Evaluating the skin around your stoma

Hear from Sarah our Clinical Advisor

From A Bigger Life

Managing your peristomal skin, or the skin around your stoma is probably the most important thing to ensure you have a good stoma care routine.

What is good peristomal skin?

The skin around your stoma should look like the rest of your skin on your abdomen, there shouldn’t be any breaks or rashes.

Skin breaking down

One of the most common problems that people complain about is that their skin does break down. Whenever you do experience this contact your stoma care nurse, nurse or doctor to ask for advice. It’s important to identify exactly where the broken or sore skin is.

Skin immediately next to your stoma

The peristomal skin is the skin immediately next to your stoma. This area can break down and become sore and weepy which is common.

Here are a few reasons why this could happen:

Pouch has been cut to big

One of the biggest reasons is that your pouch has been cut too big and the effluent is actually going onto your skin and not directly into your bag. That can mean your skin can break down quite quickly in that area immediately next to the stoma.

How to prevent this from happening: Make sure the size of your pouch is cut out to exactly the shape and size of your stoma. If you have difficulty doing that, go back to your stoma care nurse and ask to have your stoma measured and sized. There are certain pharmacies or certain deliveries services that will cut your pouch out to the exact shape and size. Many of the manufacturer companies have pre-cut pouches that might suit you.

Change the type of pouch you are using

If it’s an ongoing problem and perhaps the stoma is retracting in and coming back out again, maybe that’s what’s causing irritation on the skin. You might need to think about an alternative pouch.

How to prevent this from happening: If you’re using a flat bag, you might need to talk to your stoma care nurse about trying a convex pouch. If you need a little bit of extra protection, a seal or a washer used around the stoma can prevent this problem from happening.

Sometimes people who have developed parastomal hernias, and the shape and size of the stoma is changing, this can lead to the pouch not adhering well next to the stoma, a seal will work in that instance.

Some other people like using a skin preparation wipe and that just allows the pouch to adhere a little bit more securely on to the skin if you are experiencing problems.

Area outside of the flange

Another common complaint would be about the area outside of the flange, a bit further outside where the pouch is stuck onto your skin. The skin there can start to deteriorate. The technical term for that is called skin stripping.

How to prevent this from happening: A remedy to prevent that from happening is to use an adhesive remover spray, which allows you to remove your pouch without any trauma. There are some countries don’t allow having an adhesive remover spray in your prescription or you have to buy it and perhaps that’s not possible for you. If that’s the case, use warm water and hold your pouch away from the skin and very gently wash the pouch off the skin so you’re not just pulling the adhesive off your delicate peristomal skin.

Wider area of sore skin

Some people suffer from eczema, dermatitis or psoriasis, developing a wider area of sore, aggravated peristomal skin. You can take an allergic reaction, sensitivity issues or for some men, if you have a lot of hair on your abdomen and you are having to shave the skin around your stoma, you can develop a larger area of peristomal problems.

How to prevent this from happening: A remedy is to try and shave once every fortnight or three weeks to reduce the inflammation. If you have psoriasis or eczema, go and speak to your dermatologist. There are some remedies for helping with a larger area of peristomal skin problems, you might need to use a steroid cream. If that is what has been recommended to you, the way you would use that is that you take off your appliance and try to apply a time whenever you know that the stoma is quiet and it’s functioning. You apply the cream on to the irritated area, wrap a tissue around the stoma to catch any effluent that’s coming out, allow the steroid cream to seep into your skin and then wipe it away and that shouldn’t interfere with how your pouch will adhere onto your skin.

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