How to Prevent Skin Irritation Around Your Stoma: 10 Things to Check

Redness. Burning. Itching. Soreness. Skin that feels raw after removing your pouch.

If you've experienced any of these, you're certainly not alone.

Problems with the skin around the stoma—called peristomal skin—are among the most common challenges people living with an ostomy encounter. A recent review of long-term ostomy care found that peristomal skin lesions affect an estimated 52–75% of people with an ostomy.

But here's something every ostomate (person living with an ostomy) should know:

Peristomal skin problems are common, but that doesn't mean you simply have to accept them as part of life with an ostomy.

The goal is to understand why the irritation is happening, address the underlying problem, and develop a pouching routine that helps keep your skin healthy.

What Should Healthy Skin Around Your Stoma Look Like?

Healthy peristomal skin should generally look and feel similar to the surrounding skin.

It shouldn't consistently:

• Burn
• Itch
• Hurt
• Bleed
• Feel raw
• Look persistently red or inflamed
• Have open areas or weeping skin

If your skin repeatedly looks irritated every time you remove your pouch, don't automatically assume that's normal.

Your skin is giving you information. The important part is figuring out what it's trying to tell you.

10 Things to Check When You're Dealing With Ostomy Skin Irritation

1. Make Sure Your Barrier Fits Properly

This is one of the most important places to start.

Your skin barrier should fit closely around the base of your stoma so that output doesn't get underneath the barrier and sit against your skin.

A poorly fitting opening can contribute to leakage, and leakage can quickly lead to irritation.

Your stoma can also change size and shape, particularly after surgery. Changes in weight, abdominal contours and other physical changes can also affect how your pouching system fits.

If you're suddenly experiencing leaks or skin irritation after previously having a good fit, it may be time to reassess your pouching system.

2. Don't Ignore Leaks

A leak isn't just an inconvenience.

Stool and urine can irritate the skin, and prolonged exposure can contribute to skin breakdown.

If you discover that output is getting underneath your barrier, don't simply keep adding more tape and hoping it holds.

A leaking pouching system needs to be addressed.

Remember our first article:

Why Does My Ostomy Keep Leaking?

Sometimes solving the leakage problem is the first step toward solving the skin problem.

Leakage → irritated skin → poor adhesion → more leakage

Breaking that cycle is important.

3. Be Gentle When Removing Your Appliance

Your skin has already been through a lot.

Repeatedly pulling adhesive aggressively from the skin can cause additional trauma, sometimes referred to as medical adhesive-related skin injury.

Instead, gently loosen the adhesive while supporting the skin.

An adhesive remover may also be helpful for some people.

The goal isn't to rip the barrier (wafer) off as quickly as possible.

Slow and gentle can make a big difference.

4. Clean Your Skin—But Don't Overdo It

You don't necessarily need an elaborate collection of products to clean the skin around your stoma.

Warm water is often sufficient for cleansing the peristomal skin.

If you use soap, choose one that doesn't leave an oily or moisturizing residue that could interfere with adhesion.

After cleaning:

Make sure your skin is completely dry before applying your new pouching system.

Moisture can interfere with adhesion and make maintaining a good seal more difficult.

5. Is It Irritation or an Allergic Reaction?

This is an important distinction.

Not all redness around your stoma has the same cause.

Irritation caused by leakage can look different from irritation caused by adhesive trauma or sensitivity to a particular product.

Some people may also react to a specific:

• Adhesive
• Barrier (wafer)
• Barrier ring (wafer ring)
• Tape
• Skin protectant
• Other accessory

Pay attention to where the irritation appears.

If redness or irritation consistently follows the exact shape of an adhesive or appears wherever a particular product touches your skin, it's worth discussing with your WOC/ostomy nurse.

Don't simply keep adding more products to irritated skin without figuring out what's causing the problem.

6. What Is the "Crusting" Technique?

If you've spent any time in the ostomy community, you've probably heard people talk about "crusting."

Generally, the term refers to using stoma powder with a compatible skin barrier (wafer) product to create a protective layer over certain types of irritated or weeping skin.

However, crusting isn't something everyone needs at every pouch change.

The appropriate products and technique depend on what's happening with your skin.

If you're unsure whether you should be using stoma powder, barrier film, or another product, ask your WOC/ostomy nurse for individualized guidance.

And remember: the goal isn't to create the most complicated pouching routine possible.

The goal is healthy skin and a reliable seal.

7. When Your Irritated Skin Won't Let Your Appliance Stick

This can be one of the most frustrating situations an ostomate encounters.

You have irritated skin.

The skin becomes moist or weepy.

Your appliance won't stick properly.

It leaks.

The leak makes your skin worse.

Then the appliance sticks even less.

It's a vicious cycle.

If you're in this situation, adding more adhesive isn't necessarily the answer.

The underlying skin problem and the cause of the leakage need to be addressed.

A WOC/ostomy nurse can help determine whether your pouching system, accessories, skin-care routine, or appliance fit needs to change.

8. Your Body Can Change—and Your Ostomy Care May Need to Change With It and that's okay

A pouching system that worked perfectly six months ago may not work the same way today.

Your:

• Weight
• Abdominal contours
• Activity level
• Stoma size
• Stoma shape
• Swelling
• Surgical changes
• Hernias
• Skin condition

can all affect your pouching system.

