Because a happy stoma means happy skin—and a whole lot less drama.
Let’s be real: when people hear the word “ostomy,” they either freeze up, lean in curiously, or quickly change the subject like you just mentioned an ex. But as an ostomy and wound care nurse in my 40s, with a passion for all things gut, skin, and real-life healing, I’m here to say: it’s time we talk about peristomal skin.
Yes, the skin around the stoma—that often-neglected little patch that can make or break your patient’s comfort, confidence, and quality of life.
So grab your barrier rings and buckle up, because I’m about to drop some nurse-approved knowledge that every ostomate, caregiver, and fellow clinician needs to hear.
1. The Skin Around Your Stoma Should Look Like the Skin on Your Arm. Period.
Red, blistered, weepy skin is not “just part of having an ostomy.”
It’s not normal. It’s not “just how it is.”
It’s a red flag. Literally.
The peristomal skin should be healthy, intact, and irritation-free. If it looks angry, it’s talking to you. It’s saying: “Hey, friend. Something’s leaking. Or rubbing. Or reacting. Help me out!”
✨ Nurse tip: Healthy skin = good seal = longer wear time = less drama. Everybody wins.
2. Leaks Aren’t a Rite of Passage
Leaks are a problem, not a milestone. While occasional mishaps happen (gravity is rude like that), chronic leakage is usually a sign that the pouching system isn’t fitting right.
Skin can’t heal if it’s being bathed in output 24/7.
And output—especially from an ileostomy—is like acid on delicate skin.
🔍 Check for:
- A poorly sized opening
- Creases or folds near the stoma
- Recessed or flush stomas
- Weight changes (yes, even 10 pounds can make a difference)
3. Pouching Systems Are Like Bras—It Has to Fit, Or It’s Just Painful
You wouldn’t wear the same bra forever, right? (Okay, some of us might. But you get the point.)
As bodies change, so must the pouching system. Post-op swelling goes down. Weight shifts. Stomas retract. Skin contours evolve.
💡 Your system should be reviewed regularly, especially in the first 6 months post-op or after major changes in weight, activity level, or surgery.
4. Barrier Films & Powders Aren’t Makeup—Use Wisely
Skin prep products are awesome tools when used correctly. But layering powder, barrier spray, and extra adhesive like you’re frosting a cake? That’s not it.
🚫 Overuse can lead to poor adhesion and more irritation.
✅ Light dusting of stoma powder for weepy skin. Seal it with a barrier film. Let dry. Apply your pouch.
Less is more.
5. Peristomal Skin Issues Are Often Preventable (and Totally Treatable)
Dermatitis, fungal rashes, ulcers—they’re not a life sentence. They’re treatable.
And when you treat the cause, not just the symptom, they often stay gone.
🎯 Treat the skin AND fix the seal.
Putting antifungal powder on a yeast rash but not addressing leakage? That’s like bailing water from a sinking boat with a spoon.
6. Your Gut Health Matters, Too (Yep, Even With a Stoma)
Just because the output comes out a new route doesn’t mean the rest of your GI tract is off the hook. Hydration, nutrition, and gut flora still influence how that output behaves.
🥦 Loose, acidic output = higher risk of skin damage.
Solid, well-formed output = happier skin.
Add probiotics, avoid trigger foods, and drink water like it’s your job.
7. Confidence Grows When Skin Stays Intact
This is more than skin care. It’s self-esteem care.
Nothing tanks someone’s confidence faster than a leak at a restaurant or painful, raw skin that makes you dread changing your appliance.
You deserve to feel comfortable, confident, and in control—not held hostage by your pouch.
TL;DR: My Ostomy Skin Care Gospel
- Your peristomal skin should be healthy, not chronically irritated.
- Leaks are not normal.
- Products must be matched to the person, not the box label.
- Gut health supports skin health—yes, even post-op.
- And most importantly: you’re not alone, and you’re not expected to figure this out without help.
As a nurse who’s lived in the wound and ostomy trenches for years, I can tell you this: great ostomy care is a team sport, and it starts with education, advocacy, and the right skin routine.
