Any ideas how to better protect peristomal skin longer?

[Shamrock4806]

I'm doing great so I think.

Illeostomy in a belly fold and only very slight skin damage, I now use a two day flip cycle to concur with a nice hot shower.

Using pectin no sting paste which I use oil free eye makeup remover to get the last of it off my skin, wash the area three times with Ivory plain soap, dry well and I get excellent adhesion, just after two days I'll start getting very tiny leaks though.

I'm trying to see if I can improve my situation any, because I would like to switch to a two piece instead of the one piece I'm using now. The bag gets sort of filthy after three days and I rather keep the wafer on for longer if possible and just switch out the bag itself instead of the whole thing.

My paste adhesion is excellent, it takes considerable amount of effort to remove it all off my skin, so I don't think that's the problem. Rather enzyme infested affluent manages to work it's way under the paste right next to the stoma.

What I'm thinking is the paste is just too thick and doesn't quite fill the crack around the stoma as well as something else perhaps. I do use spray skin protectant but that doesn't seem to help any.

So I'm thinking of something more of a liquid that can cover the skin right around the crack of the stoma better and provide longer protection,. Then put the paste on top of it. It should remain somewhat flexible as well.

Any ideas anyone?

[Shamrock4806]

Okay I think these should help...

Cavilon Advanced Skin Protectant (3M)
Not the regular Cavilon spray

Perma-Type Liquid Ostomy Seal

[Shamrock4806]

Wow, not the right thing or no longer exists

But found

Coloplast PREP Protective Skin Barrier Dabber bottle

I've been using their barrier spray and apparently it's too thin of a coating

So I'll try that, because the leaks are occurring at the
mucocutaneous junction and this is supposed to stop it.

2oz bottle should last up to 60 bag changes supposedly and it's inexpensive

[22Sunpuperwolf22]

Hi Shamrock,

Everybody has a different formula that works for them. I will suggest what I use for skin prep when I change my ileostomy bag, which is in a slight belly fold as well, though It may not work for you. I use only adhesive remover, Hytape, Sensura one piece Coloplast wafer and barrier ring, as I don't believe in using a ton of products that destroy a person's skin.. the reason for the adhesive remover is to take off the residue from the barrier ring, and the Hytape. I change my bag every 3 days, religiously. I take off the residue with adhesive remover, and then wash my ostomy skin with baby bath wash, as it is not oily like soap is, which prevents adhesion of the wafer, then after I rinse that off, I wipe the peristomal skin with a slight amount of rubbing alcohol to increase adhesion, I then apply the wafer. If I have any skin irritation, redness or skin is affected by fecal material when I have had an accidental leak, the only thing I use as ostomy powder to help heal that is MICONAZOLE NITRATE 2%.. it is the greatest Anti-fungal powder that heals all of my skin problems that I have ever had due to fecal leakage. After I apply that powder very lightly to the affected area, it heals it all up in 1 - 2 bag changes! It is the most amazing powder ever! I learned about that product from the Phoenix Magazine a few years ago. The ostomy powder we get from ostomy companies never helped me at all with skin situations.. Like I said, Shamrock, what works for me probably won't work for anybody else. Everybody has their own formula that they have experimented with over the years.

[Shamrock4806]

MICONAZOLE NITRATE 2%

That sounds great, I'll give it a shot.

I use oil free eye makeup remover as my adhesive remover, works SO MUCH BETTER. It's a liquid that I can soak it on as sprays are not as effective. Plus it does stuff to the deep skin to condition it, as long as it's very well washed off the surface skin.

Agreed the skin really has to be free of any oils, I wash three times with Ivory soap instead of using alcohol which stings the wounds for quite some time and causes me to think that I have a leak..

I also learned about micro channels forming under the paste, occurs when stress to the bag or movement occurs. They can be remedied by simply pressing down around the stoma to seal those micro channels back closed.

