Help: possible allergy to appliance

[courage50]

First let me say that I have gotten the best advice from this board on other issues. Thank you!

Over the past 6 months I have experienced the range of intermittent to constant, painful itching around my stoma. My WOCN had me try an anti-fungal powder but it didn't help.
2 weeks ago the WOCN I saw examined my stoma and surrounding area and concluded that the edges of my stoma were irritated because my seal and wafer are sitting on top of those edges. She then recommended that I cut my wafer openings so 1/8" to 1/4 " of skin around my stoma would be uncovered. (Her other idea was to cauterize the edges of my stoma with silver nitrate) With the bigger wafer opening my itching increased rather than decreased. Shortly after my second appliance change-using the bigger opening- I developed a leak under the wafer, which I haven't had for probably almost a year. I proceeded to change my appliance and discovered the reason for the increased itching: all of the exposed skin was now red, with raised bumps and very angry looking! I felt furious! (I have a history of the very kind WOCNs not giving helpful advice that actually helps! I have nothing against them, this is only my experience.)
I have gone back to applying my seal and wafer the way I always have -covering the edges of my stoma, and hopefully my skin will heal quickly.
Has anyone reading this heard of, or experienced, and allergic reaction to seals and or wafers? It does help a little if I use a skin prep wipe before application.
I have a colostomy.
TIA,
Marci

[steiconi]

was the antifungal Nystatin powder?
You need to "crust" it; a thin dusting of Nystatin powder, Cavilon, stoma powder, cavilon, stoma powder, cavilon, letting the cavilon dry between coats.

The layers make a protective coating, the Cavilon locks it in so it does its work. Your wear time will probably decrease (yes, leaks). Keep using until your skin clears, plus a day or two.

[ArcherCrab5662]

After only 6 months of having an ostomy I developed an allergy to every adhesive out there. Tried every manufacturers samples. I now use the coloplast protective barrier sheet (you have to cut to fit your stoma) and then stick my wafer to that. Haven't had an issue with the allergy since. Now, that being said, I do still occasionally have intense itching around my stoma where it was stitched to my skin occasionally. I think sometimes it gets stretched with peristalsis and that causes the itching? I don't know but it's extremely annoying and frustrating!!

[IslandWoman]

I had this same reaction, thought I was allergic to adhesive. My ileostomy nurse had me compare my rash to images of yeast infection rashes online and that is what it seemed to be. She had the pharmacist make me up a prescription for Nystatin, HC 0.5% in Occlusaderm. It is an ointment you apply under the wafer. Let it dry (or use a blow dryer on gentle) then apply the wafer. It is sticky so no adherence issues. Cleared up immediately. I use it whenever I have itching or leakage, which seems to be what causes the yeast. My Dr. told me most people do not have allergy to adhesive, it is usually yeast infection that is misdiagnosed. Perhaps you can try this. Good luck, it worked like magic for me.

[Button]

had this same reaction, thought I was allergic to adhesive. My ileostomy nurse had me compare my rash to images of yeast infection rashes online and that is what it seemed to be

Islandwoman brings up a valid point for discussion . . . a true allergic response to an ostomy wafer is actually quite rare.

In this context, an allergic reaction = a systemic or localized reaction to a material where the body identifies the material as "foe" and responds by secreting histamines and epinephrine.

Most skin irritation related to the wearing of an ostomy wafer is one or other of the following:
1. A contact dermatitis (a localized skin irritation, usually noticeable for flushed, reddened skin, weepy skin, or small, raised lesions).
2. An overgrowth of fungus or yeast

Yeast and fungus overgrowth is a problem for many individuals. Body moisture naturally is trapped under the wafer, making a ready home environment for yeast to flourish. Warm summer months tends to aggravate yeast overgrowth.

An ostomy wafer's adhesive properties are brought about by the wafer's heat sensitive ingredients. The wafer binds to the skin owing to the body's warmth and bonding properties inherent in the wafer to heat.

Wafers are composed of a hydrocolloid matrix - a composite of gelatin, pectin, and carboxy-methycellulate. Each of the major manufacturers have a slightly different "recipe" or formula for their ostomy wafers that makes their wafers unique. Thus, why some people prefer one particular ostomy brand of wafer over another - different skin types react differently to the proprietary hydrocolloid wafer formulations offered by each of the major manufacturers (Coloplast, Hollister, ConvaTech, NuHope, CyMed).

Hydrocolloid matrixes are also used in a range of wound care products. Hydrocolloid materials are, by nature, water absorbing and are valuable wound care tools for wounds with significant serous drainage.

People are more likely to be sensitive to the optional adhesive tape offered on the perimeter on many ostomy wafers. People are more likely to be sensitive and reactive to the adhesive tape than to the actual hydrocolloid matrix that is the wafer.

For anyone who is suspicious of a sensitivity to a wafer, look to see where the specific skin irritation is located. Chances are that it is under the tape boarder if the issue is a tape sensitivity. For a wafer tape sensitivity, taking a dose of Benadryl should help alleviate the irritation.

Be aware that there are tapeless wafers. Tapeless wafers are a fabulous option for individuals with thin, fragile or overly reactive skin.

