Most peristomal skin irritation, the redness and soreness on the skin around your stoma, is caused by output leaking onto the skin and sitting there. The good news is that it usually heals once you stop the leak and protect the skin while it recovers. Here are six steps to calm sore, red peristomal skin, help it heal, and keep it from coming back.
In this article
- First, what kind of irritation is it?
- Step 1: Find and fix the leak
- Step 2: Clean the skin gently
- Step 3: Protect raw skin with the crusting method
- Step 4: Seal the gaps with a barrier ring
- Step 5: Remove your wafer gently
- Step 6: Give the skin a break and watch it
- FAQ
First, what kind of irritation is it?
Healthy peristomal skin should look like the skin on the rest of your belly. When it does not, it usually falls into one of three patterns, and knowing which one you have points you to the fix.
- Leak-related (the most common). Red, sore, sometimes weeping or burning skin right where output has been sitting. This is irritant dermatitis, and it is caused by effluent reaching the skin through a gap in the seal. The fix is to stop the leak and protect the skin.
- A reaction to a product. Redness or an itchy rash that matches the exact shape of your wafer, tape, or a wipe you use. This points to an allergy or sensitivity to something touching the skin, and often appears after weeks or months of using a product.
- A fungal rash. An itchy, often spotty red rash, sometimes with smaller spots scattered at the edges, that thrives in the warm, moist area under the barrier. This needs a different treatment, so it is worth getting it checked.
If you are not sure which you are dealing with, or the skin is broken, weeping, bleeding, or not improving after about a week, contact your stoma or WOC nurse (a wound, ostomy, and continence nurse). They can look at it and tell you exactly what is going on.
Step 1: Find and fix the leak
Since leaking output is behind most sore skin, this is where healing starts. If output keeps reaching the skin, no cream or powder will keep up. Work out why the seal is failing, whether that is a wafer opening cut too large, damp skin at application, or a gap over an uneven area, and fix that first.
Our full guide to why your ostomy wafer keeps leaking walks through the seven common causes and the fix for each. Sort the leak, and the skin gets its chance to recover.
Step 2: Clean the skin gently
Clean around your stoma with plain warm water and a soft cloth, then pat it completely dry. Skip soaps with added moisturizer, oils, lotions, and baby wipes. They leave a film that both irritates raw skin and stops your wafer from sticking, which sets up the next leak. Plain water is genuinely all most people need.
Step 3: Protect raw skin with the crusting method
For skin that is weeping or raw, ostomy nurses use a simple technique called crusting to create a dry, protected surface the wafer can stick to. You dust a light layer of stoma powder onto the moist skin, brush off the excess, then dab over it with a no-sting skin barrier film. Repeat that once or twice to build thin layers into a stable crust.
Stoma powder and barrier film are sold separately by ostomy supply pharmacies, and your nurse can show you the technique and recommend products. Use ordinary skin creams sparingly or not at all under a wafer, since most of them stop the adhesive from bonding.
Step 4: Seal the gaps with a barrier ring
Once the skin is clean and dry, a barrier ring helps in two ways at once. It molds into the gaps and creases where output was getting through, which stops the leak that caused the irritation, and a ceramide ring also supports the skin barrier while it heals. Ceramide is a lipid your own skin uses to hold moisture and stay intact.
New to barrier rings? Here is what an ostomy barrier ring is and how to use one.
Ceramide-infused rings that mold over gaps to stop leaks, while the ceramide supports the peristomal skin underneath.
A soft, moldable ring that seals the gaps where output reaches the skin, at a friendlier price per ring.
Step 5: Remove your wafer gently
A lot of peristomal damage happens at removal, not during wear. Pulling a wafer off quickly strips the top layer of skin and leaves it raw. Instead, peel slowly and low to the skin, press the skin down with one hand as you lift the wafer with the other, and use an adhesive remover spray or wipe if your skin is sensitive. Going in the direction of hair growth helps too.
Step 6: Give the skin a break and watch it
When you change your appliance, leave the skin uncovered for 15 to 30 minutes before you put the new one on. This short skin break lets the area breathe and dry fully. As it heals, keep an eye on the pattern. If the redness traces the exact outline of your wafer or tape, suspect an allergy and ask about switching products. If it is itchy and spotty rather than sore, suspect a fungal rash. Either way, a nurse can confirm it.
Quick peristomal skin checklist
| What you see | Likely cause | First move |
|---|---|---|
| Sore, red skin where output sits | A leak reaching the skin | Fix the seal, add a barrier ring |
| Weeping or raw patches | Skin breakdown from effluent | Crusting method, then reseal |
| Rash in the shape of the wafer or tape | Allergy to a product | Ask your nurse about switching products |
| Itchy, spotty rash under the barrier | Possible fungal infection | Get it checked for the right treatment |
Frequently asked questions
How long does it take for peristomal skin to heal?
Once the leak is fixed and the skin is protected, mild irritation often settles in a few days, and more broken skin can take a week or two. If it is not clearly improving after about a week, see your stoma or WOC nurse.
Can I put a pouch on broken or raw skin?
Yes, you still need to wear your appliance. Use the crusting method to give raw skin a dry, protected surface first, then apply your wafer with a barrier ring. The goal is to seal output away from the skin so it can heal underneath.
What can I put on irritated skin around my stoma?
Stick to products made for ostomy skin: stoma powder and a no-sting barrier film for raw areas, and a ceramide barrier ring for protection. Avoid ordinary moisturizers and creams under the wafer, since they stop the adhesive from sticking and can make leaks worse.
Is it normal for the skin around my stoma to be a little red?
No. Healthy peristomal skin should look like the rest of your abdomen. Redness is a sign that something is irritating it, usually a leak, so treat it as a prompt to check your fit rather than something to live with.
When should I see a nurse about peristomal skin?
Reach out if the skin is bleeding, weeping, painful, or not healing after a week, if a rash matches the shape of a product, or if you keep getting irritation no matter what you try. A WOC nurse can find the cause and tailor a plan.
Related guides
- 7 reasons your ostomy wafer keeps leaking (and how to fix each)
- What is an ostomy barrier ring? Hollister CeraRing explained
- Barrier ring vs ostomy paste: which stops leaks better?
Protect your skin, stop the cycle
A ceramide barrier ring seals out the leaks that irritate your skin and supports it while it heals.
Shop Barrier Rings →Free shipping over $80. FSA and HSA eligible. Money-back guarantee.
Sources and further reading: United Ostomy Associations of America, signs of irritated peristomal skin and Hollister, the importance of healthy skin around your stoma. This article is general information, not medical advice. For broken, painful, or persistent skin problems, contact your stoma or WOC nurse.