How Do You Deal with Incurable Skin Irritation While Swimming?

Howdy Gang,

After reading that like 70% of ostomates suffer from skin irritation or allergic reactions... I got to wondering... so what do they do? I've talked to a few dermatologists about peristomal skin irritation or allergic reactions, and the answer is always the same. They don't know what causes it, and always suggest the same things... lotions and creams that you can't use or you'll have no adhesion, steroids that no one wants to use long term, or try different products... or just live with it because they don't know what to tell you. That's all good, but THEN what do we do?

Now that swimming season is here and I want to open my pool, I started thinking about my skin irritation problems. I currently cut the adhesive outer section of the barrier completely off and hold the barrier on with 4 pieces of tape, leaving as much skin open to the air as possible, and wear a belt fairly tight. That's fine until it's time to hit the water... and then not so much. The bandage portion of the barrier is what keeps water from getting under your barrier, and with that gone I'll be needing to change my barrier after every dip in the pool... which isn't realistic.

So I'm wondering what all those ostomates out there that have similar continuous irritation/allergy/weepy skin, whatever you want to call it... actually do so they can swim. I've tried a number of different manufacturers' products without much luck. Luckily my skin is fine with the barrier and ring material that goes around my stoma, so no irritation there... it's just the adhesive bandage part that drives my skin nuts. I've tried most of the "C" tapes that go around the outside of the barriers... and nope, no luck. The funny part is my skin only gets irritation about 3/4 of the way around the barrier. No irritation on the lower right quadrant next to my right pants pocket, just the other three quads. My Derm has thrown up her hands, as have all the previous ones I've seen... but with so many ostomates supposedly in the same boat I'm guessing some have found a way to deal with this crap. If you have... let me know what works for you. Otherwise, my pool is going to be nothing more than a very luxurious pond for my ducks and geese!

;O)

Bob - I have had good luck with OPSITE Flexifix from Smith & Nephew. The 5cm x 10M size works best for me, but there are variations. Four to six pieces should keep the barrier watertight even without the adhesive.

https://www.amazon.ca/OPSITE-Flexifix-Centimeter-Transparent-Conformable/dp/B002UNG16W/ref=pd_lpo_sccl_2/131-1490159-5929254?pd_rd_w=0mpaj&content-id=amzn1.sym.135c60bb-68cb-4d34-ae94-a6f8d634fb42&pf_rd_p=135c60bb-68cb-4d34-ae94-a6f8d634fb42&pf_rd_r=KHCV7XSPJXVJJA5DKC5J&pd_rd_wg=hVjKu&pd_rd_r=9f2cd8cb-a7cf-4463-b5f8-db8062caa260&pd_rd_i=B002UNG16W&psc=1

Good luck,

Bryce

Irritation is a complex issue. The best person to talk to is an ostomy nurse, especially if you have skin breakdown. Dermatologists probably will not be able to help you. The solution is probably in your technique. There are products that are best used with skin breakdown. It is important to distinguish between leakage of the barrier and your technique. Sometimes a convex barrier is needed and/or a barrier ring. Most products do not adhere to weeping skin without powder and Cavilon. This cannot be determined via messaging.

Have you tried Tegaderm?

Maybe I'm missing how you use stuff. 🤔 So you cut the adhesive part of your wafer off and it's just held on by tape? Then, you apply your bag on the wafer?

Living with Your Ostomy | Hollister

Hi Bob

Not knowing the cause of your prolonged irritation, it is difficult to comment...

Have you tried zinc powder when not in the water - puffed on - excess blown off.

If you have stubborn unstable / broken down / weeping skin - dependent upon the cause - you might try a wound dressing [of very fine 'tape' which is a carrier for a topical application of Fludroxycortide [4 micrograms per square centimeter of tape... YES it is a steroid treatment - but if used sparingly to protect whilst healing, it does allow for another barrier / flange to overstick successfully without further damage or instability BUT ONLY USE SPARINGLY - just to tip the balance of healing.

But to iterate NO LONG-TERM USE of the Fludroxycortide - and cease use immediately if any exacerbation results. [It either works well over a couple of days - not at all].

