Managing Skin Irritation Around Your Stoma: A Nurse's Guide to Peristomal Skin Care

Quick Visual Guide: What Does Your Skin Problem Look Like?

Appearance	Likely Cause	First Action
Red, raw, shiny skin	Output contact / leak	Refit stoma opening; use barrier ring
Rash matching the shape of the wafer	Allergic/contact dermatitis	Switch to a different brand baseplate
Moist, pale, soggy skin	Perspiration / MASD	Add stoma powder; consider extended-wear wafer
Pustules / pimples around follicles	Folliculitis	Use electric clipper; consult nurse
Bright red with satellite spots	Fungal (Candida)	Apply antifungal powder; contact nurse
Weeping, crusted lesions	Skin erosion / severe leak damage	Urgent nurse review

Step-by-Step: Treating Mild Peristomal Skin Irritation

For minor redness or early irritation, you can start first aid at home before seeking advice:

Step 1 — Remove your appliance carefully. Use an adhesive remover spray or wipe. Peel the baseplate slowly from the edge, supporting the skin with one hand. Never yank the appliance off.

Step 2 — Cleanse gently. Rinse the peristomal skin with warm water only. Avoid soap directly on irritated skin, and never use antiseptics (Dettol, Betadine) — these damage healing skin cells.

Step 3 — Pat dry completely. Use a soft, lint-free cloth or gauze. The skin must be completely dry before applying a new pouch — moisture trapped under the baseplate prolongs the problem.

Step 4 — Apply stoma powder (if skin is moist or weeping). Dust a thin layer of stoma powder (such as Coloplast Brava Protective Powder or Convatec Stomahesive Powder) over the irritated area, then dust off the excess. This absorbs moisture and creates a "crust" surface for the adhesive to grip.

Step 5 — Use a barrier film or ring. Apply a no-sting barrier film spray or wipe over the powdered area to seal the surface. Alternatively, use a barrier ring or washer (such as Brava Protective Ring or Eakin Cohesive Seal) around the stoma to protect vulnerable skin while also improving the seal.

Step 6 — Refit your appliance. Ensure the baseplate opening is sized correctly — ideally 1–2 mm larger than the stoma's widest point. Press firmly from the stoma outward to remove air pockets, and hold in place for 30–60 seconds with your warm hand to activate the adhesive.

Step 7 — Monitor closely. Check the skin at each pouch change. If there is no improvement within 2–3 days, or if the skin is breaking down, bleeding, or you suspect a fungal infection, contact a stoma nurse or healthcare provider.

The "Powder and Sealant" Technique: A Nurse's Tip

For persistently moist, weeping skin around the stoma, nurses often use a layering technique:

1. Apply stoma powder → dust off excess
2. Apply barrier film (no-sting skin prep wipe or spray) → let dry
3. Repeat steps 1–2 up to 3 times to build a protective "crust"
4. Apply barrier ring around the stoma
5. Attach the baseplate

This technique creates a dry, protective surface that the adhesive can grip even when the underlying skin is compromised. It is especially effective for ileostomy and urostomy patients with enzymatic irritation.

Preventing Skin Irritation: Long-Term Strategies

Once you have resolved an irritation episode, the goal is to prevent recurrence.

Choose the right fit. The most critical factor is a precisely fitted baseplate opening. Use the stoma measuring guide included in your appliance kit, and resize when your stoma changes. Many patients find that a convex baseplate provides a better seal if the stoma is flush or slightly retracted.

Change on schedule. Most baseplates are designed to last 3–5 days for colostomy, 1–3 days for ileostomy (due to higher output enzyme levels), and 1–2 days for urostomy. Changing too infrequently allows output to migrate under the baseplate; changing too frequently traumatises the skin.

Use adhesive remover every time. This is non-negotiable for skin protection in the long run.

Avoid creams or lotions in the peristomal area. Moisturisers, baby oil, or body cream prevent the adhesive from bonding properly. If you need to moisturise the area, do so after you have applied your new pouch, on the outer edges only.

