Skin Problems

Since coming out of hospital, I have developed some dermatitis in the immediate peristomal area. I think this is due to the fact that I cut the hole in one of the bags slightly too large, exposing a small ring of normal skin to stoma output. This is not like normal poo; it has not had the benefit of passing through the colon where water is absorbed, forming normal stool; it is still very acidic, and while the small intestine lining is designed to withstand this (as is the stoma, formed by bringing the end of the small intestine to the surface and turning it back on itself and sewing it to the surface), normal skin is not; it can cause severe excoriation and can be very painful and uncomfortable.

I noticed that the area was becoming itchy and sore, and when I changed the bag the next day I could see some patches of red. Immediately after surgery, the stoma is quite large, and this shrinks gradually as the swelling goes down, until it eventually reaches its permanent size. The bags come with concentric circles marked around the hole, and you measure the diameter of the stoma and cut the hole to the correct size. Immediately post-op, my stoma measured 40 mm, and after a few days this was reduced to 35 mm. I cut several bags to this size in readiness, and the last one I used was slightly too large, because the stoma had shrunk a little more.

When I realised what had happened, I cut the next one to 30 mm (the next circle in), but this was slightly too small, and I think this caused the edge of the cut circle not to sit flush with my skin, allowing further leakage underneath.

The problem got worse until the area was swollen and red all round, and very uncomfortable. Last Friday we phoned the stoma clinic but they couldn’t fit me in on that day, and as I had an appointment on the Monday anyway (yesterday) they said it should be fine until then, and the itchiness did subside somewhat.

When I saw Helen, the stoma nurse, yesterday, she examined it, and after cleaning it thoroughly, she applied some special powder which stuck to the affected area and brushed away from the normal skin.

She then applied a mouldable ring around the stoma.

These rings are soft and pliable and can be pulled into shape to fit your stoma. She said this one was impregnated with manuka honey which has healing properties. The ring provides a leak-proof seal between one’s body and the bag. She gave me a supply of these.

She also told me not to change the bag daily, as I had originally been instructed to do, but to change it every two to three days; this is the normal frequency most people use, and it allows the skin to settle down and not be interfered with by pulling the bag away.

The bags are easy to remove, though, using a small aerosol spray adhesive remover, spraying as you go, as you peel the bag away from top to bottom.

People on the Ostomy Support forum on Inspire also recommend using a very small quantity of the basic Head and Shoulders anti-dandruff shampoo (not the one with added conditioner) applied to the affected area and then rinsed off well, and then dried and wiped well with a barrier wipe. To start with, I am following the advice of the stoma nurse but if this doesn’t work, I shall try the H&S remedy – it is the zinc content in the shampoo that is the magic ingredient.