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How To Clean the Skin Around the Stoma

Laura Cox
Ostomy Lifestyle Specialist | Shield HealthCare
02/08/13  5:06 PM PST
Clean the skin around the stoma

People who manage an ostomy pay special attention to the stoma site and surrounding skin. It’s very common to be concerned about skin irritation caused by exposure to stool or urine. With this in mind, the Wound, Ostomy and Continence Nurses Society (WOCN) developed a Basic Ostomy Skin Guide to address typical questions. The guide is designed to help you use products correctly, protect the skin and gently clean and care for the stoma and surrounding skin.

Here are the WOCN’s answers to the most commonly asked questions about stoma cleaning and care.

How to Clean the Skin Around the Stoma

  • 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. Soap residue may keep your skin barrier from sticking and may also cause skin irritation.
  • If you are using a skin paste, it may be easier to remove the paste before you wet the area. Some people may use adhesive remover. Do not worry if a little bit of paste is left on your skin.
  • Always dry your skin well before putting on your new pouching system.
  • 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.
  • Unless recommended, do not apply powders or creams to the skin around your stoma because they can keep your skin barrier from sticking.
  • Sometimes you may see a small amount of blood on your cloth. The stoma tissue contains small blood vessels and may bleed a small amount when cleaned. Any bleeding that does not stop should be reported to your health care provider. The stoma has no nerve endings, so you are not able to feel if you are rubbing too hard. For this reason, use a gentle touch when cleaning around the stoma and do not scrub.
  • The basic rule that applies is not to use too many products on the skin. Do not use adhesive remover if you have skin that tears very easily. If you do use adhesive remover, always wash well with water and mild soap to remove the oily coating on the skin. Then rinse the skin well with water and dry completely.

If you recently had ostomy surgery, it’s recommended to measure your stoma once a week for the first six to eight weeks after surgery. Your stoma shrinks while it’s healing and you will need to make sure that the opening in the skin barrier is the right size for your stoma. Re-measure your stoma if you experience skin irritation close to your stoma or beneath the skin barrier wafer.

Should you experience painful skin problems or severe irritation around the stoma, please contact your health care provider or WOC Nurse.

For more information, see related ostomy skin care articles and ostomy resources here:

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My 89-year-old mother loves to swim but she has found that the pouch fills with water when she gets into the pool. What can we do to fix this?
Cathy
We recently had someone reach out to our Facebook community with a similar question, and several of our OstomyLife community members responded with their own advice.
 
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49 Comments

  1. Willard Dittmar
    Posted September 4, 2013 at 6:27 pm PST

    …always appreciate the accuracy and promptness of Shield’s!!

  2. William Senn
    Posted March 7, 2014 at 5:56 pm PST

    I have had my urostomy(stoma) for 18 years.I was taught by the Kaise ET Nurse to wash the area around the stoma with a mild soapy solution, rinse with a 25% vinegar solution, then rinse with warm clear water.Then dry the area with a soft cloth,followed by 1-2 minutes of warm air from a hair dryer.The area around the stoma where the adhesive attaches has remained a pale pink, but I have had only one small sore develop in that time and that was corrected by applying a small amount of neosporin to the site.I change the appliance every 5-7 days. My only complaint is that occasionally I experience a severe itching in the area for a short period.

  3. Nicolette Kolar
    Posted May 20, 2014 at 8:39 pm PST

    My internal ‘J’ Pouch was removed after 17 years. I have had ostomy for about a year and a half. It was not easy at first and at times still frustrating because I can not get a good seal. It’s like the ‘luck of the draw’. My Wound Care nurse, Man Tam with Kaiser is the best. When I order my supplies with Health Shield I can expect to receive the product with in 2 days. Very happy. Life is different, but managable. Thank you

  4. marina
    Posted July 2, 2014 at 1:38 am PST

    Coloplast has a booklet out that shows different infections people can get and how to treat them its very informative

  5. Posted August 12, 2014 at 5:16 am PST

    my mother got surgery for C.Rectum and her rectum had to removed completely and due to it doctors opened a stoma. They said it would be permanent. But I want to know that is any treatment is available in the world by which her stoma bag removed?

