“Remember that most ostomy skin problems can be resolved with proper treatment and care before they become more serious.”
Natalie Mascall, founder of vera sa

Aaaah, ostomy skin problems – it’s a topic that will never get old.

Ostomies can agree – sore peristomal skin (the skin surrounding your stoma) is an absolute b!tch to contend with! If red, inflamed skin is the bane of her life, this blog is for you!

Before we dive right in, it’s important to note that skin irritation around a stoma happens for various reasons. It’s important to chat with your healthcare provider if you suffer from irritated peristomal skin, as they are your first line of support for ostomy health.

Now, let’s get started.

Over the years, I’ve learnt that while it may be tempting, not all lotions and potions in your bathroom cabinet are appropriate for applying to the skin around your stoma. And trust me, many can make your peristomal skin even worse!

Before we look at common ostomy skin problems, let’s talk about what happens when your peristomal skin is inflamed.

Skin irritation around your stoma is usually caused by leakage from your ostomy pouch and the output from your stoma getting underneath the adhesive and onto your skin.

Common signs of inflamed and sore peristomal skin

If you have sore peristomal skin, you may notice the following symptoms:

Discomfort, itching, soreness, or pain in the vicinity of the stoma.
Excessive bleeding from the stoma that does not stop.
The skin around the stoma becomes inflamed and red.
A bumpy, raised rash is possible.
Skin colour changes from normal to reddened/inflamed, and it may even change to a bluish-purple or black colour.

The skin around your stoma should look similar to the skin on the rest of your body.

What causes skin rashes?

There are various possible causes for sore skin, some of which are listed below.

A malfunctioning appliance.
Stoma leaks cause the effluent (bowel or alkaline urine) to sit on the skin.
Removal of the pouch regularly, which can strip the skin.
Skin conditions such as sensitive skin, eczema, or psoriasis must be present.
Heat-related humidity.
Chemicals including fragranced soaps, detergents, deodorisers, and some brands of wet wipes.

Do you ever use perfume, soaps with moisturisers, fragrances or oils? Perhaps alcohol-based cleansing products? Try avoiding these products completely, and wash the peristomal skin gently using water only for some time.

Other factors include:

The pouch’s hole (aperture) could be the wrong size.
Uneven skin surfaces caused by skin folds or scarring from surgery
Excessive sweating can make it difficult for the pouch to adhere properly.
Your stoma’s effluent may be excessive.
The effluent may corrode the hydrocolloid (the pouch’s adhesive), irritating.
An underlying skin irritation may prevent the pouch from properly adhering.
Contact dermatitis (an allergy) caused by any stoma product.

What can I do to get it under control?

The following are some methods for treating sore skin:

Measure the aperture and stoma size to ensure that the pouch fits properly.
Use sprays or wipes with adhesive remover to aid in the gentle removal of pouches.
To relieve discomfort, apply Stoma powder sparingly to any moist, irritated skin.
Non-stinging stoma pastes can aid in flange-to-skin adhesion.
If the irritation is severe, topical steroid lotions can be used as a short-term treatment; your stoma nurse or GP must prescribe these.
Pouch backings containing alginate, aloe vera, or vitamin E can help soothe irritated skin.
If you have a skin condition like psoriasis or eczema and the sore skin around your stoma looks similar, you can try using small amounts of your regular prescribed cream.

How well does your pouch fit around your stoma?

Prevention is better than cure

As an ostomate, I’ve found that prevention is better than cure, especially concerning skin irritations due to my stoma. After much trial and error, I’ve adopted a skin wellness routine that keeps my stoma skin healthy.

Here are some tips for preventing and treating ostomy skin problems.

If your skin around the stoma is red and wet

This could be ‘irritant dermatitis,’ which appears as red, wet, or weepy areas around the stoma. You may experience pain or even bleeding. Something that irritates your skin causes irritant dermatitis. It could be stool, urine, or chemicals like solvents or pastes.

Re-measure your stoma and ensure that the barrier is cut to size (1/8 inch larger than the stoma). If the skin is wet, use the crusting technique to help provide a seal while the skin is irritated.

Recommendation: Change your pouch regularly. If the area around your stoma is uneven or has creases/folds, consider using a convex (curved barrier) and accessories to fill in or caulk those areas to achieve a better seal.

If your skin is flushed and blistered

Mechanical irritation is another possible cause of red, wet areas around your stoma. Mechanical irritation, like irritant dermatitis, appears as red, weepy areas around the stoma. You may experience pain or bleeding. It could be caused by too much force to remove the skin barrier or by washing your skin too vigorously.

Recommendation: Use the crusting technique if your skin is wet and weepy (moist skin that the barrier should take care of).

When washing the area around your stoma, use a gentle touch. Similarly, when removing your skin barrier, be gentle. Peel the barrier downward with one hand while holding the skin tight with the other.

If you have small, painful red bumps

Tiny red, painful bumps around your stoma could be a skin condition known as ‘folliculitis.’ This condition is common in men who have abdominal hair growth. The irritation of the hair follicles under the adhesive barrier near your stoma causes this. It can form if you forcefully remove the barrier rather than gently peel. It can also form if the hair around your stoma is shaved incorrectly or too frequently.

Recommendation: Antibacterial cleanser or powder may be beneficial; consult your doctor or ostomy nurse to see if you require them.

It is best to clip the hairs on the skin around your stoma with scissors. You can also use an electric shaver.

If you have an itchy, burning red rash

If the skin around the stoma is red and irritated, you may have allergic or contact dermatitis. ‘Contact dermatitis’ occurs when the skin’s outer layer is cut or damaged, making it more easily irritated. ‘Allergic dermatitis’ happens when you are allergic to a product you use on your skin. The allergy could be caused by soap, wipes, paste, powder, or the barrier or pouch material.

Recommendation: Consult your ostomy nurse to determine what is causing the problem and whether you require a product change due to an allergy. Avoid using any allergy-causing products in the future.

If you have a red rash that progresses to round, raised areas of skin

A fungal infection causes itching and burning and has the potential to spread beyond the barrier. Those with diabetes, anaemia, a weakened immune system, or who have taken antibiotics for more than a week are at a higher risk of a fungal infection.

Use the crusting technique if your skin is wet and swollen. Consult your doctor or ostomy nurse about using an antifungal powder.

Recommendation: Because fungal infections prefer moist, dark areas, thoroughly dry your skin before applying a new pouching system. To keep your skin dry, change your pouching system before any output touches it. Always be gentle when removing your pouching system to keep your skin as healthy as possible.

If you have chaffed skin

Sometimes the wrong choice of underwear can be responsible for chaffing skin. Standard underwear styles aren’t intended for use with stoma bags, which can make things difficult for you.

Specially designed ostomy underwear is the ideal solution for a more secure fit around your bag or for a discreet, flattering high-waisted style. Yes, we know that finding ostomy underwear that is secure and fashionable can be as challenging as finding that last Rolo you hid from your kids . But, don’t stress – VERA SA has you covered with our guide to stoma underwear.

Recommendation: VERA SA’s specially designed ostomy underwear is the ideal solution for a more secure fit around your bag and boasts a discreet, flattering high-waisted style.

You’ll love the VERA SA line, which proves that having a stoma doesn’t mean you can’t be confident.

Vera SA is a proud partner of CANSA and The South African Society of Ostomates.

Contact VERA SA at 082-833-9200, email info@verasa.store, or log onto

https://www.verasa.store/ for more information.

Ostomy skin problems: Freedom from sore peristomal skin