Allergies vs. sensitivity
Skin irritation under the ostomy barrier (also known as the flange) can be very uncomfortable, and even painful. It can also make getting a good seal quite challenging, and both of these factors together can seriously compromise your quality of life.
There are many common reasons why the skin around the stoma and under the barrier may be red and irritated:
- Contact with urine or stool
- Overgrowth of the bacteria and yeast that live on our skin all the time
- Shearing – when the top layer of skin gets pulled
- Excess moisture
These are all fairly common reasons for redness. And, while definitely irritating and uncomfortable, they are all fairly easily managed.
Allergies are more difficult to manage but fortunately, they are much less common. Allergies to ostomy products occur in less than 1% of people. To identify an allergy, products should be patch-tested, and a referral to a dermatologist is often made. Once an allergy has been diagnosed by the dermatologist, they can contact the ostomy manufacturer for information on all of the ingredients in the product(s) you are using that may be causing the allergy. These are then individually tested for allergy to identify the exact cause of the irritation.
Sensitivity to a product, different from an allergy, can develop over time, often after another form of damage to the skin that results in more contact between the pouching system and the deeper layers of the skin. Changing products may be required if this type of sensitivity develops.
Other skin issues, such as eczema or psoriasis, can also show up as an irritation under the flange. These should be treated by a physician-ET nurse team; the physician can prescribe treatment, and the nurse can help devise a pouching system that will stick while using these treatments. The worst thing you could do is to use a prescribed ointment or cream and then attempt to apply your flange as you normally would and expect it to stick and not leak. This can cause a great deal of unnecessary anxiety, so it is critical to work with your doctor AND your ET nurse to figure out a game plan to treat the skin condition at hand. An ET nurse can show you ostomy products that contain an element which is found in normal healthy skin which are found in lower levels with eczema and psoriasis, for instance; talk to your ET nurse about whether these products are an option for you.
Products such as soaps, wipes or even skin barrier film can also cause irritation, too. Washing with water ONLY and applying the flange to clean, bare skin is recommended to avoid these issues. (Never use alcohol to clean your skin or acetone to remove any access tape or ring residue). If you have questions about how to do a change, refer to our basic change guide for more information, or see your ET nurse.
Identifying which kind of irritation you are experiencing can take a few visits to your ET nurse. Although it can be tempting to jump to the conclusion that it’s an allergy, treatment for other possible culprits should happen first. See your ET right away if you’re having irritation – your ostomy should not be causing discomfort or pain!