MY Personal Ostomy Skin Care Tips
89Good Skin Care is Imperitive
No matter what kind of stoma you have, it is very important to take care of the skin surrounding it. I have seen several sites recommending plain water with a cotton pad. But I am a firm believer in antibacterial soap. Unless you are allergic to this type of soap, it will not hurt you in any way. I have always used Dial soap, whether it be a bar or liquid. Every time you change your pouch you need to thoroughly cleanse the area around your stoma. Use a soft cloth. Just soap up the cloth and gently scrub that area. The soap will not hurt your stoma. Once you have cleansed it, you might just pour a cup of clean water over the area to rinse it or use a clean wet cloth to wipe the soap off. ~the only other reason you might not want to do this is if you have extremely dry skin. Then, just dab it dry if you can without spillage, because if you have small blisters you do not want to burst these by "rubbing" dry.
Every stoma site is basicly the same, but different too. Some people have an inverted stoma, some have one that will protrude.My stoma was slightly protruding. Sometimes what I ate would cause it to invert slightly, and it was a little painful for me. The pain doesn't usually come from the stoma, but mostly from the exit tissue being pulled or pushed.
I found Hollister products to be the best for me. Since it has been awhile that I have had to wear a pouch, I had to do some recent research on some of their products. What I found to be helpful in any situation was the skin gel protectant. Not only did it protect my skin with each change, it aided in healing my skin of dermatitis. It does have alcohol in it, so it stings greatly. But the alcohol seemed to heal my problem. ~please see dermatitis photo Once you have dried the skin, lightly apply the protectant, wave it dry, then apply the pouch. We all know that you have to be quick at this. I would fold over 3-4 paper towels and lie them on the bathroom counter while doing all of this, and keeping somethig close by to dab any spillage quick so as to not re-intoroduce the skin to it's irritants. In the time that I had my ostomy, I met only a couple of people to talk about this with. They were generally people I come into contact with as a nurse's aid. I had one fellow who firmly believed that using wet tea bags to dab the skin with, "through" the tape of the pouch, helped to keep his skin unirritated. I tried this once or twice, and it did help with small irritations but not for big blistery ones. Allowing the blistering to heal without it being bursted is the best.
It is always best to consult your ostomy care nurse or physician first.
Dermatitis
Click thumbnail to view full-size
After Irritation
Once your skin becomes irritated it is a well known fact that keeping an appliance on is near impossible. Using a pre-paste helps if the irritation isn't too bad. And, using 2 separate pieces was always best for me. I used the wafer (one piece), then applied my pouch over that. I have seen where most people use the one piece product that has the wafer as part of it. The only problem with this is that it is "one piece". When you cut out the size to fit , there is no safety. With using 2 separate pieces, you assure for leakage. I would cut that wafer as close to the stoma as I could without it having sharp edges. I could dampen my fingers and soften the edges to fit perfectly. And usually your stoma entrance isn't perfectly round, but you know your pouch opening is, so custom fitting the wafer first assures that there is minimal leakage. Then I would put the pouch (with karaya seal) on top of the wafer. I know that products are very expensive these days, but if you have insurance to cover this, make sure to speak with your physician and make him or her understand that you need BOTH products to insure healthy skin. Without this insurance you are going to go through more pouches anyhow. Right?
Another source of irritation is that darn plastic pouch. Years ago, way before all these nice coverlets came out, I was a home economics student who enjoyed sewing. And together with my grandma, we designed our own coverlets. I have found a few sites online where you can order them, but if you know someone who sews, ask them to do some for you. It isn't hard, and it's much cheaper. Simply take one of your pouches out and lay it on a piece of typing paper. Hold it fimly down and trace around the outside. This is one piece of the pattern. I came out about 1/2" and traced another outside line to leave room for hemming. Label this "front". You want to trace the entire pouch, top to bottom. The back side is the same, only you are going to measure and draw a circle slightly above the center that is the same size as the piece between your pouch adhesive side and where it attaches to the actual pouch . You will cut this circle out. I made about 4 copies of this pattern. I also chose material that was pleasing to my skin first and foremost ( a couple of different types- flannel too) and then pleasing to the eye also. Silk or silk-types are a bother. They slip slide on the pouch and don't stay in place, so find a nice cotton blend that is just as pretty. Just pin the patterns to doubled over material, all 4 if you like, both sides, and cut them out. Set aside the ones that won't have the center cut, and proceed to cut out your holes for the ones that do. Once you have this done, you want to take the ones with the center cut and do a close zig-zag stitch around the cut out on all of them. This will keep the material from fraying from a lot of use. Then take all pieces and put in a very small hem along the bottom piece of each of them where your clamp would go. Once you have the bottom hems put in, and the centers too, you want to then pair the fronts to the backs. Before sewing, of course, you want to flip them so that the showey material is facing. LEAVE THE BOTTOM PIECE THAT YOU HEMMED, UN SEWN. Simply sew the sides together then flip back out. You leave the bottom open for quick empties, that way you don't have to take off the entire cover. You just pull it up/fold it, pull out your clamp and do a quick empty.