For more regular application re swimming etc. I have found the Salts [curved] Flange extender shaped product [allows for relevant quadrants or selective application]... come with or without Aloe too. ---- to be an effective fail-safe and very kind to vulnerable skin.

Salts "crescent" [my word] flanges work well with other brands too - but excellently with the Salts 'sundial' 'wafer/back plated products.

Good luck - you WILL find a solution!

BW

waves from the Hills across the Pond

J

Dealing with incurable skin irritations can be challenging, but there are some ways to manage and alleviate the symptoms. Here are some steps you can take:

1. Consult a dermatologist: Get a proper diagnosis and advice from a skin specialist.
2. Identify triggers: Keep a journal to track when the irritation occurs and what might be causing it.
3. Moisturize: Keep the skin hydrated with gentle, fragrance-free moisturizers.
4. Topical creams: Over-the-counter or prescription creams can help reduce inflammation and itching.
5. Lifestyle changes: Avoid irritants, wear breathable clothing, and practice good hygiene.
6. Stress management: Stress can exacerbate skin conditions, so engage in stress-reducing activities like meditation or yoga.
7. Alternative therapies: Consider acupuncture, herbal remedies, or light therapy (under medical guidance).

Remember, everyone's skin is different, so it may take trial and error to find the right combination of treatments that work for you. Be patient, and don't hesitate to seek medical advice if your symptoms worsen or change.

Bob, as you suspect, the problem may have to do with your tape boundary. A good solution is to put a layer between your tape boundary and your skin. A good one to try is 3M Cavilon.

"Cavilon No Sting Barrier Film is ideal for routine protection of intact skin under adhesive products including vascular access dressings and devices, tape, wound dressings, and ostomy barriers. It can also be used as a protective barrier film around stomas, tracheostomies, and wounds, and areas exposed to moisture, friction, and shear.

Cavilon No Sting Barrier Film offers a variety of convenient and easy-to-apply wound care options including a wand, wipe, and spray."

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I like what a traveler above suggests about putting a layer of Cavilon under the tape portion of your pouch or tape.

I had to do that for the tape collar on my pouch for a while until I found the right adhesive remover. In your case, it's an allergic type reaction I gather, but it won't hurt to try. Cavilon is a miracle worker for certain things.

I don't know if you've tried Hy-Tape yet or not, but it is a bear to get off without ripping skin.

Good day, Bob, I think it's time to get all the companies to send you more samples to start trying them all again. It's got to be the adhesive, I would think, so give a few new ones a chance. Have you tried swimming without a bag? If you say the ducks and geese are using the pool and they are defecating in there, a little bit of yours won't make any difference. Regards, IGGIE.

Hi Gang,

Thanks for all your replies. Interestingly, I posted a lengthy reply yesterday asking my question another way and replying to your individual comments... but all that seems to have disappeared or never actually made it. This is a funny site. Things disappear, titles get changed, etc. So let's try it again and maybe this time it will stick.

What I'm trying to ask is how have people who've done everything you're suggesting actually cope with continued skin irritation when all those things fail. Believe it or not, there are a myriad of skin issues that are not fixable, and these are simply labeled "contact dermatitis" or an "allergy" of some sort. Think of psoriasis before the recent biologics came along... that type of thing. So what I'm asking in this post is directed toward folks who live with unsolvable skin irritation issues and what I'm asking is how they manage on a daily basis... not so much how to try to cure the issue that's not curable. I hope that makes sense. With that all cleared up I'll address your comments... last first to reduce the amount of scrolling I have to do;