I also need to do a better job at filling my belly fold with something that's not paste, I use the wafer cutout pieces instead of costly rings because they lose adhesion being touched so much. So I need to fill better on the sides, but really get my leaks at the bottom and top mainly and that's due to stress fracture.

And another thing I've learned is that the wafer can be heated and molded some.

Apparently a "hindged stoma" is the most difficult ones possible. It's certainly been a challenge that's for sure.

I'll report back how well the Coloplast dapper bottle works.

[22Sunpuperwolf22]

Hi Shamrock,

Wow, every ostomy recipient has their own special formula, and it is intriguing to hear about the adaptations you have made to your bag changing routine! I never had been told about wiping my skin with rubbing alcohol. I just happened to remember that rubbing alcohol dried oily skin really well in the past when I happened to break out with a pimple as an adult, rare, though it happens, and so I thought how well that would work to adhere the wafer to my skin after washing with baby wash, which doesn't have an oily residue. The baby wash was my second adaptation I thought of, as I had remembered when I was a child how It washed off really nicely, didn't leave an oily residue on my skin, and didn't sting if It got into my eyes or a wound. So with those two adaptations, and the addition of the barrier ring which I apply to my my one piece coloplast sensura wafer before I apply the wafer to my abdomen, I have found that that formula has served me well since 2007!

I have also been using the same wafer since my surgery in 2007, which is a rare thing for an ostomy recipient to do after all those years and weight changes. And I am 27 or so lbs. heavier than when I had my surgery. And I have made a promise to myself to eat healthier, be sure to exercise every day, and drop a few inches around my abdomen in order for my wafer to fit better and not have the belly crease that I have gained the last several months. It is something I have been working on diligently. I don't believe in adapting my wafer application and adding more ostomy supplies to my regimen in order to work with the negative effects of weight gain. I would rather correct the weight gain, than adapt to my body shape due to bad eating behaviors over the past several months.

The fact that alcohol stings if there is a break out, just confirms that the alcohol is doing its work on drying out a skin irritation that happens to be a fungal infection, which there is no harm in drying out a fungal infection that has a slight mucous on it anyhow. Rubbing alcohol has great healing potential. I just bite the bullet and it stings for a matter of a few seconds and that is it. After the fungal infection is fully dry and I apply the Miconazole Nitrate powder to the affected skin, the healing happens in no time.

Jayme

[Shamrock4806]

I think the problem is alcohol dries out the skin below the surface layer, like into pores, unlike your baby shampoo or my ivory soap 3x method just does the surface only, which is all that adhesive needs to work.

So what happens is the skin begins to dry out and causes painful cracks etc that causes leaks, instead of a nice nearly smooth baby skin surface.

I think the oil free eye makeup remover also nourishes the pores below the skin surface, keeping the skin healthy without drying it out. Then the 3x ivory soap wash just gets it off the surface, leaving the pores untouched.


I've found this method extremely effective, so much I actually have a very hard time getting the residue paste off the skin.

So I soak a rag with the eye makeup remover and hold it against the residue paste as it will gently dissolve it, maybe help it along with a fingernail rub.

But it's a heck of a lot better than the alcohol method I used earlier, it wasn't binding as well and actually sliding off the skin when I stood up. And it stung.

Going totally alcohol free I don't feel any pain after a bag change, only if there is a leak.


I think your confusing a leak burn caused by enzymes with a fungal infection. A fungal infection will itch so bad that you want to stick something sharp through the bag to scratch it to relieve the itch.. A leak burn just hurts all the time. Two different things.

A powder with an antifungal in it works great for fungal infections but not necessary for common leak burns, just normal stoma powder will do. But I don't see the problem using a antifungal powder all the time if so wishes, because for leak burns a powder is designed to dry it out and form a crust so adhesive will bond to it. However the stoma adhesive is likely better as it's objective is to form a crust as the antifungal might not be tailored as such.

So I use stoma adhesive powder for leak burns and if I ever get a rare skin fungal infection then I'll use athletic antifungal foot powder for that area, usually where clear skin under the wafer, then cover with spray skin protectant to lock it down. Usually the fungal infection is gone by the next bag change.