I did not rinse the inside of my pouch with every empty. This leads to softening of the seal much quicker. It all depended on the consistency of the B.M. With an Ileostomy, it's generally thinner.
Coverlets
- Koolostomy dot com, the site for cool ostomy bags
Koolostomy Pouch Covers of Jacksonville Beach, Florida, 904 247 5393, specializing in the production and retail of ostomy bag pouch covers. Anyone who wears an appliance will love to have a comfortable, ergonomic, fashion integrated pouch cover.
Coverlets 2
Support Group
- stomacentralint : STOMA CENTRAL INTERNATIONAL
stomacentralint: STOMA CENTRAL INTERNATIONAL
End of First Edition
I will add to this page by posting it Second Edition, and so forth, as needed. Thanks for looking and ask as many questions as you would like. I will do my best to answer from my own experience, and if I can't, I will try to find you someone who can.
~Anita
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Comments
I commend you for writing about this...many people would be too embarrassed. I love the idea of making your own coverlet. I'll have to share that with ostomy patients. Great hub!
Thank you so much Shawna. I just remember how alone I felt at that time and I know there are others out there.
I agree, great to see someone willing to share information on this. My mother had a colostomy and I'm sure these tips would have helped her.
Thank you Marisa. And I have only touched the surface. It gives me hope, thinking that someone out there will read all this and know "they are not alone". Love your hubs too. You all are providing me with so much help. Be blessed!
Hi Anitariley, I came to see what you were inquiring about on the Hubbers Hangout. Guess this wasn't the hub where someone with a 12 score accused you of being too graphic and personal.
Knowing a bit about ostomies myself (have had 2 people close to me with them) I can read what you wrote with interest. I believe this subject would be very useful for many people. And good for you for sharing something about yourself.
I wish you good luck here on HP. Welcome!
Thank you Mighty Mom. I have since broken this hub down into 2. And I also deleted the rude comment. I am a newbie still so it is taking some time to learn to edit and not make them so big. LOL I appreciate all your comments, and once I'm wel and on my feet again I am truly looking forward to writing some more.
What do i do if the filter leaks and gets on clothing. I am just 2 months pro op with the ostomy and now I am having this issue and is really emotionally draining for me. Another, i have the two piece also, and the piece against my skin does not stick for very long, Just something I need to get used toon or something I can do? Also itches like crazy, does that eventually go away?
Dear sweet Monica,
I know all about emotional drainage. First, is the piece against your skin not sticking because of a skin issue, such as a rash? I'm really sorry I am just now getting back to you, I have been without a computer for a little bit. Lets start with the skin issue first. Get back with me A.S.A.P.
thanks~ Anita
Well you know...this week it seems to be working ok. I do have a red spot on my skin that really hurts. And then it burns sometimes when I put the paste around the stoma to put the piece against my skin on. I know the stoma is not supposed to hurt, but the area around the stoma does.
came across ur page, and I have an infant with an colostomy. He will have until he reaches 20 lbs. He was born with an imperforated anus. We were quite surprised. I was looking for ways to clean the skin around the ostomy, and saw your posting. I've been looking for soap that I can use to clean up the stickiness from the skin barriers. So I will try using dial soap! Thanks! Really informative page!
Dear Monica- Think of pouring battery acid, or something similiar to that, straight onto your skin and what that does to you. The BM coming from your stoma is quite similiar. Anything you eat or drink that is acidic is going to irritate you skin. Especially things like fresh fruits, fruit juices, soda pops, etc.
