Severe Allergic Reaction to Ostomy Wafers and Cera-Ring

Hi Ostomates and Happy Belated Thanksgiving!

I don't know if anyone has experienced this problem, so I'm looking for some advice if you have and how you coped with it. I'm only at the 6-week point of my colostomy, and I have developed a severe reaction to both the wafer adhesive and the Cera-ring. (I use Hollister flat 2 1/4 inch wafer, 2-piece pouching system, Slim Cera Ring.) No matter how close or far away I put the ring and wafer, I get itchy, angry blisters all around the perimeter where the ring/wafer adhesive touches my peristomal skin. Last time I did a change-out, the area was also bleeding from the blisters all the way around the wafer edge. I also tried Coloplast wafers and that was even worse! I had angry red rash under the entire wafer. My body was just saying, "Get this off me!! "  I tried using an ostomy belt during a short walk outside, and I even got a rash from the plastic on the belt.

Before my emergency surgery for a perforated bowel, I had a pre-existing contact allergic reaction to adhesives, polyethylene, and plastic against my skin for years. I carry Halobetasol (generic for Ultravate) steroid cream with me at all times in case I encounter adhesives or plastic. When I change out the wafer, I clean off the skin and put the cream on the blisters; I don't put another one for as long as possible, but of course, I can only go so long. It hurts ALL THE TIME, it's hard to sleep, and I had an appointment with my surgeon yesterday. He said to keep using the steroid cream, and he moved up my reversal surgery date by an entire month, so it looks like only 10 more weeks of hell. With my skin sensitivity, I'm probably the worst possible person to have an ostomy. Have any of you had issues like this? If so, what did you do?

Hi there, I think just about all of us have experienced allergic reactions to the wafer and barrier rings. You need to call and ask for samples from other companies if you haven't already done so. Like ConvaTec, Coloplast, Safe n Simple, Marleen. They will send you samples. To see if you're allergic, test it on your abdomen but on the opposite side of your ostomy. And if you need a non-adhesive system, Nu-Hope has one.

Hi Newbie,

Wow... that sucks! With those allergies, you are the worst person to have an ostomy! Here are a couple of thoughts... Are you allergic to all plastics? How about silicone?

You said that with the Hollister stuff, you only got the rash under the adhesive part of the barrier. If that's the case, simply cut the adhesive part of the barrier off and use their big thin ring... 7806 I think. Heat the ring up with a hair dryer and flatten it out with a rolling pin so it's the same diameter as the barrier with the adhesive cut off. If you wear a belt and remember to cinch it up when you lay down, you should get around 3 days out of the barrier without the adhesive border. I did that for a while while I was figuring out why my skin was hating the adhesive part of the barrier. My issue was seborrheic dermatitis (Malassezia yeast), not an allergy. The adhesiveless ring by Nu-Hope that Beth mentioned is made of plastic... but I don't know what type... might be silicone. Give them a call and find out. It's basically a large O-ring that's held against your body with their belt. If you can stand it... it'll give your skin some much-needed air-dry time.

;O)

Wow, tough problem you have there.

One problem I see is the cream is preventing the bonding of the adhesive to the skin, of course the adhesive and plastic you are having an allergic reaction to.

My suggestion is to switch over to using Coloplast again and using their four-hook ostomy belt as it's 99% cloth, wider with only the hooks are plastic which you could wrap around with a cut strip of cloth to protect your skin from contact.

Next, use their no-sting paste and wash the area with antibacterial liquid soap only in the shower; it's going to sting a bit. And after any spewing if it gets on the skin.

Next, blow dry the area very well and don't use any creams etc. If there is any bleeding that needs to stop first and scabs to form.

Now place the cut wafer on your stoma briefly to test, also to mark an outline on your skin around the flange.

Use no-sting paste mixed with a little stoma powder and coat that entire inside wafer area with a thin, skin-protecting coating of paste focusing on wounds first to ensure it is sticking to it or else remove that section and dry and try again. Score the thin paste coating with lines from about 1/2" away from the stoma out to the edge to create cracks so your skin can flex. If too close to the stoma, you'll get leaks.

Then place two thicker rings of the paste about 1/4" away from the stoma to marry to the wafer too. Slice a groove through the top of each paste hump and sprinkle some stoma powder in and mix it up to get it to activate. Spread as you see fit for even coverage but not too close to the stoma; it should spread closer when the wafer is applied and you don't want to cover the stoma with paste.

Carefully center the hole and cover the entire paste area with the wafer and press down and hold. What you're doing here is only having the paste and cloth contacting the skin.

Put on the four-hook belt with slight pressure. Never lift the belt or remove it, even in the shower which should be almost bird bath-like and lukewarm, not hot and steamy lest you sweat the bag right off.

You can place a small unopened plastic bag tucked over the cloth belt to keep it dry. Keep water away from the bag entirely, use a washcloth and a low-pressure shower head or handheld, just to do your other body parts.

If you have a severe reaction to the paste then another solution is required.

I didn't see you make use of a skin protector. Maybe I missed that? The cream sounds effective, but as you know, it has to be cleaned off before installing the ring or wafer.

