Red skin irritation around stoma

For general discussion of ostomies and continent diversions.
Anyone can read. Only registered users can post.
No commercial posting allowed.

Moderators: Bob Webtech, Jimbob, ot dave

Forum rules
Before posting, please read our Discussion Board Terms and Conditions and our Code of Conduct.
Post Reply
Mac5
Posts: 1
Joined: 2021-03-04 00:17:44

Red skin irritation around stoma

Post by Mac5 »

I have a red skin irritation on my stomach around my stoma where I usually put the wax barrier ring. Nurse says it's fungal and gave me a topical powder to put on it along with barrier skin spray. It constantly stings really bad. I started putting the barrier ring for my bag outside the irritated area thinking that may help. Has anyone experienced something similar? If so, what did you do about it and how did you relieve the stinging?
User avatar
ot dave
Posts: 2119
Joined: 2010-03-04 19:26:19

Re: Red skin irritation around stoma

Post by ot dave »

You might try using some Duoderm or Tegaderm over the irritated areas. They help to cover open/weeping skin while also allowing the areas to heal. I don't know about using the anti fungal powder in conjunction with them though....
stage III rectal CA 12/08 - colostomy 3/09
"Gatoring since 2010"
Psalms 91:2
fmcclint
Posts: 3
Joined: 2019-03-25 17:53:27

Re: Red skin irritation around stoma

Post by fmcclint »

You may want to try changing your wafer and going down 1 size on the stoma opening so that the wafer is flush with your stoma and there is no exposed skin between your stoma and the wafer. I’m frustrated that the conventional wisdom or advice from stoma nurses seems to be to use a wafer with a slightly larger stoma opening and to leave room between the stoma and the wafer as this allows fecal material to contact the skin (especially if u have an ileostomy and liquid output like me). After struggling with painful skin irritation for the first 3 years, I switched my wafer opening from 32cm to 29cm about a year ago and it completely eliminated my issues! I would also highly recommend using the XL barrier strips (Brava # 12076) instead of the standard ones as they are double the width and do a much better job of securing the wafer to your skin and eliminating leakage. Both of these changes drastically increased my wear time and changed my life! 🙂
User avatar
steiconi
Posts: 1114
Joined: 2015-05-18 03:12:03

Re: Red skin irritation around stoma

Post by steiconi »

Do you have barrier spray, like Cavilon? I was told to dust the Nystatin powder over the affected skin, then use the barrier spray.

Try not to expose skin to output, so don't cut an oversized hole.
Lee

I am not my disease.
marynlyn
Posts: 2
Joined: 2021-10-31 13:04:25

Re: Red skin irritation around stoma

Post by marynlyn »

I have had similar issues, complicated by granulomas and convexity concerns. It was not evident until quite recently that my stoma "toadstools" and the cap is larger than the stoma core. I have been wearing 1-1/4" cuts . . . dropping to 1-1/8th helped . . . skin was still exposed because the biggest granulomas went just to the edge of the 1-1/8th. Discovering that the sizing guide could slip right under the granulomas down to just one inch was a surprise! . . . and revealed an underlying problem, too. The constant oozing wetness around the stoma was due, apparently, to a fungal infection, "well hidden from view" but causing plenty of adhesion problems. Now I have reduced the size of the stoma opening on my wafer down to about 27mm and cut out an area for the protrusion of the granulomas. I use Eakin seals to swell up and cover any exposed skin and sop of any continuing moisture issues.

I did not have Nystatin powder, although I have read of it. Since last week, I have acquired a prescription for it, but have not yet tried it. I might not need to use it even, since I do know working with powders creates adhesion problems. In the interim, I have come up with my own solution, which appears to be working very well for me, although it is early days yet of course. I am sharing it with you in case it might be helpful for you.