Iggie... I've tried just about everything. For background, I didn't have any skin issues for the first 7 or so years of my ostomy. Then one day I got a small spot under the bandage portion of my barrier that itched like crazy and began to weep/ooze. Within a couple of weeks, it was a complete mess. I tried antifungals, antibiotics, barrier sprays and membranes, just about everything including the kitchen sink. The only thing that worked somewhat was the Domeboro soaks followed by a vinegar soak. After 15-20 mins of both my skin looked brand new. But then I had to slap a new barrier over it and let it fester for another 3-5 days... and the cycle repeated. I tried all the major brands of barriers, skin protectants, tapes, etc., to no avail. A big part of the problem was/is that once the skin is denuded it's very easy for bad things to happen, as the protective layer is gone. And changing your barrier every 3 or 4 days doesn't give the skin under it enough time to fully form a new protective layer. Instead, you rip off whatever part of the layer was forming and you're back to where you started. You'd think a skin protectant would be the answer, but that comes off when you change the barrier too... bringing any newly formed skin with it. As for swimming without a bag... no issue there. The problem is maintaining adhesion of my barrier when water gets under it from the missing bag and from the outer edge of the barrier, which no longer has the adhesive edge keeping it securely to my skin. I have no fear of animal poop... or any poop for that matter. Seems many on here seem to think they can catch something from touching their own poop. I hate to break it to those folks... but what came out of you is still inside of you... so it can't hurt you. The only thing that can hurt you is if your poop gets into your bloodstream. So if your fingers look like an onion sliced with a Ginsu knife you may want to glove up. Otherwise... stop wasting your money on gloves and polluting the planet. But I digress... ;O)

Hi Hi... I've tried the Cavilon, and all the other barriers. The issue is when that layer comes up when I change my barrier it denudes the skin again, which hasn't had time to heal... and the rest of the story you know. If I make a lot of effort to leave the skin barrier in place it ends up flaking off in another day or so and so does the adhesion. I've also found some great tapes with really good adhesion to wet skin... but the same thing happens when it's time to remove them. Even with the release agents... some skin gets denuded.

aTrav... same answer I gave Hi. Interestingly, I'm not 100% sure my issue is an allergic reaction to the barrier adhesive. If it was then why do I still have this problem, since I've been cutting the adhesive off the barrier for quite a few months now? Replacing the barrier adhesive with any number of tape products creates the same result. There may be a 'skin trauma' issue of sorts going on, as I've discussed it with a number of people and it's a very weird phenomenon that's not well understood (hmm... where have I heard that before?" And what's even nuttier is that I have almost no irritation in the skin surrounding the lower right section of my barrier. The other 3 quadrants are a mess, but not that lower right. And no irritation at all UNDER my barrier ring. Makes you wonder, eh? I'm starting to think my stoma doesn't like me. ;O(

Hi Wli... I don't know how to even begin messing with that username!!! Yes, I agree with your list. Done them all except parts of #7. I live the most stress-free life imaginable... so not much to manage or reduce there. I'm not licked yet, but don't like fixing things without understanding the 'why' behind the problem. BUT... I get ya. Get it fixed first and figure out the why later. ;O)

Hi J... Yes on the zinc... tried it many times. Feels great, but the problem comes right back. I've tried a number of steroids... and they do work. But the problem with them you seem to understand well. Long term steroid use is a no-no wherever it's done, the skin being no different. And of course the problem comes right back as soon as you stop applying them. I put up the topical steroid strength list by brand on here some time ago... maybe I should put it up again for folks who want to know how strong what they're using really is. As for the Salts extenders... I did give them a whirl. The results were pretty ugly. Despite the claims of allowing the skin to breathe... that didn't seem to be the case. Had to yank them after one day as my skin was screaming for help and itching like crazy. Like I said earlier... I've tried all the normal avenues... hence the reason for this post. But I do appreciate the suggestions... from you and everyone else. Please don't think otherwise.

Hi Choo-Choo... yes, cut off the adhesive so only the center portion of the barrier remains and stick that on a flattened barrier ring that covers the entire barrier surface (Hollister 7806 barrier ring is 4" wide and very thin). This way the only thing touching my skin around my stoma is the barrier ring, not the barrier material itself. I don't actually think the barrier material is any different than what the ring is made of... but at this point I can't chance it. Then I tape the barrier to my skin in 4 places. I can fit 8 pieces of tape all around the barrier, but I only use 4 to leave 4 sections of my skin open to the air, and then rotate each time I change my barrier. I think if I could give my skin a good week to heal... it would. But the issue would start right back up again when I put new tape back over it. Yeah, I know... it's weird. ;O)

Hi Kas... yes, tried Tagaderm. You should see the bookcase full of things I've tried. If anyone breaks into my house they're going to think I either robbed a drug store or have a very weird fetish for skin treatments! ;O)

Hi gentleJ. I agree... irritation is a complex issue. I've talked to 7 ostomy nurses, including those from Johns Hopkins, Georgetown, and Washington Hospital Center. I've also seen the greater Washington Derm team, composed of docs from those same hospitals, as well as 4 dermatologists in private practice. They just love to see me come in the door. Mine is definitely not a leakage problem. I'm an "expert" on leakage... and this ain't that. My skin irritation occurs beyond the barrier, not under it. I have always used a convex barrier. You are very correct when you say most products do not adhere to weeping skin. Even sometimes with powder and Cavilon... depending on just how much weeping occurs. It's a puzzler!

