't think they would fit on your stoma very well although they do come in various sizes, but they are all round.  My own (home-made ) baseplates are much better and I think that this is because they are thicker, and sanded down to a nice smooth curve at the point where it is likely to come in contact with the skin around the stoma. All the manufactured flanges seem to be thin and relatively sharp edged, which only needs a slight touch to cut into the soft tissue. I tried all the paste and rings but could not get on with them very well. I am still experimenting with silicone skin masking.

However, unfortunately I have more pressing problems with constant nosebleeds brought on by medication for thinning the blood, so at present I am trying to resolve these issues before I get back to the stoma problems.

I do hope you find a solution soon, which may mean that I don't need to find one for myself!

Best wishes

Bill

For just red irritated skin, I will use butt paste or a zinc oxide cream. I let it sit for a minute or two (for those with ileos like myself, you gotta move fast). Then I rinse it off with a washcloth + water (no soap), dry, and apply a bag. I have recurring infections right where the stoma meets the skin. The ostomy nurse gave me desoximetazone. It comes in both cream or gel. You want the gel as it will dry without rinsing. It's the only thing that works well on my infections. Also, if you use Adapt / Hollister barrier rings, I suggest you use their cerarings. They contain ceramide often found in skin creams. Ceramide is gentle on the skin, and I can feel the difference between their regular barrier rings vs the cerarings.

As a preventative...

I've been applying Stomahesive in a bead (usually two rings) using a syringe; right at the lip and then putting a Karaya ring on top of that with much success.

I found that trying to do a small bead was impossible using the tube (picture how much comes out of a tube of toothpaste) and then spreading it around. It takes about a month to use up the contents of a single syringe, so extrapolating, one tube is good for 4-5 months.

If you want to give it a try, we can meet in Annapolis and I can gift you a few syringes of different sizes.

Dave

Hi Bob, when my skin gets raw, I dry the skin with TP. Then, I put a dab of stomahesive paste on a qtip and spread it on the sore spot. After that, I take a couple squares of TP and hold that on my underside of stoma to allow the paste to dry. Finally, I put the wafer on like normal.

Words of Encouragement from Ostomy Advocates I Hollister

Hi Bob, I have that same problem you described. My doctor gave me a cream called Nystatin that I put around the edge of the stoma and the skin. Since the wafer will not stick to the cream, I put stoma powder on top of the cream. Then I use the skin barrier over that. Sometimes I add more powder and skin barrier. It has seemed to help somewhat. One problem I have is moisture from the stoma seems to cause the hole of the wafer around the stoma to get soft and the edge of the wafer to come loose.

Hey Bob, sorry for your discomfort. You know better than most about all the crap we go through and how to make things better but sometimes a careful review might reveal something just a little different. We all know we start with clean and dry. Now if we can only keep the skin dry long enough to protect it with a barrier film, AF cream or whatever so it stays there and allows the wafer to adhere to protected skin. I even thought of using a tube of some sort so the stoma junk could still exit without touching the skin for a couple mionutes. If the skin is irritated from frequent changes that’s one problem but if it’s infected that’s got to be treated first. Lots of wise caring folks here to work with you.
The best to you,
Mike

Bob,

Man, I am sorry you have to go through this again! I have no advice because I have never had this problem, but I hope you find the perfect solution! That has got to be painful as well!
Take care,

Puppyluv

Hi Pup,

No, it's not painful at all. Doesn't itch either. Just looks a bit ugly. Luckily I've never had any pain associated with deteriorated stoma skin... just a little alarming to look at.

Thanks,

Bob

Bob, that is great! Amazing that no pain comes with it.  
Cannot imagine what it looks like! Scary for sure! Hope you are able to fix it quickly!  
Does it affect your pouch adhesive?  
Pup

Hi guys,

Bill.......sounds like we might be having different problems. Sorry to hear about yours. Isn't it funny that dermatologists have no clue when dealing with stoma skin issues? I find them totally useless. Maybe we could find one that's an ostomate! Hey.....any of you ostomates a dermatologist? From what I've read, the skin weeps when it's trying to keep the wound clean. Not really sure why the body treats that skin like a wound.....but guess it does. I can touch/poke/impact that area and it doesn't bleed.......it just won't stop weeping a slightly yellowish tinted clear liquid. This last barrier change, I put some Adapt paste over part of the weeping area, so tomorrow when I change it, I'll see if it made any difference.