  6. Posted February 26, 2015 at 6:55 pm PST

    Some stomas are designed to only be temporary. This depends on the person’s diagnosis, anatomy, and life situation. This is only possible if they leave a bit of the rectum in, or they design a “diverting” ostomy. These type of ostomies are mostly used to let the intestines below the stoma site heal. If the surgeon made the stoma permanent, they will not reconnect it.

  7. Kathy Scott
    Posted August 23, 2014 at 2:25 am PST

    I have an ileostomy im using the new mio products however even convetec products my problem is high output I use extra barrier strips but I’m have leakage issues I’m so frustrated sometimes 2 -3 times in a day I use eakin rings.

  8. Posted February 26, 2015 at 6:47 pm PST

    Hi Kathy, I’m sorry to hear your high output is causing leaks. I would suggest talking to your doctor about taking stool thickeners like Imodium or incorporating foods that thicken stool in your diet (like potatoes, bread, apple sauce, bananas). I would also try to cut the hole of your wafer as close to the side of your stoma as possible. Sometimes using less strips is better. Also, I have very high output as well. I found that a convex wafer helped stop my leaking.

  9. Joe Porter
    Posted December 9, 2014 at 4:50 pm PST

    As an ostomate (Ileostomy) since 2010 here are some things I’ve learned that work for me.

    1. Never use adhesive remover unless absolutely necessary. It tends to irritate the skin.
    2. Wash area around stoma with warm water only without using soap; use no wash cloth, only your hand.
    3. It’s not the end of the world if you don’t get all of the adhesive off of the area. Just be sure the surface is smooth.
    4. Gently pat the area dry with paper towel. I also use a hair dryer (low heat setting) to be sure I get it very dry.
    5. Use stoma powder on any area where skin may be weeping or bleeding. Don’t get carried away with it or it can interfere with good adhesion.
    6. Be generous with application of a skin barrier. Let it dry completely (again I use the hair dryer) before applying wafer.
    7. I always use paste or a barrier ring (Adapt) for best results.
    8. Most importantly, take your time on all of these steps. Confidence comes with time.
    9. Typically I change every 6th day whether needed or not.
    9. I use two different systems. One is a single piece pouch by Cymed which is very comfortable. The other is a two piece system by Convatec that uses a belt attached to the wafer for better long term adhesion, especially if you’re very active.

  10. Aimee Sharp
    Posted December 11, 2014 at 1:04 am PST

    Hi Joe. Aimee here from Shield. Thank you for sharing your thoughtful, helpful tips. We are happy to hear the successful ways you manage your ileostomy. Have a great holiday season!

  11. Dale Stephens
    Posted December 28, 2014 at 11:19 pm PST

    My wife has had a colostomy since Feb. 2012.We have tried numerous wafers, pastes, and pouches. The issue we are having is with the constant breakdown of the skin around the stoma. We can’t get it to heal. Even our wound care nurse is frustrated. Any suggestions would be appreciated.

  12. Posted February 26, 2015 at 6:41 pm PST

    Hi Dale, I’m sorry to hear your wife has been having difficulty with her skin. What products is she using? I would suggest stoma powder to help the damaged skin heal, the wafer and paste that worked best for her, also, if her stoma is close to the skin she should consider trying a convex wafer! Let me know how it goes! Good luck!

  13. Posted May 2, 2015 at 2:15 pm PST

    I’ve had an urostomy since 2012 and have had a healthy stoma with it. But lately I’ve noticed the skin under my shield has turned white. I have used powders and adhesive removers because I also use the paste and rings. I have always had accidents from leakage especially at night. I use night bags some but they just aren’t that comfortable.
    I don’t have a stoma nurse in my area and after reading your response to other questions just thought you might help me. I have no pain in that area but just wondered what I’ve may have done to cause this.

  14. Posted May 4, 2015 at 5:14 pm PST

    Hi Emma, I’m sorry to hear you’ve been experiencing some leakage, but I’m glad to hear you don’t have pain. I have some white skin around my stoma as well. I read up a little bit and do believe it’s from urine contact with the skin. If the leaks are resolved I bet the white skin would start to heal as well. I will email you to try to help with your leaks.