Hi B. The Opsite is a new one, I have to admit... and I will try it. Got nothing to lose at this point, except the summer swimming season!! Even if I just slap it on to swim and then remove and reapply before I jump in again. Would still be better than changing my whole barrier. 5 points for you... which I think puts you in the lead!!

Ok... will say thanks again... you guys and gals are great! Let's hope this one sticks. Although I'll be a bit smarter about it this time and copy all this to a Word file... just in case.

What comes to mind is that you must be allergic to something, perhaps adhesives? I'm sure after all that you have been through, you have most likely tried many pouches and brands, etc.

New Hope has this adhesive-free pouch that at one point I was going to try out. They do send samples if your doctor's office gives them a call. I'm not too sure how it would work out. I'm not saying it's adhesives, but it could be, and my nurse told me that we can become allergic at any time.

At the start of my ostomy, I was allergic to most pouches. It was a real problem until I found one I could use.

For instance, I was using the Eakin brand ring for almost a year and suddenly I was having skin issues when I never had before. So, it was a trial of removing things I was using one at a time to find out the issue, and it was definitely the Eakin because 2 years after I stopped using them, I tried one and wham! It was back.

Through that ordeal, I found that some of the things I removed I really did not need. You may want to look at your products, as I'm telling you that these companies will change ingredients on us without saying a word. It could be anything you're using, including barrier wipes to adhesive removers.

Another thought is changing more often. I know you said that you're ripping off a layer of skin each time. But maybe you're leaving them on too many days?

Once I had a buildup of adhesive on my skin, it took putting a hair conditioner around my stoma and at least 10 Smith and Nephew Resolve wipes, and then a couple of swipes of alcohol to get it all off. Prior to that, you're going to be surprised and think I'm nuts, but I used Krud Kutter wipes. These are not to be used for stoma or stoma skin. But I was desperate for my irritated skin to be rid of.

I'm not saying any of this is definitely your problem, and I may have missed things you have said. It's just things I've been through and throwing it out there in case it could help you.

About the gloves...lol! I tried not using them and my hands are a wreck! It's not the poop that makes me wear them; it's my eczema. I had to start using them again, so the poor landfills will be a little fuller, unfortunately. 😁

I came back here to add that once I had to get Hollister Hollyhesive 4x4 skin barriers as suggested by my nurse to cut out my own rings and to cut pieces to put under my tape border so that my skin could heal. For some odd reason, after removing my Safe and Simple skin barrier wipes and adhesive remover wipes, that issue was solved around my tape border. I found I did not even need the skin barrier wipes after removing them from my regimen. Although I do like Cavilon for a skin rip if I get too rough taking off my bag.

G-Day Bob,

I have just done a test on all the different seals, and you can see for yourself the outcome in the photo. Regards, IGGIE

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Hi Igg,

Nice work! I keep reminding myself how lucky I am that I don't have irritation under the ring portion of my barrier... that would really suck! I'm going to post a picture of my specific issue as soon as I get a few minutes, as we all know a picture is worth a thousand words. Thanks for this info!

