One of the most common and maddening challenges for people with an ostomy is dealing with sore, irritated skin around the stoma, or peristomal skin. When the skin beneath your appliance is inflamed, painful, or broken, it can make pouching difficult, lower your confidence, and affect your overall quality of life.
Sore ostomy skin can usually be treated, and even prevented, with the right care, products, and techniques. Here’s what to know about healing sore peristomal skin and keeping it healthy long term.
Understanding the Causes of Sore Ostomy Skin
The skin around your stoma, which is also called the peristomal skin, is delicate. It is not meant to be constantly exposed to adhesives, moisture, or digestive output. Here are some common causes of irritation:
- Leaks or seepage of stool or urine under the skin barrier
- Frequent pouch changes or aggressive adhesive removal
- Allergic reactions to required ostomy products like wafers, tape, wipes
- Sweating or moisture build up under the barrier
- Fungal or bacterial infections
- Improper fit of the appliance if it is too tight, too loose, or poor seal
Recognizing the cause of your skin issue is the first step in healing it.
How to Heal Sore Ostomy Skin
Here are evidence-based and widely used methods to treat peristomal skin problems:
Identify and Eliminate the Source of Irritation
Healing will not stick unless you fix the cause. Ask yourself:
- Is output leaking onto my skin?
- Am I removing the barrier too harshly?
- Did I start a new product recently?
You might need a stoma nurse (WOCN or ET nurse) to help assess fit and seal.
2. Give Skin Time to Breathe
If your skin is raw or weepy:
- Allow it to air out for short periods between appliance changes.
- Use a soft cloth to gently pat dry the area, avoid rubbing.
Pro tip: Place a towel over your stoma or lie on a disposable pad while airing out to manage output.
3. Use Skin Barrier Products Wisely
These can protect healing skin and help new appliances stick better:
- Barrier wipes or sprays form a protective layer
- Stoma powder absorbs moisture on raw skin and creates a dry surface for better adhesion
- Crusting technique: Lightly dust stoma powder on weepy skin, seal with barrier wipe, and repeat once if needed. Let dry before applying the pouch.
Avoid overusing products, as too many layers can prevent your appliance from sealing properly.
4. Treat Infections if Present
If your skin is itchy, burning, red with satellite spots, or has a white film, you may have a yeast, or fungal, infection.
- Use antifungal powder like nystatin or clotrimazole under the barrier.
- Keep the area dry and avoid ointments under the adhesive.
See a provider if it doesn’t improve in a few days, as bacterial infections may require a prescription cream or antibiotic.
5. Adjust Your Pouching System
A well-fitting pouch is crucial for healing:
- Check your stoma size regularly. It may change post-surgery, and an incorrect hole size can lead to leaks or pressure.
- Try convex barriers if your stoma is flush, retracted, or in a skin fold.
- Use moldable rings or paste to fill gaps and create a better seal.
- Consider belt support if your appliance tends to loosen with movement or moisture.
Do not be afraid to try different brands or styles. What worked a month ago may not be working now.
Bonus Tips for Comfort and Confidence
- Warm the barrier between your hands or with a hair dryer before applying for better adhesion.
- Change your pouch regularly typically every 3–5 days to avoid breakdown.
- Use adhesive remover spray or wipes to protect skin during removal.
- Do not forget to hydrate and nourish your skin from the inside out. Drink plenty of water and eat skin-friendly foods.
When to Seek Help
See your wound/ostomy nurse or healthcare provider if:
- Pain or bleeding continues for more than a few days
- Skin breaks open or becomes ulcerated
- You suspect a stoma prolapse, hernia, or infection
- Your pouch will not stay on despite multiple attempts
You do not have to figure it out alone. Ostomy nurses are trained to troubleshoot skin issues and help you find solutions.
Products That Can Help
Here are some over the counter and prescription products that may be recommended:
| Purpose | Product Types |
| Skin protection | Barrier wipes/sprays, stoma powder |
| Leak prevention | Moldable rings, paste, convex barriers |
| Infection treatment | Antifungal powder (nystatin), antibacterial ointments (by prescription) |
| Gentle removal | Adhesive remover spray or wipes |
| Extra support | Ostomy belts, pouch covers, support garments |
Ask your provider before using anything new, especially if you have sensitive skin or are prone to allergies.
Sore skin around the stoma is common but it is not something you have to live with. With the right care and support, your skin can heal and stay healthy. Be patient with yourself, experiment carefully, and do not hesitate to reach out to your wound care ostomy nurse or medical team for help.
Citations.
UOAA
Colostomy UK
National Institute of Health and Human Services
CDC
Empowering Intimacy