  15. Pat
    Posted June 24, 2015 at 11:11 pm PST

    I have an ileostomy since 1975 and for the last two years have been having pain in the anal area. This is similar to the pain I had with ulcerative colitis. My wound nurse said it could be due to scar tissue. I also saw a colorectal surgeon and he said he couldn’t see a reason for the pain. I get temporary relief when I take a hot bath. Any ideas on what could be causing this pain?

  16. Posted June 25, 2015 at 5:09 pm PST

    Hi Pat, I sent you an email because I had a couple follow up questions to ask you before I felt I could give you an answer. For everyone who may be reading this, I wanted to note that if you have Ulcerative Colitis and still have a bit of rectum leftover (perhaps you’re intending to get a jpouch), disease can still attack that bit of rectum and cause UC pain.

  17. patty
    Posted June 26, 2015 at 12:25 am PST

    Hi My mom has been wearing the urostomy pouch since April and we have not had any problems until a week ago when she developed what looks like purple piece of skin that looks like a clot next to the stoma that has been bleeding, she saw the doctor and he says that this is not unusual and to use the silver nitrate sticks to help with the bleeding and to cut the stoma wafer to fit around it. we were not told what caused this or even what its called.

  18. Posted June 29, 2015 at 4:48 pm PST

    Hi Patty, I would suggest making an appointment with a WOC Nurse (Wound, Ostomy, Continence Nurse). They are the experts when it comes to peristomal skin care. If you do not have a WOCN you go to, you can find one near you here: http://www.wocn.org/?page=nurse_referral . As for cutting the wafer to fit around the purple piece of skin, I would get a second opinion for that (possibly from the WOCN). Urine coming in to contact with skin is very irritating and should generally be avoided. Good luck!

  19. Andrea
    Posted July 6, 2015 at 2:22 am PST

    Hello, I am having trouble with leakage. I have a ileostomy and my problem is my stoma opening is on the right side and the leakage travels across the stoma and leaks from the left side. My skin is irritated on both sides, left side from the leakage and irritation to the skin on the right due to having to change the wafer and removing it from my skin constantly. Do you have any suggestions. Sometimes I can’t even wear anything because my skin is so raw. I have to stay home from work because of it.

  20. Posted July 6, 2015 at 10:12 pm PST

    Hi Andrea,
    Sorry to hear you’re having some leakage problems. I would suggest trying to thicken your output (if it is thin) to minimize runniness and ask your doctor or WOC Nurse if you can try a convex wafer. When removing the wafer, try using adhesive remover to help the irritation, just make sure to wash the skin well with water after using an adhesive remover so there is no residue from it on the skin before applying your new wafer. Let me know how these suggestions work and please feel free to email or comment again. Good luck! – Laura

  21. swaroop
    Posted September 1, 2015 at 12:31 am PST

    Hi, I have concave stoma. i.e. it is in kind of a pit below skin level. skin around it has uneven ridges of stitch marks, and it goes inwards in the pit. i am having on and off luck with sealing system. it stays some times for 5 – 6 days and it leaks the other day at times. i have been advised to use a two piece pouching system, is it the right type for stoma in the pit? my skin gets irritated as i have to stick the base plate with benzoin and minor leaks happen often. can you please advise proper type of accessories and plate and seal for me please. i stay in India. please advise what all can be availed here OR bougt online? thanks in advance

  22. Posted September 8, 2015 at 9:08 am PST

    Hi! Do you know if products are available with adhesive already on the wafer in India? Unfortunately, I’m not very familiar with products available there. If you can get your hands on a convex wafer (face plate) that would help with your retracted stoma. I would also suggest getting an opinion from a stoma nurse. They are very helpful when it comes to finding the product that is right for you. Good luck!

  23. Diane Guardino
    Posted November 2, 2015 at 5:04 am PST

    I have had a ileostomy for over 30 years now due to Crohn’s and haven’t experienced any problems until recently. I noticed a small rash under the mesh skin barrier on the under side of my stoma, but now it has spread. It is not under the wafer but the mesh piece that attaches to the skin. It can be itchy sometimes. It’s not due to leakage. I haven’t made any changes to my products (Convatec or the paste and skin barrier). Suggestions?

