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Stoma irritation – what could be causing it?

Unfortunately, many ostomates will suffer with skin irritation from time to time. Once the skin becomes irritated and sore, it can cause a great deal of discomfort and misery. Be sure to contact your Stoma Care Nurse for advice and support as it is important to find the reason why your skin is sore, before attempting to treat it yourself.

There are many remedies especially for the skin around the stoma, which will help soothe the skin and settle the irritation. It is wise to note that not all lotions and potions in your bathroom cupboard are wise to apply on the skin around your stoma, as they may stop the bag from sticking, making things worse. You may even benefit from a change in stoma appliance. Your nurse will guide you with what to use and help identify the cause of the soreness. They will also try to resolve the underlying cause, so you hopefully don’t experience it again.

Signs of irritated skin:

The skin around your stoma should look similar to the rest of your body. If it becomes sore and irritated, you many find you identify with one or more of the symptoms of sore skin below:

  • Discomfort, itching, soreness or pain around the stoma.
  • Excessive bleeding which doesn’t resolve, from around the stoma.
  • The skin around the stoma becomes red and inflamed
  • A bumpy, raised rash may be present
  • Skin colour changes from your normal skin colour to a reddened/inflamed area, it may even change to a bluish-purple colour or even black.

Causes of irritated skin around your stoma:

What are the causes of skin irritation? We are all different and therefore the causes of sore skin will be different for each ostomate. The most common culprit for sore skin is usually caused by leakage from your stoma appliance getting underneath the adhesive and onto your skin. It is uncomfortable and can hinder the bag from working well.

Here are some of the most common causes of irritation:

  • A poorly fitting stoma appliance
  • The hole (aperture) size might be the wrong size
  • Uneven surfaces of skin, such as skin folds or scarring due to surgery
  • Leaks from the stoma, which cause the effluent (stool or urine) to sit on the skin
  • The effluent from your stoma maybe excessive
  • The effluent may corrode the hydrocolloid (adhesive of bag) causing irritation
  • Frequent removal of bag which can strip the skin
  • Try not to change the bag unnecessarily
  • Pre-existing skin conditions such as sensitive skin, eczema or psoriasis
  • An underlying skin irritation may stop the bag from sticking properly
  • Contact dermatitis (an allergy or sensitivity) from any of the stoma products
  • Humidity from hot weather
  • Excessive sweating can prevent the bag from sticking well
  • The use of chemicals such as fragranced soaps, detergents, deodorisers, bleach-based cleaning wipes or baby wipes.

Treatment options:

  • Remeasuring of the aperture and stoma size, so that the bag fits correctly
  • Adhesive remover sprays or wipes to help with the gentle removal of bags.
  • Stoma powders sprinkled sparingly to any moist irritated skin, to ease discomfort
  • Barrier creams or sprays can be used for a short period of time
  • Non-sting stoma pastes to help with adhesion of the flange to the skin, particularly useful to even out dips or creases
  • Topical steroid lotions can be used as a short course of treatment if irritation is severe, these would need to be prescribed by your stoma nurse or GP
  • Appliances with alginate, Aloe Vera or Vitamin E in the adhesive of the bag can help soothe the irritated skin
  • If you suffer with a skin condition such as psoriasis or eczema and the sore skin around your stoma resembles this too, you can try using small amounts of your usual prescribed cream. Please check with your stoma nurse first though, as you may need the preparation changing slightly (eg from an ointment to a cream) to prevent the adhesion of your stoma appliance being compromised.

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