Itching and Burning Under Barrier Adhesive

[Old_guy]

Hello.
For the most part, my wife does okay with the barrier. We use Hollister's Ceramide products. But sometimes, she complains about itching and burning under some of the barrier adhesive. I'm just trying to find something that can help relieve that but yet let the adhesive stick to the skin. I really only use the Cavilon barrier spray to crust stoma powder around the stoma. I had been reluctant to spray it over where the entire skin barrier ring thinking it might reduce sticking time and cause a leak. Am I too cautious? We change the barrier and pouch every three days.

And if using a barrier spray would be best, is there a better product than the 3M Cavilon? It is all we have known since being in the hospital a year ago.

Thank you.

[Shamrock4806]

If the itching is so bad that she wants to stick something hard under the wafer to scratch it it's likely a fungal infection just like athletes foot. Using antifungal foot powder in lieu of stoma powder covered by a spray skin protectant coating should work for this. It's okay to use the powder on non wound areas in this case but usually stoma powder is NOT to be used on healthy skin as it will dry it out and cause itching.

Now it could be dry skin itching that's the result of using alcohol, stoma powder on healthy skin (use only on wounds) or generally dry skin from other reasons.

To resolve this when she removes the wafer and barrier adhesive is to use oil free eye makeup remover (instead of ostomy adhesive remover) available in the cosmetics isle of drug and supermarkets. Neutrogena is the best. Use no water at first until the skin is clean. Soak it in around under the wafer area and it will moisturize the deep skin tissue. Then wash with plain soap and water gently just to remove it from the skin surface, after rinsing the skin should be squeaky clean when the finger is rubbed around the stoma.

Another reason could be she is using creams, oils or lubricants under the wafer which doesn't allow the barrier adhesive (paste of rings) to sufficiently bond to the skin thus output is getting underneath and causing the itching and burning.

So try this next time

1: Oil free eye makeup remover to remove the wafer, scrape off any paste etc residue with a butter knife. Use more oil free eye makeup remover to soak it in and remove residue adhesive and moisturize the deep skin tissue. Use no water during this process.

2: Wash area with plain soap and water to remove makeup remover from the surface of the skin. The finger test around the stoma should produce squeaky clean skin, it actually squeaks when rubbed.

3: Dry the area around the stoma with towel, then blow dryer, then dry parts of toilet paper to soak up any residue moisture. Finger test by dragging finger around stoma to ensure it's very dry and not slippery.

4: A light dusting of antifungal foot powder on areas of the skin under the wafer that has been itching that's not a wound. Any wounds gets a very light dusting of stoma powder. Dry brush off any excess, important or it won't bond. Coat the area with 1 or 2 light spray coatings of skin protectant and allow 30 seconds after each coat for it to dry. Finger test again and use a blow dryer if need be. If output gets on the skin then washing off with plain water (don't use spit it's salty and will burn) and drying well again should work for small output, larger and more consistent will require waiting in the shower rinsing it off until it's done and quieted down.

5: Paste is better for uneven skin, bumps, dips and other irregularities around the stoma and rather active stomas as it quick seals unlike rings which slow melt. Rings are better for near perfect flat skin around the stoma with a slow active stoma. Rings require stretching and getting it right around the stoma bonding to the skin first to insure it's sticking. Then the wafer (hole cut to fit almost tight around the stoma) and usually a heating pad on top to get it to melt and bond better to the skin. Paste just slap it on and go. But you may need three bead rings of paste instead of two. If you can when pressing the paste around the stoma is to get it to ooze out over the wafer hole just a tiny bit, it will deflect output away until the paste has adhered to the healthy skin better.

6: Many pastes have alcohol in it (Adapt) and this will cause wounds to itch and burn. Why I only use no sting pectin based pastes.(Bravda).

If you get proper barrier adhesion to the skin then the wounds will heal themselves in time. However if any pain or itching is felt that's consistent the wafer needs to be changed out quickly.

Problem of course is if it's an illeostomy or colonostomy then food and drink has to be maintained to ensure output doesn't clog, prolapse, cause pancaking or diarrhea of the stoma. Usually small sandwich sized meals more often throughout the 24 hours like about every 4-6 hours does the trick. However the food and drink type can cause issues as well, like alcohol, caffeine and salty foods.

So diet control is extremely important to maintain for consistent trouble free output that doesn't push the wafer off the skin or stoma output that is so much that it's impossible to get a good skin adhesion with your barrier adhesive.

Seeing an ostomy dietician can help if you can read through my older posts here about diet control.

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[Shamrock4806]

Another problem is she is still likely using the same wafer and company the hospital used which their needs and hers now conflict.

For instance when I got my surgery I recall the nurses pulling the wafer off almost daily to check the healing going on around the stoma, plus I was laying flat on my back most of the time thus my belly was flat so they used a flat cheap common wafer from Hollister

However after I got out and was moving around bending over and such, it was clear that that sort of wafer wasn't good match to my body contour and I needed something specific and not general.

So take the Coloplast online body contour check to see what it suggests as the best appliance for her particular body shape.

After all if the wafer is not pressing down on the barrier adhesive then it doesn't matter much.

Coloplast makes the best ostomy products in my opinion. Just need to learn to use the barrier adhesive strips too as that's usually part of the package, it contains blowouts better. However I'm not happy how their adhesive remover works, actually from any of them. They pretty much all have failed me.

Now that I've stumbled upon oil free eye makeup remover I will never go back to using their adhesive removers. My bags and barriers stick on so well I have to allmost chisel them off using a butter knife.

I've been literally crying here because I was always in pain because of leaks, but now I just get an itch and that's it! With my diet control I can also pretty much change a wafer out anytime I want. Give me about two minutes of quiet stoma time and I'll slap a prepared wafer on in seconds.

It's been about two years and just in the last few weeks finally mastered this thing and I have a high output, low profile stoma in a belly fold which is very difficult believe me. I've been pain free for weeks now.

Study the thing like your trying to pass your Masters degree on it and eventually you will succeed.