Four weeks ago, I had the same issue with weeping skin. Broken pores.

Saw a stoma nurse. Prescribed Nystatin—Nystop for short.

That, along with air time and skin protector spray, healed everything well. Took about 7 days. Stoma powder is not used for irritated skin.

Scary when you can't have that stoma covered and sealed properly.

Hibiscus, a member here, has skin allergies. Hopefully, she chimes in.

How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister

Hello newbie

Have you tried this barrier spray, it's a polymer barrier between the skin and appliance.

 

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Thanks for all of your suggestions! To clarify a few things: Yes, I'm using a barrier film spray, but just at the far edges of the wafer "bandage" area. The sores I'm dealing with are adjacent to the stoma, near where the stitches are. I can't use the Coloplast products because the wafer material sets off an even bigger reaction, and it's so stiff that I get little sores above and below the wafer on my abdomen from sitting. I use the Halobetasol cream after I take a wafer off and have cleaned my skin, and then I dry it before I put a new Cera Ring and wafer on, so it's not interfering with adhesion. I have more problems getting everything off my skin, then having these products adhere to it.

Update: my home health nurse just left (last visit) and she suggested trying a little stoma powder on the sores right after I apply the steroid cream and dry it....then use the film barrier spray before I attach the Cera Ring and wafer. She said that the sores aren't from any leakage, just a reaction to the synthetic products and adhesives. She also said that my case is very unusual, to have such allergies to plastics/adhesive/synthetics against my skin. She and my surgeon suggested ice packs and Tylenol to deal with the pain.

My body is the same way with adhesives; I can't use tape, except one type, but it can only be one brand. I had issues when finding a bag; my skin would get red, huge welts, hives burned my skin to the crying point, and the itch was a burning itch. I am allergic to the powders, a lot of the adhesive removers, skin barrier wipes, and a lot of the rings. I can use Coloplast, though it's the one and only one. So, the point is, which product is it that you're allergic to? Is it the wafer? Is it the cream or barrier ring or skin barrier? And have you tried calling and getting samples from all the brands? They also have one now made of silicone you can try, and if nothing else works, Nu-Hope has an adhesive-less bag.

Newbie,

I feel ya on your skin being super sensitive… fortunately/unfortunately, you're not alone, even though it might feel that way sometimes.

I tried 7 ostomy systems because my skin is so sensitive. I can only use silicone tape.

Sensura Mio is what ended up working for me. With your skin being so sensitive, even though your ostomy is temporary, you might want to go ahead and schedule an appointment with a dermatologist. Sounds like that may be a good type of doctor to have working with you right now.

At a WOC (wound ostomy continence) nurse visit, we tried cutting all the adhesive off a Hollister and securing it with silicone from NICU bandages… that was a 2-hour visit. He tried to keep me from taking the wafer off to see if the itching would stop… I ripped it off.

I read your visit was with a home nurse and not an ostomy nurse… I could change my ileostomy better than my home health nurses and I'd only been home a couple of days, so the advice from a home health nurse… take with a grain of salt, unless they've had a lot of experience with ostomies. Most only know the most basic of ostomy care (if you're a home health nurse reading this, you're awesome 😃).

I used Domeboro to treat my skin directly and took Benadryl to help with the itching. With your skin being so sensitive to contact allergies, less is more, so whatever we can do to put less on your skin 😃

Coloplast Sensura Mio is the one that was really bad on my skin...the whole wafer was painful and itching where it attached to my skin. Plus, it was so stiff that it poked me above and below when I sat, and formed even more red welts on my skin. (My colostomy stoma is high up on the descending colon.) So, the Hollister wafers are not as bad because the edges are flexible and bend with me.

There are two things making contact with the sores: the inside edge of the wafer where it's cut, and the Cera Ring that goes between that and the stoma. When I remove it to change it out, there is blood along the edge of the inside of the wafer and on the Cera ring...and constant pain from the sores.

A week after I was released from the hospital, I had my annual skin cancer check with my dermatologist, and she said that Ultravate would work for my adhesive/plastic allergy from the products, so yes, I've consulted with a dermatologist.

Oh, and my home health nurse IS a stoma nurse, and deals with them all the time. However, I live in a rural area, and we don't have the best health care around here, and it's difficult to find good doctors (especially primary care doctors; I'm on my  5th one in 8 years because they keep retiring or leaving.) So, there's that.

I may request samples from other companies, but my ostomy nurse just discharged me today and put in my long-term order with Byram based on what I'm using now.  So, I guess if I find something else, I can contact Byram.

Thanks for all the suggestions on what to try...keep 'em coming!! And thank you...

Your stoma nurse should have given you another brand of barrier ring to try if you are having an allergic reaction to it. There are several different brands. Some even have two. Hollister has one without the cera in it, Coloplast has a barrier ring, Convetec has a barrier ring, Safe n Simple, Marleen, but hope. These are all brands you can try for rings and wafers. You shouldn't have to deal with painful skin or irritated skin from an allergic reaction. All you have to do is call the companies, ask for samples, and they will send them out, or have your stoma nurse do it. You also don't want to let the skin get worse than it is, or you will also have adhesion problems.

