I'm a caregiver for my wife, her ileostomy is giving us fits. The skin is enraged around the stoma, so not getting adhesion of the base, more leaks, rinse, repeat. I've tried Calamine, (it burns), zinc, (slippery), and changing from flat, circular barrier rings to convex.
I hope somebody might have something topical that would help the skin and also not perpetuate leakage. Thanks for whatever you can share!
Is the area around the stoma flat? round? creases? dips/valleys? How high is the stoma above the skin? Does she have colostomy or ileostomy?
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Change your product and try samples from other companies. It's probably the adhesive you're allergic to; also, go see your stoma nurse. Regards, IGGIE
My wife had a similar problem and it was causing constant leaks. We went to Emergency yesterday and saw the Ostomy/Wound Care nurse. She used a Cavillon Advanced Skin Protectant and instead of a stoma ring, she cut a suitable sized hole in a large wound care pad. It has been a little over 24 hours and no leaks and less pain. She also gave some extras and said to continue using this 'til the skin is healed and then return to the regular stoma rings. Fortunately we have universal health care so there was no cost other than our time and it was well worthwhile.
I have shared this before and many will pooh-pooh the idea, but it truly works for me... I put a small dab of Vicks VapoRub on the edge where regular skin meets the raw red outside edge of stoma skin (where the rubber meets the road, if you will), then make sure the pouch hole is as close to this as possible... Vicks is an old-fashioned remedy and it works for me to eliminate the irritation of the skin almost immediately, and by my next change (every other day/ileostomy), the healing is well on its way. The trick is to seal as best you can and as close as you can to the angry skin... sounds crazy, but it works for me... jb
Hi walter,
You have to figure out why she's getting leaks or you'll never get her skin to calm down. Her irritated skin won't heal, no matter what you put on it, if it continues to see output......which is highly acidic. Get her to an ostomy nurse or a wound care nurse if you can't find the former, and get the leaking under control. If her skin is currently so bad that nothing will stick to it you need to use a product that allows the skin to heal without coming into contact with output. Nu-Hope Labs makes a non-adhesive barrier that essentially uses a large soft O-ring to seal the stoma that's held on by a belt. This allows the skin to be exposed to the air and heal. But see an ostomy nurse to find out if you need to go that route or if there's a simpler solution.
;O)
Hi, have a word with a stoma nurse they usually have knowledge of this type of problem. I have used a barrier dressing called Duoderm to help with this type of issue. Regards. Elwick
I had the exact same issues. I went to a stoma clinic for 3 weeks and the nurse that helped me was AMAZING. She/they, the stoma nurses, really have seen it all and they will help. Look around for an ostomy clinic. You won't be sorry and good luck.
Hi, I respectfully disagree with saying stoma nurses have seen it all. True, they've seen it but never felt it or lived with it.
And be advised, if you get a textbook nurse versus a street-smart nurse, you lose.
Everything I learned from this forum so far to treat irritating skin, my current issue, has been contradicted by my nurse who has 30 plus years under her belt.
She discarded the idea of using Domeboro.
She didn't heat the appliance prior to installing it.
She advised using Stomahesive powder AFTER Nystatin powder fixed the redness, which might be the smartest thing she told me. And that is being contradicted by fellow ostomates here.
You have to be somewhat of a lawyer. Know the answer before you ask the question.
All this advice from me is just from last week, Friday 10-18-24.
Always double-check the information you are given, then make a rational decision.
Warrior, I agree with you. In my experience, the stoma nurses don't know jack and will leave you messed up instead of helping. Especially when the stoma nurse takes notes from the patient. Lol, I had one stoma nurse writing down notes from me. Most of our stuff becomes common sense; for example, if you have a flush stoma, you don't want to double or triple barrier rings. It creates a wall, and nothing will get into the bag but pool around your stoma and eat your skin. And no, don't make the hole bigger than the base of your stoma, or you will leak and bye-bye skin. We know more than they do; we have hands-on experience. And for any other problem, I am going to my doc, not a stoma nurse. I had a stoma nurse before I left the hospital let me leave with a dead stoma. On another surgery, I had a stoma nurse wrap a barrier ring too tight and was cutting off blood circulation; one slathered my skin with cream (which we know the barrier won't stick to) and tried to stick the barrier over that 🤣, and she had 25 years of experience. Lol, since I've had to have my stoma relocated and revised six times, you know the stoma nurse comes into the hospital. I would send them out, but you know they try and stick around and stand there.
Righto.
I believe we have nurses as members with stomas here.
A few peeps with Ph.D.'s too.
Only you know your family.
It's here. It's the experience going through this shit that makes them know their shit. No textbooks... life street smarts.
I think she should have way more stoma nurses that actually have a stoma. It is a must to have one to know the scenario.
Yes! Change your appliance more frequently to avoid this, but cure it this way: Fast until you're empty. You basically have diaper rash. Clean and thoroughly dry the affected area and apply Nistatin powder. Let the affected area have air and light for a few hours. Apply a thin coat of Nistatin powder with your regular prep pad, dry, and apply new appliance. Change and repeat in 2 days, being careful to pull the appliance off in the shower gently and slowly as to not damage the area. Do it once more, and it should be pretty good.