Stay hydrated. Adequate hydration (especially important for ileostomates, who are at risk of dehydration) keeps skin supple and more resistant to damage.

Watch your diet. Certain foods can increase stool acidity or volume, worsening output-related skin irritation. Keeping a food diary can help identify personal triggers.

Trim — don't shave — peristomal hair. Use a small electric clipper or scissors, never a wet razor.

EMIS+ Products for Peristomal Skin Care

We stock a curated range of products specifically selected for peristomal skin care:

• Coloplast Brava Protective Powder — absorbs moisture and creates a skin-friendly surface for adhesives
• Coloplast Brava No-Sting Barrier Film — seals damaged skin without pain (alcohol-free)
• Coloplast Brava Adhesive Remover — silicone-based, gentle on sensitive peristomal skin
• Coloplast Brava Protective Ring (Soft/Elastic) — fits snugly around the stoma for a watertight seal
• Convatec Stomahesive Powder — light-weight paste for light-to-moderate moisture
• Convatec Eakin Cohesive Seal — highly conformable barrier ring with excellent softness
• Salts Peri-Prep Skin Barrier Wipes — fast-drying, no-sting, alcohol-free wipe for pre-application prep

All products at EMIS+ are 100% authentic and sourced from authorised distributors. Our nursing team is happy to advise on the right product combination for your stoma type and skin condition.

When to Seek Professional Help

Not all peristomal skin problems can be managed at home. Seek advice from your stoma nurse or doctor if:

• Skin irritation is not improving after 48–72 hours of home treatment
• You notice blisters, deep erosions, or open wounds
• There is significant bleeding from the peristomal skin
• You suspect a fungal infection (bright red rash with satellite spots)
• You notice unusual growths, thickened skin, or a change in stoma colour
• You are experiencing repeated leaks despite trying different appliances
• The skin is hypergranulating (raised, moist, red bumps at the stoma edge)

EMIS+ offers a free nurse consultation for all customers. If you are experiencing persistent peristomal skin issues, book a session with our registered nurse for a personalised assessment and product recommendation.

FAQ: Peristomal Skin Care in Singapore

Why is my skin red right around the edge of my stoma?

Redness immediately at the stoma edge is often caused by the stoma appliance opening being slightly too large, allowing output to sit on the skin. Try reducing the cut size of your baseplate to within 1–2 mm of the stoma, and use a barrier ring for extra protection.

Can I use Vaseline or baby cream on my stoma skin?

It is best to avoid any oil-based products, including Vaseline or most moisturisers, in the area where your baseplate adheres. These products create a barrier that prevents the adhesive from bonding, which leads to leaks — and more skin contact with output. Use EMIS+-recommended barrier products instead.

How do I know if my stoma skin rash is fungal?

Fungal (Candida) rashes typically look bright red, flat, and slightly shiny, with small dot-like "satellite" spots spreading outward from the main rash. They are often itchy. Standard barrier creams will not resolve a fungal rash — you need an antifungal treatment. Speak to your doctor or stoma nurse.

My skin bleeds a little when I remove my pouch. Is this normal?

Occasional minor bleeding can happen if the skin is fragile or if there is hair in the area. However, consistent bleeding on removal suggests the skin barrier is breaking down. Always use adhesive remover, and see your stoma nurse if bleeding continues.

I live in Singapore — does the heat and humidity make skin problems worse?

Yes. Singapore's climate increases perspiration, which can soften the adhesive and break down the skin barrier more quickly. Using an extended-wear baseplate, an absorbent stoma belt, and a barrier film before application can help counteract humidity-related issues.

How often should I change my pouching system?

Colostomy systems generally last 3–5 days; ileostomy systems 1–3 days; urostomy systems 1–2 days. However, if you notice leaking, swelling, or skin discomfort, change sooner. Never leave a leaking pouch on the skin — even a small leak can cause significant skin damage within hours.

Can I swim or shower with a stoma pouch?

