Need advice for stoma skin irritation - help!

Hi everyone, I just have a question relating to skin irritation rashes around the stoma. I have been suffering with really bad skin the last 2 months and it's now gotten to a point where my ostomy bag isn't adhering to my skin. I use Hollister Moderma bags, it's where the plaster part of the bag goes is where my skin is very irritated. It's raw and weeping a lot through the plaster part. I have tried the Cavilon spray but that hasn't worked. If anybody has any advice, it would be greatly appreciated..... Thank you, Jane x

Hi Jane X,

Been where you are, not fun. Sounds like you're skin's having an allergic reaction to part of your barrier. Not sure what you mean when you say the "plaster part", but am guessing you mean the part that touches the stoma and not the adhesive bandage part. Regardless, you have a few options. I had the same problem as you describe and it was caused by slow leakage right where the barrier touches the stoma. I tried the Hollister sealer that comes in a squeeze tube, but that didn't last. Hollister recommended I try their moldable barrier ring and that did the trick. I stretch it and roll it with my fingers to make a thick washer that fits tightly around my stoma and then put the barrier on. Hollister also makes a product called HolliHesive (#7700) which is basically a flat piece of skin barrier. It goes between your barrier (or wafer) and your skin to keep them from touching. Not sure what the HolliHesive is made of, and although I have a few boxes of them I've never used it myself, but that's what it's made for. If you contact Hollister you can send them pics of your problem and they'll take a look and recommend other products. You probably know all this already, just writing it for anyone else who doesn't know this. There's also a similar product available wherever they sell sports tape. Does the same thing, goes between your skin and the sports tape so when you pull the tape off your skin doesn't come with it. Don't remember the name, but I'll look in my ostomy supply junk box and see if I can find it. I remember folks telling me to use lots of stoma powder and wipes to keep the skin dry, but when the skin weeps continually that doesn't work.

What you really need to do is find out why your skin is reacting this way. Suggest you find a good dermatologist or ostomy nurse, which you also probably are doing or have done. Now if your skin is too far gone to put anything on it at all a company called Nu Hope makes a special barrier (wafer) that's essentially an O-ring without any of the adhesive bandage that surrounds your current barrier. It's held onto your stoma with a belt, and since it's not glued to your body like your current barrier you can't be doing gymnastics or anything crazy while wearing it, or it will leak. But if you just lay low for a few days and give your skin some time to heal this product may be a Godsend. By using this O-ring barrier the skin around the O-ring is exposed to the air and can heal, and you can apply topicals to the skin that would not allow your regular barrier to stay stuck. I don't remember if they have to custom make these for your specific stoma shape/size or not, but you might want to contact them. They can overnight you something to help you out.

Back to the ostomy nurse thing. I've found that ostomy nurses are wonderful people. I've made friend of a number of them at the large University Hospitals in my area and I can send them pics of any issue I'm having and they'll respond quickly with any advice they have. My local hospital's ostomy doc and wound care folks were pretty useless, but the bigger hospitals usually have someone who's seen it all when it comes to ostomy issues. So don't hesitate to reach out to them, even if they're not close. I find most people will go out of their way to help folks like us if we just give them a chance.

Please post here and let me know how you're doing. I'm not a paying member so I'm not sure what types of messaging I can and can't receive/send on here. But I can access this forum. Hopefully others will chime in as well. Hang in there, we'll get you through this.

Regards,

Bob

Thanks so much, Bob, but the skin around my stoma is fine. It's exactly where the adhesive bandage goes that my skin is having trouble.

Hi Jane, I had revision surgery last year and they used Hollister products with the tape type of wafer, and I use Convatec solid wafer, not tape style. During the ten days I was in the hospital, my skin got so red and sore. I couldn't wait to go home and get back to using my usual products.

Try using protective barrier wipes before applying a barrier. This protects your skin from peeling and irritation. Also, use non-moisturizing soaps (like Ivory) to clean your stoma area.

