Most peristomal skin problems, meaning sore, red, itchy, or broken skin around a stoma, come down to one of a few causes: a leak or poor fit, a reaction to a product, too much moisture, or irritation from removal. Matching what you see to the likely cause is the fastest route to the right fix. Healthy peristomal skin should look just like the skin elsewhere on your abdomen, so any redness, soreness, or change is best acted on early.
This guide helps you spot the likely cause from what the skin looks like, then points you to the fix. It is a starting point, not a diagnosis. Your stoma nurse is the person who can confirm what is going on and tailor the treatment.
Why does the skin around a stoma break down?
The peristomal skin sits under an adhesive all day, close to output that can be irritating, and gets stressed every time you change the appliance. That combination means small problems are common, and most trace back to moisture or irritants reaching the skin, a reaction to something touching it, or physical stress from removal. The good news is that once you know the cause, the fix is usually straightforward.
Peristomal skin problems at a glance
Find the description that matches your skin, then read the matching section below.
| What you see | Likely cause | First step |
|---|---|---|
| Red, raw, sore skin in a shape that matches where output reaches | Irritant damage from a leak or poor fit | Fix the fit and seal |
| Itchy red rash, often bumpy, matching the shape of the barrier or tape | Allergic reaction to a product | Stop using it; see your nurse |
| Pale, white, soggy, soft skin | Too much moisture (maceration) | Improve drying and wear time |
| Raised, wart-like, or darkened patches near the stoma | Long-term exposure to output | See your nurse; stop the leak |
| Small pus-filled spots around hair follicles | Folliculitis, often from hair removal | Gentle hair removal; let it settle |
| A moist, red, raised lump at the stoma edge that bleeds easily | Overgranulation | See your nurse |
Red, raw, sore skin: a leak or poor fit
If the sore area matches the path where output reaches the skin, the cause is almost always a leak or a barrier opening that is too big. This is by far the most common peristomal skin problem. Output sitting on the skin strips and inflames it, which then makes the next seal harder, so it can become a cycle.
The fix is to stop output reaching the skin. Remeasure your stoma (it changes in the weeks after surgery and can change again later), cut the barrier opening to fit closely, and use a moldable barrier ring to fill the small gaps and folds where leaks start. Our step-by-step on how to stop peristomal skin irritation walks through calming the skin, and why your wafer keeps leaking covers the fit causes in detail.
Itchy, bumpy rash: an allergic reaction
If the rash is itchy and raised and matches the exact shape of your barrier, tape, or a wipe you use, it may be an allergic contact reaction to that product. The tell is that the rash stops precisely where the product ends. Stop using the suspected product and speak to your stoma nurse, who can help identify the trigger and suggest an alternative. Do not just push through it, since the reaction usually continues until the trigger is removed.
Pale, soggy skin: too much moisture
Skin that looks white, wrinkled, and soft has been wet for too long, which is called maceration. It comes from sweat, output, or moisture trapped under the barrier, often paired with a wear time that is too long for you. The fix is to make sure the skin is fully dry before applying a new appliance, review how long you wear it before changing, and ask your nurse about a barrier or accessory that handles moisture better.
Raised or darkened patches: long-term exposure
Raised, wart-like, or darkened patches near the stoma usually point to skin that has been exposed to output over a long period. This needs your stoma nurse, both to treat the skin and to solve the underlying leak or fit issue that caused it. It tends to improve once output is reliably kept off the skin.
Pus-filled spots around hair: folliculitis
Small, tender, pus-filled spots centered on hair follicles are often folliculitis, which can follow shaving or repeated adhesive removal pulling at the hairs. Remove peristomal hair gently, with electric clippers or careful trimming rather than a close wet shave, and in the direction of growth. If it does not settle or spreads, check with your nurse.
A moist red lump at the edge: overgranulation
A soft, moist, red or pink raised area at the junction of the stoma and skin that bleeds easily is often overgranulation, which is extra tissue forming in response to friction or moisture. This one is for your stoma nurse to assess and treat. Reducing rubbing and keeping the area dry can help in the meantime.
The most common fix: stop the leak
Because a leak or poor fit causes most peristomal skin problems, getting a reliable seal solves more of them than anything else. A moldable barrier ring fills the gaps and folds around the stoma where output sneaks through, which protects the skin while it heals and helps stop the problem coming back. New to rings? See what an ostomy barrier ring does.
Moldable, ceramide-infused rings that fill gaps for a secure seal, keeping output off the skin. FSA and HSA eligible.
A soft, flexible barrier ring that molds around the stoma for a comfortable, secure seal at a friendly price. FSA and HSA eligible.
When should you see your stoma nurse?
Speak to your stoma nurse if the skin stays sore, broken, or weepy despite improving the fit, if you suspect an allergic reaction, if you see raised patches or a bleeding lump, or if anything is not settling within a few days. Peristomal skin problems are common and treatable, and your nurse can match the treatment to the exact cause. Seek prompt medical advice for spreading redness, increasing pain, or signs of infection.
Frequently asked questions
Why is the skin around my stoma red and sore?
The most common reason is a leak or a barrier opening that is too large, letting output reach and irritate the skin. The giveaway is that the sore area matches where output sits. Refit the barrier closely and use a moldable ring to seal the gaps, and the skin usually recovers.
How do I know if it is a leak or an allergy?
A leak causes soreness in the shape of where output reaches the skin. An allergic reaction is usually itchy and bumpy and matches the exact outline of a product like the barrier, tape, or a wipe. If the rash stops precisely where a product ends, suspect an allergy and check with your nurse.
Can I put cream on peristomal skin?
Be careful, because most creams and ointments leave a residue that stops the appliance sticking. Only use products meant for ostomy use, such as a stoma powder or a barrier wipe, and apply them as directed. Your stoma nurse can recommend what is safe for your situation.
How long does sore peristomal skin take to heal?
Once the cause is removed, mild irritation often improves within a few days to a couple of weeks. If it is not improving, the underlying cause is probably still present, or it needs your nurse's input.
Is some redness around the stoma normal?
Healthy peristomal skin should look like the skin elsewhere on your abdomen, so persistent redness is a sign to act on rather than ignore. Brief mild pinkness right after removing the appliance can be normal, but soreness that lasts is not.
Heal the skin by sealing the leak
A reliable seal keeps output off the skin so it can recover. Our Hollister CeraRing and SoftFlex rings ship free over $80 and are FSA and HSA eligible.
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Written by the Adhereskin Care Team. This guide is general information, not medical advice, and is not a substitute for a diagnosis. Peristomal skin problems should be assessed by your stoma nurse (WOC nurse) or doctor, especially if they do not settle or you see signs of infection.