:O)

Hi Hi,

All good points! I'm starting to think my issue is as much allergic as it is trauma-based. And "allergic" may be the wrong word. I'll post a pic (as I told Iggie), so you can see what I mean. Mine seems to be more a "reaction" than an allergic reaction. By that, I mean I have no irritation under my barrier... just around my barrier. So when I do my soaks and my skin is nice and normal, ready for me to apply my new ring and barrier... all is good. But after I put on the ring and barrier, the skin adjacent, not under the edge of my barrier, turns red. For no reason at all. It's not in contact with anything, but still gets angry. And then I have to put something over parts of that redness to keep my barrier on, since I cut off the bandage portion of the barrier. So it's like you put socks on that only come up to your ankle... and from there to the top of your calves turn red, not what's under the socks. Weird, right? I've also worn a complete barrier including the adhesive section on my left side for weeks... and had no reaction whatsoever. So I think it's related to there being a stoma there, and for some reason my skin doesn't like not being consulted on that decision before it happened. The derms say skin can do that, and other weird stuff, but can't explain why. So this is a puzzler. And at this point, I've shifted from trying to fix it to learning to live with it. Hence this post. It's funny because I once saw an old dermatologist who told me right to my face to just learn to live with it... and over time my skin would toughen up and I'd be fine. I immediately wrote him off as a crackpot... but he may just have the last laugh... and be right. Wouldn't that be the shit? And yes, I do recall the Nu-Hope non-adhesive barrier and looked into it some time ago. I'll revisit that as I can't remember shit these days. Thanks for your reply!

;O)

Are you using tape? I think you said around the barrier. Maybe it's an allergy to the leftover adhesive from your tapes? Or does it turn red with nothing at all on it? Could it be your soap?

Bob, I can somewhat understand your pain. I had to live with constantly irritated skin due to fistulas — ostomy appliances were used to try and contain the output. Unfortunately, with a fistula, there is no stoma, just an opening on your skin. Multiple surgeons and an ostomy specialist spent 6 weeks trying to figure out ways to contain the output. The solution was a moldable barrier along with wearing an ostomy belt. It wasn't the perfect solution — my skin would never heal because of the skin trauma caused by frequent barrier changes. That problem was finally resolved by using "Mepilex Lite Foam Dressing." The dressing was applied on top of the irritated skin and the barrier was applied on top of the dressing, which allowed the irritated skin to heal and no damage to the skin when the barrier was removed. I saw where ConvaTec has a competing product called "ConvaFoam." Unfortunately, ConvaTec states that you can't use their product in the shower or while swimming. ConvaTec does provide free samples of "ConvaFoam." The foam dressings are designed to provide an environment to allow a wound to heal and able to remove without damaging the skin underneath.

Before the discovery of Mepilex, I would have to take a pain pill before removing my barrier. I never had to deal with the itching you experienced, only pain. If you have never tried Mepilex, it may be worth a try.

Hi Guys,

First, thanks to all the folks who PM'd me on this subject. I understand you're not wanting to post in the forum, and I'm much obliged for your input! Interesting tidbit regarding this skin irritation issue: a while back, I also made a spreadsheet, like Iggie's, but more general in terms of all the known skin issues that relate to irritation. I then went down the list and checked off everything I was sure it wasn't. And at the end, I found I'd checked everything off! Fast forward to the other night when I was going through my "stoma issues" picture book (for like the millionth time), and something caught my eye. It showed irritation similar to mine, but it was around the stoma, not out past the end of the barrier. I'd seen it before, but mine was a bit different, so I ignored it, thinking it was stoma specific. But reading up on it further, it sounds more and more like what I may have. And another reason I didn't make this connection earlier is because I think my issue has been a moving target of sorts. Possibly a Staph (bacterial) infection initially, that morphed into a fungal infection...and now into what I have now. I'm researching it now and will be discussing it with my Derm later this week when I see her. Bad news is that what I'm thinking it might be isn't curable...but maybe it can be managed.

But first, I have to confirm if it's what I think it is...and that's something called Peristomal Seborrheic Dermatitis. It's described as "a common skin condition that can affect the skin around a stoma. It can cause red, irritated, flaky skin, and itchiness that may lead to scales that come off easily. The rash can also appear pink and scaly, and can be similar to psoriasis or irritant dermatitis. Other symptoms include:
Patches of greasy skin with white or yellow scales or crust
A rash that may appear darker or lighter in people with brown or Black skin, and redder in people with white skin
Ring-shaped rash
Pics show very similar dry crusty skin like mine over a red irritated base. Sounds and looks very similar on a macro level...so we'll see. I take pics of my stoma before and during each barrier change, so we'll see if my Derms see what I see...or if it's just wishful thinking on my part. Some wish, eh?

;O)