I know it burns, it's like pouring alcohol or salt onto an open wound. The only way to get it to heal, and protect it, is to apply the Hollister skin barrier right over the irritation. I keep something to wave over it to cool it until it dries, then the burn goes away. The alcohol in it seems to dry it up quickly (1-3 days). You may even want to try things such as pepto bismol or maalox with your meals, or even a benadryl, to help reverse the reactions. And I will tell you all now, Beano should be your bestest friend. LOL
The direct area surrounding the stoma will hurt occasionally from any bulky, fiberous food that may be too large to pass through the original opening. Eventually, you will learn what foods you should or should not eat. If you should happen to feel constipated, and nothing is passing through, try the "milking" procedure. It will hurt a little, but it's better to get it passed through than to suffer. I am adding my email address here so that you can contact me with ANYTHING you need to know, anything I can answer any how.
anitariley65@yahoo.com
Good luck, and don't be afraid to email me for anything you need.
Anita
Dear Amanda~ I feel so sorry for you and your child to have to endure this. If you cannot get the sticky cleaned up with dial, another thing that works quite well is regular, old, Dawn dish soap. I have tons of it around the house for many little things. Just wet your cloth and put a tiny dab of Dawn on the tip of one of your fingers (cloth over your finger) and gently scrub. GENTLY. It shouldn't hurt a thing unless your childs skin is sensitive to it. Think back to the old days, the only thing folks used as enema's was plain soap and water.
I hope this works for you.
Anita
thanks for the informative post.
You are quite welcome.
Dear Anita,
Thank you for your helpful posts.
I am interested in reading about how you dealt with the irritated skin under the adhesive as our little 1yr old is using a one piece Hollister product which seems to irritate him. I am also having trouble cutting the wafer/base plate to size as his stoma is oblong, and narrower at the base than the top. I guess it kind of looks like a mushroom. So what happens is we sort of scrape the stoma a bit trying to get a good close seal to stop leakage onto his skin. Have you come across any solutions for this?
Karla
Dear Karla-
The product I used for the skin irritation may not work for a baby. It had alcohol in it and burned a little when applied. Not only did it protect the skin, it also helped to heal it quicker. It was hollister skin barrier. It is a clear paste.
http://www.hollister.com/us/products/product_serie
This one on the web page here may work better for a little one.
When working with getting the cut right, cut just a hair (1/8") smaller on the barrier. The next little trick helped me loads. I just moistened my fingers with warm tap water and ran it along the inside cut to soften it. Once it's softened about another 1/8-1/4" around the inside cut, then slip it on. Stoma's are quite sensitive and tend to bleed a little, but as long as it is just a little, it won't hurt the baby. Softening it like that will help it to mold perfectly around the odd shape of his stoma. Mine was that way too. I hope this helps.
Anita
Dear Karla & Amanda- Do you have any of the cloth coverlets for your baby's pouch? If not, please get right back with me as soon as you can. I would like to have you do some measurements for me so I can send you some homemade coverlets.
Anita
Dear Anita,
First of all, thank you so much for all your information, for I learned quite a bit. I'm fairly new to having this ostomy, and need to learn a lot. I have a lot of little blisters on my stoma, and don't know how to care for them. I don't know why but they scare me! I'd sure appreciate it if you could tell me how to take care of the blisters. They seem to be getting larger. My stoma also bleeds very easily. Is that normal? Thank you for all the help you can give me!
Take Care!
Linda
Linda- how long have you had your ostomy? I had what looked like little blisters too, and they and the stoma bled easily too. But it is not a major concern. Especially if your ostomy is new. If you yahoo IM I can give you my ID so we can talk that way?
Anita
And you are very welcome. I had some ppl ask me how I could get this personal on open web, and all I can tell anyone is that I was sooo friggin lost and alone, and I wouldn't want anyone to feel the way I did, so I put it out there. I'm on for awhile, so drop me a line right back if you can.
Hi, I have had my ileostomy since Jan. 1976 after ulcerative colitis at 7 years old. All of this time has provided lots of testing. The skin under the face plate is a huge issue. I would like to hear what "ostomy type" products others are or have used. I have been told and believe that liquid soap is not always the "best" choice because the faceplate may not stick as well.