Torquey........thanks for the laugh! Don't know why.........but when I think of a hot flight attendant and "butt paste," it just makes me laugh! You go girl! Ok....back to the subject at hand. Yes, I do use the Cera products, but haven't really seen any difference......glad you do.

Hi Dave........we are on the same page....I noticed the same thing when I squeezed out some Adapt paste....way too much! Being my own vet with all the critters I have, I've got tons of syringes......plus I still have tons of TPN supplies scattered around the place as well. But thanks much for the offer to meet....it's much appreciated! From what I've read about wounds, the only way to stop the oozing wetness is to allow air to hit it and allow it to crust up. Once that happens, the skin underneath begins to heal in the clean environment the wetness created. For that reason, I really don't want to cover it with anything, but I have to get the damn barrier back on. So I doubt the Adapt paste I put on really helped, but if what you're doing is working for you, that's great.....and maybe I need to rethink things. Thanks again!

Hi Ron.......you mention stomadhesive too. Is that a brand name or are you talking about something like the Adapt paste from Hollister? Guess I need to look into that stuff if it's something different! Thanks!

Lovely......yes, I remember I did try the Nystatin paste in the past......but couldn't get anything to stick to it, even when I used stoma powder over it......but I can try it again. What you say about the wetness lifting the edge of the wafer is what I think is happening to me as well. Errrrrrrrrr!

Hi Mike......agree totally. I've gone back and looked at my notes and I'm not noticing anything. Next, I want to see if maybe this stuff is seasonal? Makes me want to date an ostomy nurse! Anybody know any good-looking ostomy or wound nurses??? C'mon, I'd be a pretty cool brother-in-law!

Thanks everyone for the replies!

Regards,

Bob

My Dr. also wrote an Rx for Nystatin. I apply the Nystatin around the stoma and leave it on. After that, I do everything as normal. One guy told me he applies Pepto Bismol. I never tried that, but he said that works for him. Hope you find an answer that works for you!!

Kangaroo

Bob, did you also put the skin barrier over the stoma power?

Hi Lovely,

Yes, and I've tried putting on up to 3 applications of the skin barrier wipe before putting on the barrier. Sometimes that would hold back the weeping from coming through long enough to get the barrier on, but most times the weeping would go right through the dried powder crust before I had the barrier properly positioned. It sort of drives me nuts because even if the wipes hold back the weeping I know it's only doing this temporarily, and within a few minutes of getting the barrier on I know that skin around my stoma is wet again.....it's just under a new barrier. Luckily for me I only have that weepy skin right at the junction of my stoma and abdominal skin. I'm talking about a ring of weepy skin maybe 4 or 5 mm (1/8 to 3/16 inch) wide only.....I'm sure others have more of it to deal with. So the weepy skin doesn't really impede adhesion of my barrier per se.......just right on the sides and corner of the stoma where the ring contacts the stoma wall. I get the feeling from searching on here for weepy skin posts that the problem is way more widespread amongst us than I initially thought. Thanks for your suggestions.

Regards,

Bob

Hi Bob, yeah, the Stomahesive is Convatec's brand of paste. I've also used calamine lotion in the same manner as the paste when I don't have any paste on hand, but it takes longer to dry before putting the wafer on.

Hi, I hope all of you solve this problem. I guess I never realized what an amazing doctor I had in Tampa. Not only did he save my life, but it is now a year and things have finally normalized. I have no problems with that at all. I just lost my mom, which makes my depression worse. And of course, I hate seeing this bag and knowing it is forever. I suppose this, too, shall pass and I should feel lucky to be alive.

Hi looking,

Sorry to hear about your mom.....that really sucks. I'm glad to hear you have no skin problems. I'm sure there are lots of ostomates that don't have any problems......you just don't hear from them because they have no reason to be on here. Funny thing I found when I searched yesterday is that most of the folks complaining of stoma skin problems used Hollister products. I changed my barrier this morning and things looked a little better. When applying the new barrier I did the standard "crusting" technique with three rounds of powder and barrier wipes before applying the ring and then barrier. My skin around my stoma was still actively weeping, but only in one area instead of all the way around....so we'll see how it goes.