Words of Encouragement from Ostomy Advocates I Hollister

Hi Jane,

Ok, got it. I have the same (but not as severe) issue from time to time. You've got Contact Dermatitis, which is what dermatologists call anything they can't explain or fix. The fastest way to get it under control is to call your doc and get a prescription for Betamethasone foam. It's a strong topical steroid for skin issues and it works fast and well. I paid something like $90 for an aerosol can of it last year, but it's worth it because it works. You shake it, turn it upside down and press the nozzle. It comes out as a foam, like shaving cream. Just a dab will do ya, and the can will last for a long time. A few doses of Beta will get your skin back to normal, but won't prevent whatever is irritating your skin from continuing to do so. What I've found works for me is swimming in the pool (because the chlorine in the water seems to reduce the skin irritation), and Flonase spray. Flonase is for allergies and your skin is allergic to something in the bandage portion of your barrier. Not sure how often you change your barrier, but when my skin got like yours I changed it every morning (after swimming) to make sure the Beta continued to work on my skin, and did this until it got cleared up. I'm still searching for a cure for my skin allergy, but I use the Flonase each time I change my barrier and the Beta if things get bad........and it's very livable. Still haven't found a good dermatologist who knows anything about this skin issue. Hope this helps.

Regards,

Bob

You can also try a product called Marathon. They come in small tubes and it dries really fast and leaves kind of a hard shell on top of your skin and gives your skin time to heal. I use it all the time but it's not cheap. My extended medical covers mine but it's been a lifesaver for me and any skin issues. Good luck.

Try warming the Karaya seal with a hair dryer (less than a minute on high) before applying. Also, as others suggest, clean off old adhesive with Uni-Solve and apply skin prep before placing the wafer on.

Xerxes

Uro,

Thanks for the tip about Marathon.........I never saw that before, but I looked it up and I'm going to try some of that. Looks to be around 50 for 10 tubes from my quick search, but as you said it can be used on good or damaged skin. Sounds pretty impressive.

Xeres, sounds like her skin may be weeping too much (if her bandage won't stick) for skin prep to handle.......although it's worth giving it a shot. Skin preps come in all kinds of varieties, so you may have to experiment a bit to see which ones your skin likes. I prefer those that sting....but I like pain.

Jane......let us know how you make out.

Regards,

Bob

Right after I came home from my operation, I got an awful bleeding rash on my skin, right where the wafer was sticking to my skin. The nurse tried the ring, the powder, and something else, but my skin still raw. So I took everything off for 24 hours and applied Desitin extra strength on the rash. Of course, I barely slept, I just taped a small garbage bag around in case I fell asleep and something came out. But it was the only thing that actually cured my skin within 24 hours. After that, everything was fine and I never had that problem again. Now if I get a bit of a rash, I keep off the wafer for a few hours and apply Desitin, and I get back to my healthy skin right away.

I'd get in touch with Hollister and request some sample wafers without a tape border. I absolutely cannot use the ones with a tape border; they will light my skin up within a few hours.

Sasquatch,

  I've seen those barriers without the tape border, but can't imagine it would stay attached to me for long... I'm too active.  How do you keep yours attached?  Don't mean to hijack the post, but can't message.

 Thanks,

Bob

Try some different bags. You are obviously reacting to the glue or adhesive in the bag you are using. It happens, it's happened to me. At least if you try a few different new bags, I would suggest a different company as well. Or maybe you're reacting to the Cavillon spray. It could be anything. So the key is to start changing things one by one to see what it is you're reacting to. I swear by the stoma powder. If you haven't tried it, that may be your answer. Good luck, let us know how it goes but definitely try a different bag.

Just use it as usual, the adhesive that is on the inner part of the wafer extends all the way to the edge. They are the exact same size as the ones with the tape border. The edges do tend to peel a little sometimes, when it starts, I use some waterproof tape, usually gives the wear time a couple more days.

Are you using Skin Prep or any other kind of skin barrier? I not only use it around the stoma area, but also where the adhesive bandage part touches. You might want to make sure you get the "non-stinging" variety. I've seen Skin Prep used on babies suffering from severe diaper rash. It puts a protective barrier over the affected skin. You might want to also consult with your ostomy nurse or dermatologist.

