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Ostomy Skin Care When living with an ostomy, you may or may not realize how important it is to take care of the skin around your stoma. This area is called peristomal skin and often skin-related issues around this area may go unnoticed.
Knowing how to identify irritated skin around your stoma early and keeping it healthy could help avoid greater complications and make for a stress-free experience with your ostomy. Here are some tips on how to keep your peristomal skin healthy.

Why is it important to maintain healthy skin?

If the skin around your stoma becomes damaged, it could be painful and lead to infection. It also becomes more difficult for the skin barrier of your pouching system to adhere to your skin. Prevention is the key to maintaining both healthy peristomal skin and your comfort.

What are common causes of peristomal skin damage?1,2

  • Leakage: Healthy skin exposed to fecalor urine out put under the skin barrier can breakdown fast.
  • Pressure:  belts and some clothing may cause pressure on the stoma area.
  • Stoma size:  ensure the skin barrier is cut to the right size. It should always fit closely around your stoma to protect against leakage.
  • Skin folds  or creases: may prevent the skin barrier from sticking securely to your stomach and result in leakage. A different shaped product may be required if your stoma is flush or retracted.
  • Skin stripping:  removing a skin barrier too quickly can pull the top layers of skin away. The more frequent it happens, the more the skin can be irritated.
  • Pouching system:  if the red or irritated area of the skin is the same shape as the skin barrier, you may have developed an allergy or sensitivity.

What should healthy skin look and feel like to you?

Peristomal skin should look and feel no different than the skin on the rest of your stomach.  Take a closer look.  Use a mirror if it’s easier or take a picture with your mobile device, to check and track the health of your skin close-up. Once you know what healthy skin looks like, you can watch for signs of skin irritation.

Healthy Peristomal Skin ; Healthy Skin
Irritated Peristomal Skin ; Irritated Skin

Do you have red or irritated skin around your stoma?1,2

Having a peristomal skin complication is one of the most common reasons people living with an ostomy seek medical attention. An ostomy can present potential problems, and the most common of these is red, itchy, or sore skin around the stoma. If you believe you have a peristomal skin complication, contact your healthcare professional.

How to spot if you have peristomal skin issues1,2, ask yourself:

  • Does your peristomal skin feel itchy or sore under your ostomy pouching system?
  • Does your skin feel moist, warm or have a wet appearance?
  • Compared to your full body skin tone, does your peristomal skin look pink, red or inflamed? Blistering or weeping?
  • Does the color return to it’s usual tone, after you remove your pouching system after a short time?

Do you have the right fit? Proper fit of the skin barrier around the stoma is important to prevent peristomal skin problems:

  • For one-piece ostomy pouching systems, a thin,  flexible adhesive  will protect your skin and allow for more frequent pouching system changes.
  • For two-piece ostomy pouching systems, moldable skin barriers designed to hug the contours of your stoma and eliminate gaps to provide a snug fit that may help minimize peristomal skin problems.

How to scale peristomal skin problems:

It’s important to know, not everyone experiences problems with the skin around their stoma. But your skin health can change over a very short period, if not regularly checked. All the examples shown below of irritated skin can be addressed. No matter how mild or severe your symptoms it’s important to seek help from your healthcare professional.

If you feel you are experiencing even mild irritation, it’s worth getting advice. Some peristomal skin problems do not go away on their own, requiring specific attention. You should expect to have healthy peristomal skin. Most conditions can be addressed by changing products, routines and additional care.

Stages of Peristomal Skin Problems. ;

If you feel you are experiencing even mild irritation, it’s worth getting advice. Some peristomal skin problems do not go away on their own, requiring specific attention. You should expect to have healthy peristomal skin. Most conditions can be addressed by changing products, routines and additional care.

1. O’Flynn SK. Preventing and solving peristomal skin problems. StomaTips. October 1, 2020. Accessed January 17, 2024. https://www.stomatips.com/features/article/preventing-and-solving-peristomal-skin-problems
2. Alvey B, Beck DE. Peristomal Dermatology. PMC PubMed Central: Clinics in colon and rectal surgery. February 2008. Accessed January 17, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780183/

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