Yes. Modern pouching systems are water-resistant. You can shower with your pouch on or off. For swimming, ensure the edges of the baseplate are sealed with waterproof tape or a barrier film to prevent pool water from lifting the adhesive.

Where can I buy stoma skin care products in Singapore?

EMIS+ offers the full range of Coloplast, Convatec, and Salts peristomal skin care products with islandwide delivery, often next-day. You can also request free nurse advice when ordering.

Summary: Peristomal Skin Care at a Glance

Healthy peristomal skin is achievable with the right technique, products, and monitoring habits. The key principles are:

• Fit your appliance precisely — size matters most
• Use adhesive remover at every change
• Treat early: powder, barrier film, barrier ring
• Identify the cause (output contact vs. allergy vs. moisture vs. fungal)
• Change on schedule and never leave a leak unaddressed
• Seek nurse advice if the problem persists beyond 2–3 days

At EMIS+, our nurses are here to support you every step of the way — from choosing the right appliance to troubleshooting persistent skin issues. Reach out to us for a free consultation.

This article was written by the EMIS+ Nursing Team and is intended for informational purposes only. It does not replace individual medical advice. If you have concerns about your stoma or peristomal skin, please consult your stoma nurse, enterostomal therapist, or doctor.

Skin irritation around the stoma is one of the most common complaints among ostomates — yet it is also one of the most preventable. Whether you have a colostomy, ileostomy, or urostomy, healthy peristomal skin is the foundation of a comfortable, leak-free pouching experience. This nurse-written guide explains why irritation happens, how to treat it, and — most importantly — how to stop it from returning.

What Is Peristomal Skin?

Peristomal skin refers to the skin surrounding your stoma, typically within a 10-centimetre radius. This area is in constant contact with your pouching system's adhesive baseplate and, if leaks occur, with stool or urine output. Keeping this skin intact and healthy is essential: damaged skin affects how well your appliance adheres, which in turn increases the risk of further leaks, odour, and discomfort.

Healthy peristomal skin should look and feel the same as the skin on the rest of your abdomen — no redness, rash, weeping, or broken areas.

Why Does Skin Irritation Happen Around a Stoma?

Understanding the cause of your skin irritation is the first step to fixing it. The most common causes include:

1. Output Contact (Chemical Irritation)

Ileostomy and urostomy output contains digestive enzymes and acids that are extremely harsh on skin. Even brief contact — as little as 15–30 minutes — can cause redness, burning, and erosion. This is often caused by a poorly fitted baseplate where the opening is too large for the stoma, allowing output to pool under the wafer and touch skin.

2. Allergic or Irritant Contact Dermatitis

Some people react to ingredients in adhesive baseplates, barrier sprays, cleansers, or skin wipes. This typically presents as a rash that mirrors the exact shape of the product that caused it — a telltale sign of contact dermatitis.

3. Mechanical Trauma

Frequent, rough removal of the appliance can strip away the top layer of skin (epidermal stripping), leaving raw, painful patches. Using adhesive remover and peeling the baseplate from the edge rather than pulling it off quickly prevents this.

4. Moisture / Perspiration Entrapment

Singapore's humid climate means sweat can build up under the baseplate, softening the adhesive and breaking down the skin's natural barrier. This can lead to a condition called moisture-associated skin damage (MASD), which appears as moist, macerated, soggy-looking skin.

5. Folliculitis (Hair Follicle Infection)

Shaving or removing peristomal hair without care can nick the skin or cause ingrown hairs, leading to red, pustular folliculitis. Using an electric clipper rather than a razor is safer.

6. Fungal Infection (Candidiasis)

A yeast/fungal rash thrives in warm, moist conditions — especially if the skin has been compromised. It typically appears as a bright red, flat rash with small satellite spots at its edges, and may itch intensely. It does not improve with standard barrier creams.

7. Poorly Fitted Appliance

As your stoma changes size and shape in the months following surgery, an ill-fitting baseplate is a leading cause of all of the above. The stoma should ideally be measured every few weeks in the first 6–8 weeks after surgery, and any time you notice changes.