NB – if unsure, ALWAYS consult with your Stoma Nurse and never assume anything, these are just general guidelines. Your specific medical history, stoma, and needs should be taking into consideration as some information is case specific and does not apply to all.
Why is the skin around my stoma itching with a red rash?
- This might most likely be a skin irritation caused by a fungal infection (Candida) due to leakage on the skin of the stoma contents and needs to be assessed by a Stoma Care Nurse who will advise you on how to treat this and stop the leaking of the pouch.
- This itchy rash will have a “satellite” appearance in areas where skin is warm and moist.
- This might follow having taken a course of antibiotics, or seen in patients taking steroids, or could be seen on the skin of patients using antibacterial skin soaps to wash the skin around the stoma.
- In South Africa the only product that will deal with a fungal infection around the stoma which will not interfere with the adhesion of the pouch is Gentian Violet.
- Clean the skin extremely well and apply a thin layer of Gentian Violet, let it dry completely and then apply our pouching system. Do this for one month or only until the itching subsides.
- Please do not use this permanently as it does get absorbed through the skin and studies have shown that long terms use can possibly contribute to the development of cancer.
Why is the skin around my stoma bleeding?
- This is most likely because you cleaned the ostomy and rubbing a little too roughly over it may cause bleeding. This is normal but should be avoided.
- Gently clean the ostomy and the surrounding skin to prevent bleeding.
- Should bleeding be like a trickle and if it stops, then you do not have to be concerned about the event, but if the bleeding does not stop or is more than normal, please contact the Stoma Care Nurse immediately for an appointment.
- Steady slow bleeding can also be due to trauma to the ostomy, if you are on anticoagulants (blood thinning medications), if you are having Chemotherapy, or with some liver diseases affecting clotting of your blood. Please visit your Stoma Care Nurse and apply direct pressure to the area, as well as a cold pack wrapped in a towel until you can get to the Stoma Clinic.
- Should the blood be from the opening where the stool or urine normally flows out from, go immediately to the emergency department and contact your physician.
Why is the skin around my stoma red, painful and broken, looks like a shallow wound ?
- This is most likely because your pouch is not giving you a secure fit and you are experiencing leakage of the ostomy content onto the skin around the stoma.
- Most irritating to skin – output from an Ileostomy
- Moderate irritation to skin – Colostomy
- The least irritating to skin – output from an Urostomy, but this can still cause skin damage with long term exposure to urine.
- The stool and urine that are in contact with your skin can cause the skin to break down and cause wounds around the stoma which could be very painful.
- Therefore, should your pouch leak, you must change it immediately and clean the skin very well before the new pouch is applied.
- Do not wait for the content to “pool” on the skin and cause damage, do not wait until it leaks out at the edge of the barrier/ wafer/ base plate.
Why is my pouch not sticking to my skin?
- Firstly, ensure that the skin around the ostomy is 100% dry before you apply the pouch, as the smallest amount of liquid that might have leaked or might be left on the skin can prevent the pouch from sticking/ adhering to the skin.
- This is most likely because the skin is broken or weeping fluid that keeps it wet. The pouch will not stick to a wet surface.
- You will need assistance from your Stoma Care Nurse to manage and heal this broken skin area and she will teach you how to create a dry surface area to get your pouch to stick again, as well as show you how to prevent future leaking.
Why is my skin red everywhere where the adhesive part of the pouch touches my skin?
- This is most likely an allergic dermatitis and could look like a rash and could even have areas of small water blisters.
- You will need assistance from your Stoma Care Nurse to manage and assess this rash, the ostomy and to evaluate the pouching system you are currently using.
- A TRUE allergy to ostomy adhesives is uncommon, but a change of brand might alleviate the problem.
Why do I have pimples on the skin around my ostomy?
- This is most likely because of an infection in the hair follicles and is called Folliculitis.
- Hair follicles become inflamed due to pulling on them when the pouch is removed, and therefore it is best to shave this hair to prevent this complication from reoccurring.
- Interval between shaving depends on the patient