I put colloidal silver solution around the stoma and let it soak in for a few minutes, and wash it off because I don't know if it would create adhesion issues. Then I spray on an antifungal product I found on Amazon called "Active Skin Repair--Athletic" (although I think they might be changing the name to "Active Skin Repair -- Fungal.") The Active Skin Repair has multiple products to its line, so be sure to get the "Athletic" one. Since I have been using both the colloidal silver and the antifungal together, I can't say that the silver is a requirement or what the separate benefit might be. I have used that six times now . . . and the antifungal four times. The big news is that last time, I went three days and no leakage when I changed the bag. This is the first time since I came home in early July!! And no peristomal skin irritation now. The antifungal spray I washed off the first few times, but am now letting it air dry/blow dry onto my skin before I apply my appliance, and I just leave it on. It doesn't appear to leave anything behind that causes adhesion issues at all.

After four months of constant leaks and peristomal skin irritation/breakdown, I have finally found appliances that work (Convatec Natura moldable 2-piece for the granulomas; also, Coloplast X-Pro one-piece works well), coupled with a process that works (treating the unsuspected fungal infection). It might be premature to declare victory, but I am so pleased and amazed to have a bag change with no leaks and no peristomal skin problems. I truly hope that somebody finds this report to be of value for their own situation. : ) Lyn
User avatar
To Dream a Dream
Posts: 1414
Joined: 2010-08-10 18:35:53

Re: Red skin irritation around stoma

Post by To Dream a Dream »

Agreeing with the above posts, especially the Natura Moldable wafers which have a bit of stretch built into them to conform to a mushroom shaped stoma. I have been using ConvaTec's Sensi Care sting free skin barrier wipes directly around the stoma & Active Lifestyle Products Inc.'s Sure Seal Rings placed over the wafer. Thin, permeable to oxygen & supportive. As I deal with the effects of aging, I find this combination a big help in promoting healthy skin.
Crohn's Dx '66 (perforated ileum)
Multiple Bowel Resections
Ileo '77 Revision '85
Celiac Dx
marynlyn
Posts: 2
Joined: 2021-10-31 13:04:25

Re: Red skin irritation around stoma

Post by marynlyn »

Oh, thanks for the recommendation! I have not heard of Active Lifestyle products at all, pretty new to all this and searching out products that might work better. The process is all pretty happenstance! I know it will take time and experience. I will give them a spin! : ) Lyn
JerryNYC
Posts: 194
Joined: 2005-11-23 08:55:42

Re: Red skin irritation around stoma

Post by JerryNYC »

Marynlyn, Thanks for the reminder about Convatec Natura moldable wafers. I've been using the regular Natura wafers since "forever" but I would like to give the moldable ones a try because of my stoma shape. I think that the most important thing about ileostomy care is protecting the actual skin immediately around the stoma from the enzymes secreted by the ileum. I've been using "Adapt" barrier rings for this. I cut the rings so that I have 2 half-circles and then press them down around the stoma. The 2 separate pieces over the skin allow me to get as close to the edge of the stoma as possible, which is difficult with a full circle. I then put the wafer over this. The edges of the wafer are hard and can injure the stoma if pressed directly against it, whereas the Adapt rings are softer and become moldable when they are pressed close to the stoma. I think I'm going to try the Convatec moldable wafers instead (or maybe try them together with the Adapt rings). By the way, you mention "granulomas" around your stoma. Are you sure that this is not "granulation tissue" instead? The two are very different from one another and I believe granulation tissue to be much more likely. (And I alway spray the skin around the stoma with "Cavilon" before I press on the Adapt rings.
fapope
Posts: 17
Joined: 2019-12-14 04:44:51

Re: Red skin irritation around stoma

Post by fapope »

I was particularly vulnerable to skin eruptions around my stoma. As others have replied it can often be associated to a fungal outbreak, reaction to the products you use or a little bit of leakage from the stoma. Or a combination ? I was able to maintain good control by 1). Using a bead of stoma paste around my stoma before applying a bag. This prevented most of that minor ingress under the edge of the flange. 2). Rubbing a oral antacid liquid (ie Mylanta) around the skin the flange will cover and then drying this well with a hair drier. When you wash the stoma area, there can still be residual moisture in the pores which may encourage fungal growth. Hence the use of a hairdryer will assist elimination this cause as well.. The worst offender for skin eruptions for me were adhesive remover wipes. I thereafter only used remover spray. Barrier Sprays worked reasonable well but only for a week or so
Post Reply