  24. Posted November 4, 2015 at 3:04 pm PST

    Hi Diane, great question! I’m sorry to hear that you’ve been experiencing this rash. If they appear as small bumps and have spread, it may be a yeast infection (have no fear, they’re easy to clear up)! Ask your WOCN or doctor if they thhink it’s that. If so, they will prescribe you some Nystatin Powder.

    If the rash starts to look like it’s under the whole mesh (instead of just spots) it may be an allergic reaction to that part of the product. Our skin changes over the years and sometimes it becomes intolerant of products we’ve used.

    Since I cannot see your skin, please see a WOCN or your physician so he or she can help you further!

  25. Sissy Dillard
    Posted November 5, 2015 at 1:27 pm PST

    Just had surgery one week ago, my stoma burns is that normal.

  26. Posted November 6, 2015 at 9:20 am PST

    Hi Sissy, I would say that “burning” is not a normal sensation. All bodies respond to surgery differently, but I would contact your surgeon as soon as possible and describe your symptoms. Good luck!

  27. Jennifer
    Posted November 13, 2015 at 8:30 pm PST

    I am helping to care for my father with a new ileostomy. Have so many leakage problems! This is a nightmare! We are out of supplies too! The stoma is retracting and sits in a crease. This is not working! How do we get this to work? He has no quality of life. The surgery was11/2/15 but this is ridiculous! They day he was discharged the nurse changed the bag FOUR times before we could leave! We have a home health nurse but that is useless cause the bag always leaks we change it and then the nurse arrives a day later. Please help us!!! We are lost and so frustrated!!! I have called every ostomy manufacturer for free samples and supplies. He uses a one piece hollister bag. Please please help us!!!

  28. Posted November 30, 2015 at 9:40 am PST

    Hi Jennifer,
    I am so sorry to hear about your father’s difficulty with pouching. My first suggestion would be to try a convex wafer since his stoma is retracted and in a crease. I would also treat any broken down skin by cleaning the area with warm water, thoroughly drying it, then apply stoma powder to broken down bits and brush off the excess before applying the wafer. I would also suggest looking for an ostomy outpatient clinic near you to get an opinion from a different WOCN (Wound, Ostomy, Continence Nurse). He or she will be your best bet. I hope you find something that works and please let us know if you need different suggestions or if these suggestions helped!

  29. Barb
    Posted November 26, 2015 at 10:54 am PST

    What is an idea amount of time to wait before a wafer change

  30. Posted November 30, 2015 at 9:43 am PST

    Hi Barb,
    I find the best time to change the wafer is about 20-30 minutes after you wake up. I like to get out of bed and walk around for a bit. It’s important to not eat or drink for that 20-30 minutes before changing the wafer so you won’t have any output during the change.

  31. shelly
    Posted June 5, 2016 at 5:39 pm PST

    I make my own bath soap using dr.bronners and essential oils , does anyone know if this would be safe to shower with when my bags is off

  32. Posted June 8, 2016 at 11:46 am PST

    If you are putting essential oils in the soap, I would keep it away from your skin around your stoma. It shouldn’t be dangerous, but any oily soap or soaps with lotions in it can affect the seal of your wafer to the skin around your stoma. If you want to shower with your pouch off, just wash around the stoma with water. It should be no issue!

  33. charles cocuzza
    Posted July 7, 2016 at 10:34 am PST

    I had a urostomy15 months ago. I get alot of infections which

    normally lands me in hospital. take aumentin anti biaotic
    it usually helps but i still bleed sometimes alot of blood
    is this normal

  34. Posted July 15, 2016 at 9:00 am PST

    Hi Charles, I do not think it is normal to still bleed a lot out 15 months post-op. I would contact your doctor and tell him your symptoms and see if he is concerned.

  35. Micaela Bennett
    Posted August 27, 2016 at 8:34 am PST

    My stoma is bleeding…. What can I do to stop this? Otherwise the stoma looks healthy, as well as the skin around.
    Should I go to my wocn nurse or is this something about better cleaning of stoma?
    Thank you
    Micaela Bennett

  36. Posted September 7, 2016 at 7:27 am PST

    Hi Micaela,

    Some light bleeding is normal since the capillaries are close to the surface of the stoma, but if it’s more than just one or two dots of blood, you should definitely talk to your WOCN. I would let him/her know what’s going on regardless, just to put your mind at ease!