Excellent suggestion. It just occurred to me that I might be reacting to the ceramide, that's in both the ring and the wafer. I seem to recall that a couple of years ago, my dermatologist had me try some OTC CeraVe products for some minor skin issue, and it gave me a rash. Aha! Definitely worth trying some without. I will contact Hollister and ask them to send samples of both of those. I like Hollister's two-piece pouching system (and the closed pouches, especially with a colostomy, don't have to drain them) so I'll see if I can try something different from them first. I'm now discharged from my ostomy nurse, so I'm on my own going forward. Thank you.

Of course... don't want you to suffer. Allergies with the skin aren't fun at all and can be very painful, and the skin around the stoma—you don't want that at all. I hope you can find one that works for you. Just remember, there are like 3-4 other ostomy companies you can try.

Have you tried placing the hydrocolloid barrier extenders around your stoma to give a dry surface and some protection? That worked for me when my skin needed to heal.  

Hi: Where do the barrier extenders go? Do you put them on first around the stoma, and then the Cera Ring, then the wafer? Or, do you use the barrier extenders in place of the Cera Ring? My stoma is currently 32 mm, so the arc of the barrier extenders looks like it would be for a larger area, and wouldn't be close enough to the stoma to get a seal.

I agree with you about this arc, which seems likely to fit around a baseball-sized stoma, not one 32 mm round.

Members are suggesting this, yet my question about how you get a tight fit has gone unanswered.

What you described initially is how they suggest using the extenders first, O-ring second, then bag.

I personally have tried using the barrier extenders around the stoma before placing the wafer; it didn't work for me at all, but then again, I was flush and was leaking like crazy.

Hi there,

I absolutely feel your pain! I have a severe adhesive allergy (also latex). In the beginning I reacted to everything. I sometimes even get hives and welts from pressure on my skin (bras and underwear especially) 😞 In the beginning of my ileostomy journey I struggled to keep anything stuck to me because the weeping blisters kept things from sticking. The pain of putting that wafer over broken skin and the weight of a filling bag pulling on it... Ouch! I'm m in good shape now, but I still have the odd flare up. 

I've found a few tricks that got my skin healthy. 

Antihistamines - regular old Benadryl for a severe flare up, or Claritin, any of the long acting ones non-drowsy ones until things settle down. I also use an antihistamine spray like flonase right on the peristomal skin. When I change my wafer, I use an adhesive remover and wash the area really well (usually a nice long shower). Then I spray with Flonase and let it dry before I apply a skin protector.

Which brings me to Cavilon advanced skin protectant. It's not readily available, unfortunately, but a good wound care nurse should be able to find it. It works much better than any other skin barrier liquid I've tried.

Next, Coloplast Brava protective sheets. I used these to heal badly broken skin. I got the square sheets and cut a stoma sized home in the middle, fit as close as possible to the stoma. It covered the whole area under the wafer and ring, allowing my skin to heal without irritation. They're VERY sticky, so watch out when removing that your skin doesn't tear!

Last, on a temporary basis, I used a kinda cheap ostomy ring that I found on Amazon - Heagi. I used the 4mm ones. They aren't very durable, but I didn't react to them. 

I hope you find a system really soon! I just had to keep trying different products and combinations until I found what works for me. Free samples from various companies are awesome.  Hang in there 💪 

Thanks for all of your suggestions. I've been very busy preparing for a live old time radio show this week (I'm the Director) so haven't had time to reply. I've found a couple of things that are working to heal my allergic reaction and sores. I went back to using the thicker CeraRings (I was using the Slim rings, and they seemed to "melt" and irritate the skin.) Now, there's a firm layer of the ring left when I change out the wafer. The sores adjacent to the stoma look nearly healed now. I'm also changing the wafer every other day instead of twice a week (I have plenty of supplies!), so my skin gets a breather more often. However, the rash from the adhesive at the bottom edge of the wafer (the "bandage" area) is much worse and now bleeding. I did the usual routine of steroid cream then drying it, then using a spray barrier film. Then, I tried putting a barrier extender on my skin directly, and adhered the bottom edge of the wafer to the extender instead of my skin. Fingers crossed!

Also, just some suggestions to those who are living with an unplanned or emergency ostomy surgery, like myself. Mental health help is a very important part of the healing process; don't be afraid to seek it out. I was having some "PTSD" symptoms, re-living the trauma of the ambulance, the ER, and coming close to not making it. I'd have nightmares and trouble sleeping. My doctor suggested a local hypnotherapist. Now, some of you may not be believers in alternative therapies like this, but for me, it was very useful. She applied a technique that she uses with military and law enforcement people dealing with PTSD, and it enabled me to stop re-living the events of that day. She also did a conventional hypnosis after that, and it is helping me to "move on" and be more optimistic about the healing process. I hope you all get the help you need, whether it's dealing with trauma, depression, or just adjusting to life with an ostomy. Of course, this website is also great, but don't hesitate to find professional help as well.