Your abdomen also isn't necessarily flat—and that's okay.

Creases, folds, scars and other contours can make maintaining a good seal more challenging.

Sometimes the solution isn't changing your skin-care routine.

It may be finding a pouching system that better matches your body today.

9. Use Ostomy Accessories for a Reason

Ostomy accessories can be incredibly useful when they're matched to the problem you're trying to solve.

Depending on the individual situation, products such as:

• Barrier rings
• Ostomy paste
• Skin barrier (wafer) films
• Adhesive removers
• Ostomy powder
• Ostomy belts

may have a role.

For example, a barrier (wafer) ring may help some people address uneven areas around the stoma, while convexity or a belt may be appropriate in certain situations.

But accessories aren't one-size-fits-all.

More isn't necessarily better.

Before adding another product to your routine, ask:

What problem am I trying to solve with this product?

If you don't know, that's a good reason to talk with your WOC/ostomy nurse.

10. Know When to Stop Experimenting and Call Your Ostomy Nurse

This might be the most important tip!

It's completely understandable to try different products when something isn't working.

But sometimes people end up cycling through:

Different pouches → different barriers → rings → paste → powder → sprays → tapes → different convexity → another pouch

without ever identifying the underlying problem.

If you've tried multiple products and your skin continues to deteriorate, it's time to get help from your health care professional.

A WOC/ostomy nurse can evaluate:

• Your stoma
• Your peristomal skin
• Your abdominal contours
• Your appliance fit
• Your leakage pattern
• Your pouching technique
• The products and accessories you're using

and help identify what may be contributing to the problem.

You shouldn't have to spend months trying one product after another hoping something finally works.

What If My Skin Is Already Irritated?

First, don't panic.

Take a close look at what's happening and think about what may have changed.

Ask yourself:

Did I have a leak?

Did I change products?

Did I recently remove my appliance more aggressively?

Is the irritation underneath the barrier or around the adhesive?

Is the skin wet or weeping?

Has my stoma changed?

Has my weight or abdominal shape changed?

These questions can help you start identifying the possible cause.

But if you can't figure it out—or the problem isn't improving—don't keep experimenting indefinitely.

Reach out to your WOC/ostomy nurse or healthcare professional.

What About Ostomy Powder?

Ostomy powder can be useful in certain situations, particularly when treating some types of moist or irritated skin.

But it isn't something everyone needs to use routinely.

The WOCN consumer guide recommends stoma powder for certain skin problems and discontinuing it once the problem resolves. (WOCN Peristomal Skin Assessment Guide)

When Should You Contact a Healthcare Professional?

Contact your WOC/ostomy nurse or healthcare professional if you're experiencing:

• Persistent or worsening redness
• Significant pain or burning
• Open or broken skin
• Repeated leakage
• Weeping or draining skin
• Bleeding that concerns you
• Signs of infection
• A pouching system that repeatedly won't stay on
• A significant change in your stoma
• Skin problems that aren't improving

And if you don't have access to a WOC/ostomy nurse, ask your healthcare provider about resources that may be available in your area.

You don't have to figure this out alone.

Healthy Skin Is Worth Paying Attention To

Living with an ostomy involves learning what works for your body.

Your stoma may change.

Your weight may change.

Your abdominal contours may change.

Your activity level may change.

And the pouching system that worked perfectly last year may not be the best solution today.

That doesn't mean you've done anything wrong.

It means your ostomy care may need to evolve with you.

We've come a long way in ostomy care, with better products, specialized WOC nursing, education, support programs and technology available to patients.

The goal isn't simply to manage your ostomy.

The goal is to help you live well with it.

Quick Skin-Care Checklist

Before applying your next pouching system, ask:

☐ Is my skin clean?

☐ Is it completely dry?

☐ Does my barrier opening fit appropriately around my stoma?

☐ Am I seeing any signs of leakage?

☐ Is my skin burning, itching or sore?

☐ Am I removing my old barrier gently?

☐ Am I using accessories because I need them—not simply because I have them?

☐ Has the shape or size of my stoma changed?

☐ Has my body shape or weight changed?

☐ Have I recently changed a product?

☐ Do I need help from a WOC/ostomy nurse?

Healthy skin is worth paying attention to.

At Sam's Medical Supply, we believe finding the right ostomy products is only part of the equation.

Understanding how to use them, knowing what to watch for, and knowing where to turn when something isn't working are just as important.

We're here to help provide the products you need from brands you trust—and to help connect you with resources that can help you manage life with an ostomy with greater confidence.

Because you shouldn't have to figure it all out by yourself.

This article is intended for general educational purposes and is not a substitute for individualized medical advice. If you are experiencing persistent or worsening peristomal skin problems, significant pain, open wounds, drainage, signs of infection, or difficulty maintaining your pouch seal, contact your WOC/ostomy nurse or healthcare professional.

Sources

• Wound, Ostomy and Continence Nurses Society (WOCN) — Peristomal Skin Assessment Guide. WOCN Peristomal Skin Assessment Guide
• Frontiers in Gastroenterology — Where healthcare systems fall short in long-term ostomy care: implications for quality of life, healthcare utilization, and sustainable care pathways. Frontiers research article