  37. craig Patterson
    Posted September 13, 2016 at 4:17 pm PST

    I am getting raw areas under the tape of my stormy bag, two areas, not more than two inches long. What is best method to clear up and heal? Thanks!!

  38. Aimee Sharp
    Posted September 14, 2016 at 9:08 am PST

    Hi Craig! No worries, your stormy bag gave us a laugh. Do your raw areas appear to be like the small yeast infection Laura has around her stoma in this video? Do you use all the supplies Laura shows in that video? Without knowing more, we would recommend seeing, or at least sending a picture to, your WOC Nurse. Best of luck! -Aimee, Shield HealthCare

  39. craig Patterson
    Posted September 13, 2016 at 4:23 pm PST

    It should read stormy bag.

  40. craig Patterson
    Posted September 13, 2016 at 4:25 pm PST

    For some reason my phone has a mind of its own.

  41. craig Patterson
    Posted September 14, 2016 at 10:24 am PST

    No, my problems are what I think is referee to as tape stripping. It is under the tape that attaches the pouch to me. I have this stormy for a year and a half and this has just shown up in the last two months. I do use a tape remover, could that be my problem? Maybe I am allergic to the alcohol in the pad. Your thoughts!!

  42. Aimee Sharp
    Posted September 14, 2016 at 12:04 pm PST

    Hi again! Clearly, your stoma is trying to tell you that its name is Stormy (if you haven’t named it already). In Laura’s video about pouch changing that I linked to before, we do have a note that says, “Do not use adhesive remover if you have skin that tears very easily. If you do use adhesive remover, always wash well with water and mild soap to remove the oily coating on the skin and dry completely.” Additionally, during one of my (many!) talks with Laura about ostomy products and skin care, she let me know that oftentimes people can become allergic to an ingredient that they’ve been using for years. Perhaps if you switched to an alcohol-free adhesive remover wipe and then gave it a few days to see if the irritation clears up? But to be on the safe side, we’d still recommend contacting your WOC Nurse. Thanks! -Aimee

  43. craig Patterson
    Posted September 14, 2016 at 10:26 am PST

    And it did it again!!, I give up!

  44. Julie Haywood
    Posted October 27, 2016 at 8:04 pm PST

    Please help!!! I have stoma since 2013, however 02/16/16 they tried to remove it. After 2 days it rejected and another stoma was placed right next to old one. Thus leaving the hole very large. I use a Sur-Fit Natura Moldable Convex Skin Barrier with Flange. My problem is on-going and my skin is breaking down very bad. It is raw everywhere and burns the minute stool touched it. When my body is releasing stool it burns even inside and around stoma. What can I put on my skin to ease pain, and heal rash?

  45. Aimee Sharp
    Posted November 2, 2016 at 7:27 am PST

    Hi Julie! We posted your issue to our FB page and received the following suggestion: “Beauduex butt paste…..extra strength in the red tube and box…….wonderful stuff.” We think that’s a great place to start, besides speaking to a WOC nurse. You can find our Facebook page here. Hopefully that helps! Thanks for commenting. -Aimee, Shield HealthCare

  46. Aimee Sharp
    Posted December 5, 2016 at 9:54 am PST

    Hi again, Julie! We received another suggestion on our Facebook page to your comment: “I think maybe if you cut barrier tighter to the base of your stoma it will heal the rash around the stoma. I use a two piece click thru coloplast with 70mm barrier and 4.2mm moldable ring.” Feel free to comment back here or on the Facebook post. Aimee, Shield HealthCare

  47. pauline
    Posted March 17, 2017 at 11:06 pm PST

    ive gt a rush around my stona and is very itchy

  48. Posted March 20, 2017 at 9:29 am PST

    Hi Pauline, I would contact your local stoma nurse or doctor to discuss your concerns! He or she can help diagnose the rash and prescribe treatment if necessary. I hope it resolves soon!

  49. Posted May 10, 2017 at 5:18 pm PST

    I use baby wipes in order to cleanse my stoma when i change my appliance. I just make sure that there is no lanolin in them.I never have any problem with the adhesive sticking.I have had an issue with products with weak adhesive.

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