Tapeless wafers are equally binding as are wafers with taped collars. I have fragile skin due to 20 + years of corticosteroid use. I use the Coloplast Mio wafer (tapeless) and the CyMed microskin wafer. Both are low-profile, highly flexible wafers. It is a rare occasion that I experience a wafer leakage or Code Brown.

Bottom Line: True allergies to an ostomy hydrocolloid wafer are rare. More often, skin irritation is a contact dermatitis due to the taped collar OR yeast or fungus overgrowth.

If you have a contact dermatitis, switching to a wafer without a taped collar is a good option.

If you have yeast or fungus overgrowth, prescription Nystatin or homeopathic Purple Violet is the direction to pursue.

Three Cheers to healthy skin for one and all,
- Karen -

[Mysticobra]

Hello.
My two cents.
I don't have a problem around my stoma. But I have seen if my wafer is up against it it will get a bump on it after wearing it.
I don't have a allergic reaction to any of it but I have an ileo because of uc. Autoimmune disease of course.
Now that I got rid of the problem of uc I have another problem associated with autoimmune diseases.
It's called.
Dermatitis Herpetiformis.
It's not painful but man o man it causes intense itching and of course you cannot scratch it.
I never had it crop up until my colon was removed.
And right now it's terribly itchy under my wafer. I have see a dermatologist for it tried meds for it and nothing works. So it's just something I have to ignore and live with.
It affects my arms and legs also. Cannot scratch them either.
If it's not one thing its another.

I do hope you get yours figured out. I know it's not what I have. The molded part of my wafer doesn't bother my skin just the tape part. But. I have so many on hand I cannot afford not to use them. I just cut as much of the tape part off as I can and move on.
Richard

[Nann-55]

Just a quick note on allergy to appliance; I had the same issue with the Convetec wafer and Holisster. I found out from Coloplast that these two products have animal pecten in there products in which could have caused my skin issue around my stoma. I used the anti fungal powder and did clear everything up. Cannot wear any Convetec products, I love Coloplast products they don't use animal pecten in there products.
Hope the info will help. Nann

[steiconi]

One other thing: I get an itchy rash that can blister at the outer edge of the tape, especially at the corners (I get the same problem with tegaderm). Someone here suggested it could be due to the difference in the way skin and tape move, so I started "fringing" the edge of the tape (1/4" long cuts about 1/4" apart). Solved the problem! If I forget to fringe, the problem recurs.

[courage50]

Thank you all for your ideas and input. I truly appreciate each answer I get when I post!
I think I have deduced that I am allergic to my Coloplast products. I ordered some samples of squares of adhesive to wear under my wafer and, presto!, no more itching! Then we went out of town and I did not bring the squares, went swimming, so needed to change my wafer. Without the protective square the itching is definitely back. The thing that doesn't make a lot of sense to me is that the squares are also made by Coloplast. Maybe they're made of a different material...?
Anyway, I ordered some Hollister samples today of their Ceramide base product.
I'm trying not to be too frustrated because I've been dealing with this for awhile now and the constant itching often keeps me awake at night- I do NOT need any help in that category!
Someone had asked if I used the Nystatin powder: the powder I have used off and on for months, is the anti-fungal powder given to me by the WOCN. It didn't seem to help at all. I also was put on a month long course of oral anti-fungal medication and that too made no difference.
Also, my skin peri-stomal skin does not look like the fungal rashes I see pictured online.
So I'll give the new products a try and see what happens.
I will update my progress.
Marci

[COL-PAT]

Hi, I don't know who you get your supplies from, but we use con-v-tec supplies, and they have this wounderfull powder
that you apply, then wipe off any excess, you wounder hope it can work when you wipe off the majority but it really does, my husband had bladder cancer and now has a stoma and every now and then he gets real red under the wafer, we apply the powder and the next time we change him the skin looks great again. Hope this is of some help. Sincerely, Mrs. C. H.

[MyBernard]

I thought I was allergic to to wafer adhesive, but my dermatologist (correctly) diagnosed irritation from the Prep wipes I had from Hollister. New Prep, no itching!

Might want to try that!

Melissa

[perkling]

One other thing: I get an itchy rash that can blister at the outer edge of the tape, especially at the corners (I get the same problem with tegaderm). Someone here suggested it could be due to the difference in the way skin and tape move, so I started "fringing" the edge of the tape (1/4" long cuts about 1/4" apart). Solved the problem! If I forget to fringe, the problem recurs.

Old post here, but am interested in this "fringing" - do you cut pieces of the tape off, or do you simply cut slits around the edge of the tape? Thanks so much.

[steiconi]

Slits only. But I've moved on to tapeless wafers, no fringe required.

[sassie]

I had problems and was told it was yeast, then allergies to tape etc. I ordered "Benzoin Compound Tincture" and it cleared me up plus it really makes the flange stick, i can pull back part of the flange and restick it using BCT on a Q-tip dabbed where i had loosened..I got mine off ebay and then had the pharmacy order it for me, price was not high..

"Benzoin Compound Tincture

This liquid adherent and skin protectant preparation helps protect skin from adhesives like medical tape and bandages.
It forms a fine, protective coating over skin abrasions, wounds, and oral lesions."