Laurie- ulcerative colitis is tough, and has different issues than mine, but, Hollister was always the best for me. You are right about liquid soap, but cleaning with dial, regular dial and not a moisturizing type, will not give you problems, unless you are sensitive to it. It's all such a messy job, but completely necessary. After you cleanse and rinse it, pat it dry with a paper towel. Do you have ridges to fill in or very irritated skin? What you use to help depends on that. I hope I can help.
Dear Anita,
Thank you for writing about such an important issue.
I have been involved in ostomy skin care for 13 years, mostly in the development of truly life-changing accessory products, designed to improve and maintain the condition of peristomal skin.
Recent exciting developments in ostomy skin care may not have reached you yet, depending on where you are in the world, but I would be delighted to discuss with you and would value your opinions.
Please feel free to contact me: ben.curtis@triohealthcare.co.uk
or visit the website.
It would be great to learn more from you.
Dear Anita,
My daughter just turned 5 and has lost most of her intestine and the ability to eat do to side effects from a bone marrow transplant. She has endured much over the last year and will need to endure much more. Her skin under her Ostomy is really red and irritated and it is very painful. Nothing will stick to it now. Her stoma is egg shaped and sticks out about a quarter inch but it is crooked so her stool always comes out the side opposite her belly button. She has a fistula about 1 1/2 inches from the stoma and we have to cut a half moon in the wafer so we don't cover it. She also hasn't had any formed stool at all for over a year so it is basically just watery from the TPN. My wife and I are at our wits end trying to get a bag to stay on for more than an hour. We blow through a months supply in a couple days. We also have an ostomy nurse that has been helping us but she hasn't found the solution yet. Any suggestions are greatly appreciated.
Gary
Dear Gary-
What has the doctor said about the fistula? Has he put her on antibiotics? Or is it already fully formed and leaking BM through it. If not, the doctor needs to treat it immediately. It CAN be treated and eventually go away.
I would also recommend using a second piece/the wafer, under the bag itself. I know it is a lot of cutting, but it may be necessary. Just buy one box of 5 and try them. Like I said above, in another note, moisten your fingers after you make the initial cut on the wafer(make it a tiny bit smaller than the stoma) and soften the edges, about 1/4 inches in, like molding clay. If you think she would tolerate it, I would use the skin gel protectant on her skin first. Both of you blow on it to cool the sting, make a game of it. You would have to leave the area of the fistula dry though, and still cut a place for it.
Getting that taken care of is so important.
I don't know how you are doing this. I would feel the same as you. You may personally email me if you like. My email address is above. You can even call me. I'll provide my phone # in an email address.
I am checking out some of the products offered from the site mentioned in the email before yours. I want them to send me some samples to check out, and possibly send to people with the skin problems such as yours. It's worth a shot. God bless you all. I hope I can help.
Anita
Its a good hub anyway.
Keeping your natural skin is of great importance and also choosing the right medication is another since once infected,we have to look for medication.
This hub has information on how to look for a good medication, and indeed i mean good. Try it out.
I find that when I put the skin prep. on using a hair dryer to blow it dry takes the sting away a bit more quickly. I had an ileostomy in May 09 and thought they would do the reversal in Oct., but now I have to wait 3 more months. I had cancer and chemo and 3 abdominal surgeries, so they want to be sure everything is healed. Also, I use stoma paste when attaching the bag. A small amount around the stoma and the same on the bag, adhere it to the skin and use the hair dryer to heat it a little and then rub it good. Seems to work pretty well. I appreciate a site that goes into detail, it is a scary thing to deal with when you don't have any other resources to ask questions with. I have had some irritation under the wafer and found that at the first sign of itching or burning you need to change the bag. I do use Dial soap and the skin preps. Have had a couple of major leakages during the night, what a MESS!
Wow Carol, you are right. I never thought about using a hairdryer, lol. You sound as if you've done very well also. I had the ileostomy for so many years, yet I can remember every detail. Now I have the Barnett Continent Intestinal Resivoir. BCIR
It is taking as long to get use to as the ileostomy did. I had it done in June 2000, also had to have a complete hysterectomy too because of all the scar and indometrial tissue. You still have to deal with a stoma, only it is an internal one that you just wear a big band-aid over.
I will be doing a page on that too, when I have time. Right now I'm preparing our worn down house for my first grandbaby. IT'S A BOY !!!
I couldn't be happier.
Take care all, and keep writing your own advice in here.
Anita
Lgali says:
11 months ago
very informative hub