I learned a trick from other ostomates on another site, Head & Shoulders shampoo! Wash the area around the stoma with H&S and let it sit for a minute then wash it off. Make sure it's the original Classic Clean formula. I always keep a travel size bottle in the shower.
First, thanks for replying! It's an ileostomy, it has receded to below the height of her surrounding belly, if that makes sense. I need a convex barrier to even have a prayer of preventing leaks. We went to the hospital yesterday and got a treatment with a purple liquid that is supposed to harden to a shell. It lasted about four hours, came off with the next leak. Trying a couple of hydrocolloidal patches now, might not be using them exactly right yet. Thanks again
I think you might be right about allergy to the adhesive. Using Hollister now, got Coloplast samples on the way, thanks for the advice!
Have you tried 3m advanced skin protectant? It is the same concept as the marathon you used but it works way better
It definitely sounds like allergic reaction to the adhesive. Glad you're getting samples. Keep us posted!
While in the shower, use antibacterial dish soap around the stoma. It will burn a little but a lot less than alcohol or iodine to kill infection. Once done, then use a tiny bit of conditioner around the stoma and massage in, then wash the area around again with soap. Do not use conditioner again.
After each stoma output, wash again with antibacterial dish soap and rinse, until it stops spewing.
Dry the area thoroughly using a blow dryer and soft toilet paper, always using a dry spot. The skin should feel chapped and rough to the touch, not slippery or wet. If output is on the stoma, that's okay, wipe up, but if it touches the skin, head back to the shower for another wash with soap. Repeat above until very dry.
Use a little stoma powder just around the stoma and on damaged skin. Dry brush off well until it appears to disappear with dry toilet paper. It will leave an invisible residue.
Use Flonase or generic nose spray, or skin protectant, spray into the cap and pour around the stoma and spread out to cover adhesive areas. Dry well with a blow dryer and repeat. (Using the Flonase kills the sting of burns.)
Next, cut your wafer hole to be just a hair larger than your stoma in size. If it's oval, then cut it oval. Squeeze out a generous tube of no-sting paste around the stoma and spread down so it adheres to the skin. If not, remove and repeat the above steps. Why very dry skin is important: The paste needs to be 1/2 inch wide just like a ring and right next to the stoma.
Next, cover the same flat area on the wafer after you peel off the backing first. Now line up the bottom of the wafer hole with the bottom of the stoma and press down; you don't want the paste extending much past the edge of the wafer hole as seen through the bag. Press down gently to get a good skin bond around the stoma.
Put extra barrier strips all around and an ostomy belt if needed.
If you're drinking coffee, switch to tea instead. It makes the output very acidic and leak burns worse.
The purple treatment is called Medline Marathon and can only be obtained with a doctor's prescription. It's rather expensive as well.
It's usually only needed for scab-type wounds around the stoma. Paste is used afterwards to fill in unevenness that rings are not so good at.
With scabs coming off frequently, an almost daily wafer change is necessary until the wounds are healed up more.
I do not like Hollister products used in the hospital as I find I may be allergic to them; they are clunky, stiff, and irritating. Alcohol-based paste is absolute crap also, but cheap crap hospitals typically need as they are ripping wafers off regularly anyway. You, like I, likely have an allergic reaction to both. Hollister may have a better line, but I haven't used them since another better hospital introduced Coloplast, and I like their products better. Sorry, Hollister...
I use no-sting paste and Coloplast wafers, etc., now, much better products in my opinion, but willing to sample others to see if they work better for me.
Unfortunately, with wounds, the scabs come off regularly, so a daily bag change until the skin heals up better, so that and the alcohol wipes used in the hospital I was having a bad reaction to.
The bag changes come less and less over time as the skin heals up more.
I use antibacterial dish soap to kill infection after each spewing followed by only one massaged-in conditioner treatment around the stoma, then only the dish soap after that rather than using alcohol or iodine anything as it seems it keeps on stinging.
I also use generic Flonase as a skin protectant as it stops the burn pain.
That's a recessed stoma and they are the most difficult.
You'll need a one-piece convex, ostomy belt, no-sting paste, stoma adhesive powder, and extra-large barrier strips.
You also should look into another surgery to get the stoma redone so it sticks out.
Hydrocolloid sheets don't work to stop stoma output.
They can only be used to protect clean healthy skin from surface discharge, like from a failed wafer. They have no sideways protection and stoma output will go right under them quick.
The only thing that works well to seal in output is paste, no sting paste actually..then it has to be applied to perfectly dry, oil and dust free skin..or whatever.. rings can work for those with protruding stomas and clean healthy flat skin around stoma.
If your going to use a protective sheet, cut the hole larger than the stoma out to 1/2 inch to leave skin room for paste to stick to. However don't put the protective sheet over damaged or bumpy skin as it won't bind and may lift off the paste when you move.
I now use cut half moon shaped extra large barrier strips around the stoma making a circle of sorts, then stoma powder dry brushed off well until it disappears, then a third coat of skin barrier, dried extremely well then no sting paste on thick to form a wall, not protruding much past edge of wafer hole and pressed around stoma. This has been working very well for me.
