If your skin is red and wet around the stoma
This may be 'irritant dermatitis' - which looks like red, wet or weepy areas surrounding the stoma. You might notice pain or even bleeding. Irritant dermatitis is caused by something that irritates your skin. It could be stool, urine, or products such as solvents or pastes.
Treatment: re-measure your stoma and make sure you cut the barrier to size (1/8 inch larger than the stoma). Use the crusting technique if the skin is wet, this will help provide a seal while the skin is irritated.
Prevention: Make sure you change your pouch on a regular schedule. If uneven skin may be the cause of the irritation, consider an extended-wear barrier or a convex (curved) barrier. If creases or folds in the skin may be the cause, use strip paste or a moldable ostomy ring to 'caulk' and level out those areas those areas. That can help you get a better seal.
If your skin is wet and bumpy
Another possible cause of red, wet areas around your stoma may be from 'mechanical irritation'. Like irritant dermatitis, mechanical irritation looks like red, weepy areas around the stoma. Pain or bleeding might occur. It's caused by removing the skin barrier with too much force, or by washing your skin too vigorously.
Treatment: If your skin is wet and weepy (moist skin the barrier should take care of), use the crusting technique.
Prevention: Use a gentle touch when washing the area around your stoma. Likewise, be gentle when removing your skin barrier. Using the push pull technique, carefully peel the barrier downward while holding the skin tight with the other hand.
If you have tiny red, painful bumps
Tiny red, painful bumps around your stoma may be a skin issue called 'folliculitis'. This condition is common in men with hair growth on the abdomen. This is caused by an irritation of the hair follicles under the adhesive barrier near your stoma. It can develop if you use force rather than gently peeling when removing the barrier. It can also develop if you shave the hair in the area around your stoma incorrectly, or too often.
Treatment: If your skin is wet and weepy, use the crusting technique*. An antibacterial cleanser or powder may be useful: talk to your doctor or ostomy nurse to find out if you need them.
Prevention: It is best to use a scissors to clip the hairs on the skin around your stoma. An electric shaver can also be used. If you use a razor, you should use a clean, sharp safety razor, and use a non-moisturizing shaving foam.
If you have an itchy, burning red rash
If the skin is red and irritated surrounding the stoma, it is also possible that you may have allergic or contact dermatitis. 'Contact dermatitis' can occur when the outer layer of skin has been cut or damaged, making it more easily irritated. 'Allergic dermatitis' occurs if you are allergic to a product that you are putting on your skin. The allergy may be caused by soap, wipes, paste, powder or the barrier or pouch material.
Treatment: Talk to your ostomy nurse to find out what might be causing the problem and if you need a product change due to allergy.
Future Prevention: Avoid using any allergy-causing products.
If you are experiencing a red rash that progresses to round, raised areas of skin, you may have a fungal infection. A fungal infection causes itching and burning and can spread beyond the edge of the barrier. People at higher risk of a fungal infection are those who have diabetes, have anemia, have a lowered immune system or have taken antibiotics for more than a week.
Treatment: If your skin is wet and weepy, use the crusting technique.* Ask your doctor or ostomy nurse if you should use an antifungal powder.
Future Prevention: Because fungal infections like moist, dark areas, always dry your skin thoroughly before applying a new pouching system. To keep your skin dry, be sure to change your pouching system before any output gets on your skin. It is also best to remove your pouching system gently, to keep your skin as healthy as possible.
1. Cleanse skin area around the stoma with warm water and pat dry. If there is residue from stoma paste on the skin you may roll it off with a dry washcloth or use Brava adhesive remover. Do not scrub this off. This will irritate the skin and may cause further damage. PAT THE SKIN DRY.
2. SPRINKLE Stoma Powder directly on the skin on the open or irritated areas. Powder will not hurt the stoma if it makes contact. Dust off excess powder to prevent clumping.
3. USE a Brava skin barrier spray or wipe to “blot” or “dab” gently on top of stoma powder. THIS WILL SEAL THE POWDER ONTO THE SKIN. If using an alcohol skin sealant, fan the skin to decrease any burning sensation. This will resolve once the alcohol has dried. Powder will disappear/dissolve. After 10-15 seconds, a “crust” will form on the skin providing protection. Repeat the process allowing to dry completely before applying the next layer.
4. After the area dries, pouch as usual. If the skin itches and develops an irregular rash that does not improve, this may be due to yeast/candidiasis. This will require use of an antifungal powder.
Note: If you detect any of these skin issues, contact your ostomy nurse or health care provider.