Skin problems
Sore Skin
Sore peristomal skin is one of the most common problems reported by people with a stoma. Symptoms can include red but intact skin (erythema). As problems worsen, the skin can become broken, oozing, eroded or ulcerated. The cause of the soreness needs to be investigated before treatment is started. A common cause is the stomal output coming into contact with peristomal skin.
Allergy
Exposure to materials and chemical compounds that irritate the skin on contact (i.e., tape, skin barriers, soap, adhesives, powders, pastes, or pouch material) can cause allergy.
Skin infection
Micro-organisms may proliferate because the stoma is warm, humid and soiled. They may colonise the stoma without causing disease. True skin infection is more likely if the patient suffers from general ill-health or diabetes, or takes immunosuppressive medication.
Rash
Sometimes a rash is caused by a skin infection, skin sensitivity or leakage. The rash may be red or red with bumps. The rash is usually itchy.
Folliculitis (inflammation of the hair follicle)
Redness that occurs at the base of each hair shaft may indicate the hair is pulled out traumatically with flange removal.
Skin Care
- Check the size of your stoma every few months, always make sure your pouch fits snugly around the stoma
- Take your time when changing your pouch, careful removal will help prevent damage to the skin
- For men, if you need to shave around your stoma, avoid shaving creams. Instead, use clean warm water and a new disposable razor. A cardboard toilet roll tube held over the stoma may protect it.
- Effluent from the ileostomy contains enzymes and bile salts that can irritate the skin. Advise the use of a skin barrier and prompt attention to any signs of pouch leakage.
- To clean the skin around your stoma, all you really need to use is warm water and a washcloth (or good quality paper towels). The use of gauze or gloves is not usually necessary, although you can use them if you feel more comfortable.
- For those that prefer to use soap to clean around the stoma, it’s best to use a very mild soap. Avoid using soaps and cleansers with oils, perfumes or deodorants since these can sometimes cause skin problems or prevent your skin barrier from sticking.
- Rinse the soap off the skin around your stoma very well because the residue may keep your skin barrier from sticking and may also cause skin irritation.
- Always dry your skin well before putting on your new pouching system. A hairdryer turned to the lowest setting may help.
- Do not use alcohol or any other harsh chemicals to clean your skin or stoma. They may irritate your skin.
- Do not use baby wipes or towelettes than contain lanolin or other oils, as these can interfere with the skin barrier adhesive and may irritate your skin.
References:
https://www.unitypoint.org/desmoines/services-skin-care-issues.aspx
http://www.colostomyassociation.org.uk/index.php?p=201&pp=3&i=67&page=Sore%20skin/Leakage
