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]

She has a leak probably, one should feel no pain whatsoever if the ostomy appliance was applied correctly.

So she needs to stop eating/drinking and wait until the output subsides for an hour or so, remove it and take a shower and try again.

However 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 (30 seconds to dry after each coat) 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 (wounds only) 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 unless a fungal infection) or generally dry skin from other reasons. The fix for this is using oil free eye makeup remover as a adhesive remover and as a deep skin conditioner.

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 and dry wipe the stoma of output at first until the skin is clean. Soak the oil free eye makeup remover around under the wafer area and it will moisturize the deep skin tissue and remove any stuck on adhesive. 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. If not wash with the soap and water again.

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.

Another factor is heat, the adhesives work better if the skin is warm or the adhesive is warm.

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. Dry wipe any residue output. 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, dry wipe the stoma clean.

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 (heats up the skin for better adhesion) 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. Or 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. It's important to water wash the output away or it will eat into the skin under the adhesive. Ensure area is extremely dry and warm (blow dryer) but not chapped skin.

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 tight 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. Something one can't do with a ring unfortunately.

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). Alcohol will dry out the skin oils and cause itching.

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 or else the wounds just get bigger and take longer to heal

Problem of course is if it's an illeostomy or colostomy 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 and a stoma nurse can help a lot. You can read through my older posts here about diet control.

viewtopic.php?t=27735

[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.

[GeorgeS]

I occasionally use Safe N Simple Protect - Spray Skin Barrier Prep, then use a hair dryer before applying the flange. I will also use HOLLISTER INC
Adapt™ Stoma Powder: lightly before using the hair dryer, if needed.

I have ordered samples of Brava® Protective Sheet and Brava® Powder today to try to keep the skin drier due to sweat and weeping skin.

[Shamrock4806]

I occasionally use Safe N Simple Protect - Spray Skin Barrier Prep, then use a hair dryer before applying the flange. I will also use HOLLISTER INC
Adapt™ Stoma Powder: lightly before using the hair dryer, if needed.

I have ordered samples of Brava® Protective Sheet and Brava® Powder today to try to keep the skin drier due to sweat and weeping skin.

If your having a large area of weeping skin, the best product for that is Solventum (Formerly 3M) Cavilon Advanced Skin Protectant with the wand.

It's a one time use product at about $15 a pop. You first dry the area as best you can, have the stoma powder ready to shake, and activate the wand and spread it around and on the effected areas. Then immediately shake stoma powder all over it before it has a chance to dry (within 30 seconds) a light even coat of powder and then let it stand for 30 seconds to dry.

Then you apply Brava No Sting Paste three beads rings around your cut to fit wafer hole and slap it on starting from the bottom getting it right up under the stoma as that's where it tend to leak the most. Press down and then around to get it to seal, then press the wafer adhesive down next.

You apply extra large barrier strips all around to keep the wafer down and to hold against leaks and blowouts.

Anytime you feel itching or pain it's time for another wafer change as soon as the stoma is quiet which means eating small nutritious meals that avoid causing diarrhea or acid output (like coffee does). So until that skin heals up you'll need to change the wafer more often.

I have found no luck using the Brava Protective Sheets at all. You still have to apply a paste barrier ring around the stoma because output often gets under the Protective Sheets and causes it to come off. Then applying more paste on top of the Protective sheet to fill in gaps between it and the wafer. They also tend to buckle as it's one big sheet and this causes leaks as well.

The only protection a Protective Sheet gives is if there is a break in the seal between the wafer and the Protective Sheet as output will go on top of it. It will not protect from sideways, underneath or if the paste barrier to skin bond is compromised.

The method I've outlined above is used by the top ostomy nurse in Miami at the best hospital there. He's the one that saved me from countless failings of other wannabes ostomy nurses and from my own failings.

[Shamrock4806]

And sweating occurs from the skin underneath the barrier so if your having or with sweating then you need to remain cooler or quit taking hot showers with a bag on. Take lukewarm ones instead.

I've also found that thoroughly cleaning the skin using the oil free makeup remover method with a light regular plain soap and water wash produces a superior skin bonding that resists sweating the appliance off of causing leaks slightly better than not.

[Shamrock4806]

Also if the stoma is in a belly fold, these can be especially difficult. One needs to use a wafer that can flex and really secure it down with extra large barrier strips.

I've finally solved mine as you can read on the other thread. Quote ab involved process. But it works for three days and I can sit for hours as well

[Shamrock4806]

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.

She likely has a leak from not getting good enough adhesion. Or it could be dry skin or a fungal infection.

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.

Skin protectant can be used under the entire wafer area no problem as long as one gives it 30 seconds to dry after each coat. It protects the skin a bit longer from output than not using it but it won't stop it.

Three days is about normal for changing a wafer but some manage to 5 days. I have a illeostomy in a belly fold so it's been about 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.

They are all about the same really. I've used that one and Brava spray skin protectant. No difference really. Just gives a little more time before skin damage occurs from the output eating it.


What likely is the problem is something extra being applied to the skin, or using moisturizer type soap, or something else not allowing good adhesion to the skin.

I avoid using rings for the fact handling them reduces their adhesive qualities via skin oils etc.

I prefer using no sting paste myself for it's better adhesion and flexible nature for my belly fold.

Plus I can ooze it out some over the stoma to deflect output away from the skin edge until it has sufficient time to bond to the skin.

[Shamrock4806]

Oh and another problem I was having was my scar tissue, while under the wafer, was itching and irritated. So was my exposed but I could take care of that obviously.

Well Cocoa Butter based skin lotion did the trick for me.

So what I do now is before I apply my wafer, I fill my belly button with the cocoa butter lotion as I have a particular irritating scar inside it, then rub some just in my scar tissue all the way up and down it, keeping it off normal skin.

I put a ball of toilet paper in my belly button hole, cover it with a thin piece of cardboard and put my wafer adhesive over that.

Obviously the wafer adhesive will not stick to the cocoa butter areas, but I put extra large barrier strips on afterwards twice around while exhaled to hold everything down. So it just sorts of skips sticking to the scar tissue.

I've been a happy camper.