I had somewhat of the same problem. A Ostomy RN told me to use a shampoo with zinc to clean around my stoma (Colostomy). Walmart has samples (travel size) of Head and Shoulders shampoo. Then buy a tube of Boudreaux's Butt Paste in the baby section. Rub it on and leave it on for 5 minutes, then wipe it off and apply a coating of Prep Protective Skin Barrier, by Coloplast (#0925). It comes in a dobber-type bottle from many ostomy suppliers. Let it dry thoroughly and apply your pouch. Change as soon as you start to itch or leak, 3 to 4 days, and it should heal in a couple of days. Then use the barrier dobber at every change. This has been a miracle for me. I can now go 5 to 7 days between changes. Best thing I have found to work and by using the travel sizes, it is not that expensive.

Had the same problem due to leakage around an irregular stoma. Tried everything. Finally, a nurse at Convatec suggested Duoderm Extra thin pads which I cut up and picture frame around the stoma. It has a healing adhesive and cleared up a 2-year problem in weeks. It's available on Amazon.

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Not only did it cure the skin, but it also helps prevent leakage. Used to have total failures at least every other day. Down to every 4 to 5 days between changes with no major failures. Today's price was $21.54 for a box of 10. That does 20 changes for me cutting them into strips for an ileostomy.

Would be less around a larger stoma - a colostomy. Good luck.

Try calamine lotion. Several coats. Do not shake the bottle first. Open and slowly drain off water from the top of the bottle. That will give you a stronger solution.

Apply and let dry. It dries quickly. Apply a few times. Let dry. Soothing. Good luck.

Can you tell me where to purchase the marathon barrier?

I buy my Marathon product from the place that supplies my ostomy pouches. They should be able to order it in for you if they don't have any in stock. The stuff is amazing for protecting your skin while giving it time to heal.

After you figure out what's irritating your skin, Bard Natural Care Gel is great for healing. I put it on my skin first before the barrier wipe/spray when changing my appliance. It doesn't interfere with adherence.

Your right about trying different stuff, I have learned to use water nothing much to clean my skin around my stoma. I use the rings, they are amazing and everyone should use them. Hollister products I use and there I feel the easiest for me anyway. I have learned as well not to change, keep same method. Any one to chat, I'm here. I'm having my problems too. I have a lot of feelings of twisting and uncomfortable pain. Going for test. Fluoroscopy upper GI; next Tuesday Victoria.

I've been having a similar problem and they gave me desoximetasone gel. Rub a small amount on the affected area. It takes a minute to dry, then you can use your barrier rings and/or Brava adhesive strips around the barrier, but no barrier sprays nor wipes. Change the bag every 2 days using this method up to 10 days. I have noticed the pain is not as bad, and I'm looking forward to additional positive results. Good luck.

Hi Jane,

I would suggest that you see a dermatologist. They are the best at diagnosing skin conditions and treating them. I had the same problem and I was told I had eczema. I was given Stelara that treats eczema and psoriasis and no more irritating spots around my stoma. I only take it every third month by injection in my arm. This may not be for everyone but I know it worked for me.

Mike

Hello little red

Thanks for the info about the zinc shampoo. I'm going to remember that.

Jo

When I have skin irritation, I use Compound Tincture of Benzoin swabs. It burns but it works.

Jo, it works like a charm for me. I got the suggestion from my ET RN at my hospital. I did buy the travel size of Head and Shoulders because of the zinc, $1.49 at Walmart. And I was told to use it at every change, even after my skin heals. Then also to use the butt paste until it heals and then only the Head and Shoulders and the barrier dobber. So far, it is working. The butt paste comes in different strengths. I purchased the maximum strength. It is a small tube and a little pricey, around $5.00, but you only use a tiny bit each time. I used it 3 times (changes) and it did the trick. I applied the butt paste, left it on for about 5 plus minutes, and then wiped it off with Kleenex. I applied the protective skin barrier, let it dry, and applied my bag.