I haven't had a skin fungal infection in over two years now. It's because the output never makes it out that far anymore, just tiny tiny leaks, which hopefully this PREP dabber bottle from Coloplast should do the trick as it's supposedly thicker and more flexible than barrier spray.

I keep my weight at an even 200 lbs as to keep the stoma a outtie and not an innie.

[Shamrock4806]

I think what your trying to describe is a leak burn that never seems to heal, like the enzymes have gotten so entrenched that simply washing isn't good enough.

I don't think I have that problem because the pain goes away after a new bag install.

But I remember in the past having such a situation.

My leaks are caused by shearing, because of the belly fold and likely because I've taken back to drinking coffee again, which I've now discontinued.

The leaks occur in different spots, mostly the top and bottom. The sides are reinforced with wafer cutout filler pieces.

I think an antiseptic powder in lieu of stoma powder should do the trick like you say.

[22Sunpuperwolf22]

Hi Shamrock,

I apply the Miconazole Nitrate powder for fungal infections that itch as well as fecal output that causes my wounds to burn as well as itch. Even though the powder says Antifungal, it helps to heal both kinds of wounds. Like I stated, we all do what works for each of us. I was told by the Phoenix Magazine that the MIconazole treats both types of wounds, and I have used it for both, and it heals both types of wounds that are a result of fecal leakage, very well. Though, those are just my experiences. You should do what you feel works for you. I just gave you my suggestions that work for me. That doesn't mean it will work for anybody else. Same with the rubbing alcohol.. It works well for my type of skin, not necessarily for another type of skin.

Take care, Shamrock.

[Shamrock4806]

Hi Shamrock,

I apply the Miconazole Nitrate powder for fungal infections that itch as well as fecal output that causes my wounds to burn as well as itch. Even though the powder says Antifungal, it helps to heal both kinds of wounds....

Okay according to ChatGPT they are not the same thing.

-----

Miconazole nitrate powder is ONLY a substitute when you have a yeast (fungal) rash.
It is not a replacement for regular stoma powder.

Miconazole nitrate powder can be used around a stoma but only for a specific purpose:

It treats a fungal/yeast rash. Not for enzymes.
It does not replace stoma powder for everyday use or for moisture-wicking “crusting.”

If the issue is weepy/moist skin without yeast:

Miconazole powder will not help;

Regular stoma powder is the correct tool because it’s designed to absorb moisture and improve adhesion. Which of course protects the skin from more enzymes.

Use miconazole powder for:

Bright red, itchy, or splotchy rash

“Satellite dots” or burning or itching around the stoma

Moist, warm-fold yeast infections

If the skin damage is caused by yeast, then miconazole clears the infection, and the skin will heal faster once the yeast is gone.

But that’s because the infection is removed — not because miconazole heals the tissue.


Use regular stoma powder for:

Moist or weepy skin

Protecting skin so the wafer sticks better

Crusting to improve adhesion


Key differences:

Miconazole = antifungal medication

Stoma powder = absorbs moisture + improves adhesion


If you do use miconazole under a wafer:

Apply a very light dusting

Crust with a barrier spray before applying the wafer


Bottom line:

Miconazole helps only if it’s yeast. Enzymes are not yeast. Washing the wound clears enzymes.

Stoma powder helps only if the skin is wet/weeping.

They are not interchangeable for everyday use.


My leak burns are very small and barely damage the skin because I'm top of changing the wafer out at the slightest discomfort. They don't itch constantly like a fungal/yeast infection does.

So for me stoma powder is the right choice as I need maximum adhesion to defend against future enzymes attack. My skin heals just fine in a couple of days as long as I don't allow the burn to continue for long.

Now I've had yeast infections before and they itch like one wants to stick something in there under the wafer to scratch, if I have that then I know it's a yeast infection and I need to apply anti fungal foot powder there only, then cover with barrier spray.