Skin care in Ostomy

Healthy skin around your stoma (peristomal skin) is vital for a secure ostomy seal and your overall comfort. Ideally, this skin should look just like the skin on the rest of your abdomen.+1

Here is a guide to maintaining healthy skin and managing common issues.

1. The Daily Care Routine

The “keep it simple” rule is usually best. Over-using products can actually lead to more irritation.+1

• Cleaning: Use warm water and a soft cloth or high-quality paper towel. Avoid baby wipes, as they often contain oils or perfumes that prevent the pouch from sticking.+1
• Soap Choice: If you prefer soap, use a very mild, residue-free version. Avoid soaps with moisturizers, deodorants, or oils.+1
• Drying: The skin must be completely dry before applying a new barrier. You can pat it dry or use a hair dryer on a cool/low setting.+1
• Hair Removal: If hair interferes with the seal, shave the area carefully with a clean, disposable razor or clippers in the direction of hair growth. Avoid shaving creams.+1

2. Ensuring a Proper Fit

A poor fit is the #1 cause of skin irritation.

• The Snugness Rule: The opening in your skin barrier should fit closely around the stoma, typically leaving only about 1/8 inch (3mm) of skin visible.
• Monitor Size: Stomas can change shape and size over time (especially after surgery or weight changes). Measure your stoma every few months to ensure your template is still accurate.
• Fill the Gaps: Use stoma paste or barrier rings to fill in any uneven skin folds, scars, or crevices to create a flat surface for the barrier.

3. Gentle Removal

• Push, Don’t Pull: Instead of “ripping” the barrier off, gently push the skin down and away from the adhesive with one hand while lifting the barrier with the other.
• Adhesive Removers: If your skin is sensitive, use an alcohol-free adhesive remover spray or wipe. If you use an oil-based remover, be sure to wash the residue off with water before applying a new pouch.

4. Managing Common Irritations

If your skin becomes red, weepy, or itchy, try these targeted steps:

The “Crusting” Technique: For raw or moist skin, sprinkle a small amount of stoma powder on the irritated area, then “seal” it by dabbing it with a no-sting skin barrier wipe. Let it dry before applying the pouch.+1

Itching or Bumps: This may indicate a fungal infection (Candidiasis). If a pouch change doesn’t help, consult your ostomy nurse; they may recommend an antifungal powder.