If you’re living with an ostomy, you probably already know that one of the most common issues impacting ostomates is skin irritation around the stoma. While peristomal skin problems are common, they don’t have to be the norm for you.
Let’s go over some common causes of peristomal skin issues and troubleshoot stoma problems with simple changes to your routine and product solutions.
Peristomal Skin Care is an Important Part of Your Ostomy Routine
After ostomy surgery, the first thing you usually have to learn is how to change and empty your ostomy pouch. In addition to your new ostomy pouching routine, your ostomy nurses will likely discuss the importance of proper, hygienic peristomal skin care.
So why is it so important to take good care of the skin around your stoma? Peristomal skin irritation isn’t just uncomfortable and frustrating. It can also cause damage. In some cases, it can even lead to infection. Plus, it can even make it harder for your pouching system to attach, especially if the skin is raw or moist.
The best way to avoid issues like this is to practice good hygiene and use the best ostomy products for your unique needs.
What should healthy peristomal skin look like?
When you’re new to living with an ostomy, you may wonder what healthy skin around the stoma is supposed to look like.
Normal, healthy peristomal skin typically looks like the skin on your abdomen. If your skin is healthy, it should not feel uncomfortable, painful, itchy, or sore.
You may notice a slight amount of pinkness between skin barrier changes after removing adhesives.
What does unhealthy peristomal skin look like?
Again, normal, healthy skin around your stoma will typically appear like the skin elsewhere on your abdomen.
Unhealthy peristomal skin may:
- Appear red, pink, purple, or another unusual color
- Develop rashes, blisters, bumps, or pimples
- Have a bulge or a protrusion
- Appear raw, irritated, broken, or weepy
Some issues, such as bulges under the skin around your stoma, indicate a deeper ostomy problem, like a hernia. If you notice any unusual changes to your skin or your stoma, please contact your healthcare professional, such as your doctor or ostomy nurse. They’ll be able to evaluate what’s causing the issue and advise on next steps.
If you’re not sure who to call or contact and it’s not a medical emergency, reach out to 180 Medical. As your ostomy supplier, it’s our goal to ensure you’re living your healthiest life with your ostomy. We can connect you with a certified ostomy nurse over the phone or via a video call so they can help.
Some issues, like general skin irritation, may be helped with simple changes to the current products you’re using. However, a qualified healthcare professional is your best source for any medical advice. What works for one person may not work for another, so it’s a good idea to have your issue properly evaluated and diagnosed by a physician or nurse.
What Are Common Causes of Peristomal Skin Problems?
Have you noticed that the skin around your stoma feels or appears hot, wet, weepy, raw, red or pink, itchy, or sore? You may be dealing with a skin problem related to your ostomy.
But why? Ostomy skin irritation can happen for a variety of reasons. Here are a few of the common causes.
Ostomy Leakage
One of the top ways stoma irritation and peristomal skin problems occur is due to ostomy leakage.
When your ostomy leaks stool or urine under the skin barrier and makes contact with your healthy skin over time, that skin can become irritated and even begin to break down a bit.
Sometimes, ostomy leakage is just due to having an incorrect size, fit, or type of ostomy skin barrier.
Get more information with our full guide on ostomy pouch leakage.
Allergies or Sensitivities
Some ostomates deal with immediate skin irritation after applying their ostomy skin barrier. This may indicate an allergy or sensitivity to either an element in the barrier itself or to the adhesive on the barrier.
If you think you may have an allergy or be sensitive to your current ostomy supplies, reach out to your healthcare professional.
Skin Stripping Due to Adhesives
However, many people who deal with irritation directly under their skin barrier may be irritating their peristomal skin by removing their barriers too quickly or using a barrier adhesive that strips away the top healthy layers of skin.
Frequent skin barrier changes may also irritate and strip the skin, causing peristomal skin problems.
Sometimes, this issue may be helped by using certain ostomy accessories, such as a skin-friendly adhesive remover or skin barrier wipes, like ESENTA™ ostomy skin care products.
Too Much Pressure Around the Stoma
Some types of irritation around the stoma may occur due to excessive pressure on the area.
This can occur due to several possible reasons:
- Not having the right fit, size, or type of ostomy pouching system for your unique needs
- The pouch stays full for too long without being changed or emptied
- An ostomy belt that’s too tight for your body
- Wearing clothing that’s too tight and presses up against your ostomy
Sometimes, fixing this common issue is as simple as making a few changes to your routine, like changing or emptying your pouch more often.
How often to change your pouch depends on your unique situation, like the amount and consistency of your output. However, a general rule is to monitor your pouch and change or empty it before it’s 2/3 full.
Poor Ostomy Hygiene
Part of living with an ostomy is properly caring for and cleaning your stoma regularly. The stoma and the skin around it must be treated with care.
Poor hygiene, like not bathing often or not cleaning the skin correctly, may cause irritation, rashes, redness, pimples, or even infection in some cases.
On the other hand, if you’re cleaning too vigorously or using soap or another product with oil, fragrance, or perfumes around the stoma, this could also cause peristomal skin irritation.