Regards,

Bob

Hi, looking forward. Sorry to hear about your mom. I know a mom and a sister are different, but I lost my sister a year ago. We were very close. We talked every day and I think of her every day, and that leaves me being the last one in my family. So just try to stay busy. It will help a little. I hope you continue to have no problems with your ostomy.

Hey Bob, it sounds like we have the same problem. My weepy stoma causes the edges of my wafer to kinda swell up and get soft. I may need to try a different wafer. I use Hollister products also. My stoma seems to sink in sometimes, and it does not stick out like a lot of pictures I have seen, and that could be why the wafer gets loose right around the stoma. These things are kinda hard to explain. Take care.

Hi Lovely,

No, you explained that well.....I understand and think you're right.....if your stoma sinks or moves at all there's no way the barrier or barrier ring can compensate. Once you apply your barrier and ring, the ring will spread out (relax) due to our body heat, but once it stabilizes its form around your stoma, it pretty much retains that shape whether your stoma moves around or not. We really need a ring or barrier interface made of something more like silicone caulk, which stays flexible, than whatever they currently use. I don't think my stoma moves much, but I've never thought to watch it for any length of time. But while watching an ostomy powder "how to make a crust" video, I did see the guy's stoma (rosebud) actually move in and out quite a lot while he was demonstrating how to make the crust.....now I can see why output can seep past the inner diameter of the barrier ring, which is what makes the skin that alarming bright red color.

It's funny.......I've been Googling "weeping skin ostomy", and there's lots on the subject......just no identification of what the cause is. And from the frequency with which it's mentioned, it seems to be a VERY widespread problem. I change my barrier in the morning, so I'll see how well my meticulously applied triple crust worked.

Regards,

Bob

My stoma is definitely a 'mover'. At first, I thought its movements were simply coordinated with my breathing, but no way. My little guy does his own thing and dances to the beat of his own drum. Speaking of nystatin, I used that today. Had my first leak in a long time. The confidence was flying high and then whammo! In the tub, I went. I wish I could just leave the nystatin on, but I would have a hard time keeping the bag on, so I rinse it off after it's been on a minute or so.

Hi Bob, I see you have had a lot of suggestions from others... I thought I would reiterate what others have said. Maybe switch from Hollister to Convatec unless you have been using Hollister for years, that probably isn't your problem. A different flange might help though. Also, definitely crust it well and apply a barrier ring. I do not recommend the Eakin ring, others might love it but we found it very hard to remove. We highly recommend the Adapt barrier ring. This regimen has worked very well on red, raw, weeping peristomal skin for my husband. Best of luck. Keep us posted on how you are doing. :-)

Torquey,

I don't know why, but when you say yours is CS a mover and dances around, I picture the baby tree Groot "I am Groot" from Guardians of the Galaxy 2 who's dancing around at the end....just makes me laugh! I guess what I'm struggling with is why the skin at the base of my stoma weeps in the first place. The skin isn't cut or bleeding, so it's not a "wound," per se, and from what I'm reading, the skin only weeps to keep a skin wound clean so it can heal. The dermatologists I've seen can't even tell me if I'm dealing with an allergy, a wound, or something else. So basically, they have no clue. I find THAT very frustrating.

Ostomate's wife, I have contacted both Convatec and Coloplast and received samples from both. Convatec sent me barriers that were too small and told me when I called back that they didn't have anything bigger in convex. Colo said they were sending something bigger, but they haven't arrived yet. Tomorrow will be my third change with 3 layers of crusting, and I do use an Adapt barrier ring and some Adapt paste as well. So far, so good.

Thanks,

Bob

I find osteomyelitis powder really dries the area and cures the red skin.

Hi Freyamac,

Never heard of that... will Google it and check it out. Thanks. Update on my weepy condition... I've been using the liquid Nystatin after a Head N Shoulders "rub and remove". The weepiness has drastically reduced. Sometimes it even completely stops before I put on my new barrier. Talked to ANOTHER dermatologist the other day... she had no clue. I have no idea how they stay in business... every time I've been to see one with a skin problem they've been useless. I guess they survive on providing Botox injections. Anyway, I plan to stick with the Nystatin for a bit and see what's what. I still also use the O'Keefe's on my skin outside of where the barrier ring sits on my skin. It really keeps my skin moisturized and doesn't affect adhesion if you rub it in real well. I'm actually in a good place right now with my barriers. But keep the suggestions coming, as nothing keeps working forever.

Thanks,

Bob