Miss Jane, you certainly need professional help. All of these suggestions are fantastic, but we're not there and can't see what you're suffering. Irish healthcare isn't that bad and should be able to see someone without too much of a wait. In the meantime, try everything. If nothing "osomy" works, I really like the Desitin Ointment idea—it may be called something else in Ireland. You can find it in the baby care areas of the store. The base is Zinc Oxide and Cod Liver Oil. Desitin has been used for skin problems for a long time. As it is used for baby's bottoms, wet and "dirty" if you get my meaning, it's perfect for problems like ours. Please keep us informed. Many would love to know how you solved this problem. All the best.

TAPE BORDERS. I don't like them either, although I use them as I have them. They are good for extended wear time, but I'm not interested in that. I change my bag every other day, unless I get lazy, then I'll go a third or even fourth day. I try everything, but my current go-to pouch is Hollister 88400. This is an opaque filtered bag with a simple cut-to-fit adhesive wafer. Simple and easy. Depending on the size of your stoma, the actual adhesion area isn't all that big. I've never had a leak or fall off!

Some adhesion tips I've discovered over the last 1.5 years: 1. You must keep the skin completely dry. This includes that one area we all have where our stoma is constantly leaking. This is normal, of course, as it keeps our stomas moist and healthy. Mine is just to the right at the bottom of my stoma. If this area is not completely dry, it won't stick.

HEAT SEALING. I've done this since day one, and I swear by it. After cleaning and towel drying, I use a thick (hotel quality) white washcloth—dry. You must keep it dry. I hold it in front of the whole peristomal area and run a hairdryer on HIGH. Yes, the washcloth will be nice and warm. Don't use hot, blowing air near your stoma, but heavy washcloths then become the "hot towels from the warmer" we've all enjoyed in the hospital.

INSERT: Use a piece of gauze or a small bit of paper towel on your stoma near your "constantly wet area". It won't blow off, as you are applying the heat to the covering cloth, not your skin. When the skin is dry, I pull off the covering and use the hot hairdryer on the pouch adhesive, just about 5 seconds. Before I apply it, I use the hot washcloth to be sure everything is dry—the hot washcloth will stay warm. Then I apply the warmed wafer. There isn't much good about our ostomies, but applying a warmed adhesive wafer to your clean skin is wonderful.

As I really like excellent adhesion, I then take my trusty, dry heavy washcloth and hold it in front of the pouch, then blast it with hot air for about 30 seconds. Off goes the dryer, and I hold the still warm cloth against my pouch until the heat starts to dissipate.

All should be secure. If not, you were either too wet or you have something on your skin that interferes with adhesion. Or you have an off-spec appliance.

If that's not enough, I started this after watching a video of an experienced ostomate. I leave my bathroom, head to my bedroom, and turn on an electric hot pad. Sometimes I lay down and listen to some classical music or a book on CD, or the radio. About 5-15 minutes is usually enough. After the heat dissipates on my skin, I'm good to go anywhere and nothing moves. Remember, no tape borders needed. The woman who uploaded the video used something I can't find anywhere: a rice paper strip with plastic rings on either end. This appliance goes in the microwave for 10 seconds, then you lay it over your applied appliance. Her testimony was that since she started using it, she never had a leak. My makeshift system works just as well.

Get rid of Hollister. I had the same problem. I use Coloplast now. Contact your ostomy nurse. Call Coloplast and ask for free samples ASAP. I also use a 4 × 4 skin barrier. No problems. I feel your frustration and pain.

All this information is wonderful... I'm learning a lot! And you'd never get this much diverse experience/knowledge from a single ostomy nurse or health professional. Too bad this site doesn't have "stickies" in the forum where this info could be listed as a reference/archive. Instead, folks have to keep asking these questions every so often or the info gets buried. After seeing a number of dermatologists (which were useless) and a number of ostomy nurses (much better but didn't solve the problem), I was thinking I've tried everything I can... but after reading all this, I need to go re-read this whole thread with pencil and paper, write down all the new things to try... and get ordering!! Thanks everyone for the info!

Regards,

Bob