Talk to your healthcare professional or ostomy nurse for tips and advice on how to care for your stoma.
Tips for Troubleshooting Peristomal Skin Complications
Tip 1. Talk to your healthcare professional, like a doctor or certified ostomy nurse.
Anytime you notice concerning changes to your stoma or the skin around it, talk to a qualified medical professional.
They’re going to the best source of proper diagnosis and a personalized solution.
Any issues, such as unusual color changes, new bulges, pain, bleeding, or signs of infection, need to be addressed immediately.
Tip 2. Practice good ostomy hygiene.
Keeping your stoma and peristomal skin clean and healthy is a huge part of taking good care of yourself and your ostomy.
While your physician or ostomy nurse is the best resource for any medical advice, you can start taking basic steps at home to improve your ostomy hygiene.
Remember, you can shower with your pouch on or off, although you may not be able to control your stoma output.
How do I clean the skin around my stoma?
Between pouch changes, most people can simply use warm water and a washcloth to clean around the stoma. Next, take a clean, dry towel to pat away any moisture. Take care not to rub or scrub with it. Just pat or dab gently.
Some people like to use soap to clean their peristomal skin. Just be sure to use a mild soap without fragrance, deodorants, or harsh chemicals.
Also, steer clear of exfoliating soaps that may have beads or walnut shells. These can scrub the skin, removing the top healthy layers, which can then cause issues with your ostomy pouching system adhering properly. Plus, it may make the skin raw and more sensitive.
Avoid cleansing wipes or baby wipes with lanolin, oils, alcohol, or other harsh chemicals.
Some ostomy accessories, such as adhesive remover wipes or spray, may be helpful to add to your pouching routine, depending on your healthcare professional’s guidance.
Tip 3. Make sure you’re using the right ostomy supplies for your needs.
One of the next things to look at when you’re finding yourself with ostomy-related skin irritation is what types and sizes of ostomy supplies and accessories you’re currently using.
Examine Ostomy Skin Barrier Size and Type
First, you’ll want to take another look at the size and fit of your current skin barrier, also known as an ostomy wafer. For instance, if you’re noticing irritation due to frequent leakage, you may want to re-measure your stoma to make sure you’ve got the right size.
Next, examine your skin while you’re standing and sitting. Do you have any creases or folds in the skin around your stoma? Is your stoma recessed or flush with the skin rather than protruding? If so, reach out to our Ostomy Specialists at 180 Medical. We’ll gladly help you navigate your ostomy product options. Plus, we can send you something to help you determine the correct size and shape of your stoma.
Then we can look at options that may work best for you. For instance, if you have difficulty trimming your skin barrier to fit your stoma perfectly, you may want to try a skin barrier with Convatec Moldable Technology™.
Try Out Ostomy Accessories That May Help
Ostomy accessories are any ostomy supplies that complement your current pouching system. This could include ostomy support belts, stoma powder, barrier wipes, or even barrier strips.
Frequently Asked Questions About Peristomal Skin Irritation
What should healthy peristomal skin look like?
Healthy peristomal skin should typically look similar to the skin on the rest of your abdomen. It should not feel painful, itchy, sore, raw, or irritated. A small amount of pinkness after removing an ostomy barrier may happen, but ongoing redness, rash, weeping, or discomfort should be discussed with your healthcare provider or ostomy nurse.
What causes skin irritation around a stoma?
Peristomal skin irritation may be caused by ostomy leakage, poor pouch fit, adhesive sensitivity, frequent barrier changes, trapped moisture, pressure around the stoma, or cleaning products that irritate the skin or interfere with adhesion.
How do I clean the skin around my stoma?
In general, many people can clean the skin around the stoma with warm water and a soft washcloth during pouch changes. If you use soap, choose a mild option without fragrance, oils, deodorants, or harsh chemicals. Gently pat the skin dry before applying a new skin barrier.
When should I contact a doctor or ostomy nurse about peristomal skin problems?
Contact your doctor or ostomy nurse if your peristomal skin becomes painful, red, rashy, weepy, bumpy, bleeding, unusually wet, or irritated, or if your stoma changes color, bleeds excessively, or you notice a new bulge around the stoma.
Can ostomy leakage cause peristomal skin problems?
Yes. When stool or urine leaks under the skin barrier and sits against the skin, it can cause irritation and skin breakdown. Ongoing leakage may mean your pouching system, skin barrier size, or ostomy accessories need to be reassessed.
Where Can I Get Ostomy Supplies Covered by Insurance?
Need more help finding the right ostomy supplies to reduce the occurrence of peristomal skin problems? Contact us today.
180 Medical specializes in supplying high-quality ostomy products paired with compassionate, reliable service.
Disclaimer: This article is for informational purposes only and is not intended as medical advice. Information provided on 180medical.com should not be used as a substitute for medical advice, diagnosis, or treatment from a qualified healthcare professional. Please consult your healthcare provider with any questions about your condition, treatment, or medical supply needs.
