Peristomal skin problems
First things first, let’s look at some general peristomal skin problems. Now, the skin around your stoma (called peristomal skin) handles a lot. It's covered by an adhesive appliance day after day, and when something isn't quite right, it's usually the first place you'll notice it.
Sore skin around a stoma
Sore, red or broken skin is one of the most common stoma bag problems, and it's almost always linked to something fixable. The most frequent cause is output coming into contact with the skin, usually because of a leak or an ill-fitting aperture. Stool and urine are both irritating to skin, and even brief exposure can cause skin irritation and soreness if it happens repeatedly.
To help heal sore skin around your stoma, start by checking your fit. Is the aperture the right size? Is there any sign of output on the back of the baseplate when you remove it? Keeping the skin clean, dry, and properly covered is the upmost basics of an effective stoma skin care.
Itchy skin around a stoma
The skin around your stoma is itching? Itchy stoma skin can have a few different causes. Sometimes it's the early sign of a sensitivity to the adhesive as this can develop even after years of using the same product without any issue. It can also point to a fungal or yeast infection around the stoma, which tends to present itself as a red, itchy rash with defined edges, sometimes with small satellite spots. Both are worth flagging to your stoma care nurse so the right cause (and treatment) can be identified.
Yeast infection around a stoma
Because yeast loves moisture and warm, moist skin under an adhesive baseplate can create all the right conditions for a yeast infection. If you notice an itchy, red rash that doesn't seem to improve with regular skin care, mention it to your nurse. Antifungal treatment is usually effective, and adjusting your bag-change routine may also help prevent it from coming back.
Skin care around a stoma: the basics
As for your stoma skin care, make sure you learn the basics. Contrary to what most think, peristomal skin care doesn't really need to be complicated. Clean the skin gently with warm water, and if you use soap, keep it mild and unperfumed. Dry the area thoroughly (pat, don’t rub) before applying a fresh appliance. Steer clear of alcohol-based wipes, as they can dry out and irritate the skin over time.
For skin that's already broken or sore, your stoma care nurse can recommend appropriate barrier products and creams. Avoid applying thick creams directly under the adhesive unless they're specifically designed for that purpose, as they can affect how well the bag sticks.
Other stoma issues
Stoma infection
You should also know how to recognise a stoma infection. Signs to look out for include increased redness or warmth around the stoma, swelling that doesn't settle, discharge that looks different from normal, or skin that feels unusually tender. A fever or a generally unwell feeling with any of these is a reason to seek medical advice promptly.
Folliculitis (inflammation of the hair follicles around the stoma) is a more minor but uncomfortable skin issue and is usually seen after shaving the peristomal area. It looks like small, sometimes pus-filled spots. Your stoma care nurse can advise on safe hair removal techniques and how to manage it.
Stoma necrosis
Stoma necrosis is rare, but it's still important to know what to look for. A healthy stoma should always be pink or red and moist. If your stoma starts to look dark red, purple, or black, or feels hard and cold to the touch, this indicates a restricted blood supply and requires urgent medical attention. This isn’t a situation where you can wait to see if it improves, you must contact your care team immediately.
Bruised or swollen stoma
In the weeks following surgery, some swelling is completely normal: your stoma will gradually reduce in size as healing progresses. A stoma that looks a bit bruised after minor contact is usually not a cause for alarm, but if your stoma consistently seems to appear swollen, changes colour, or you're experiencing pain, it's worth getting it checked. A swollen stoma can also affect the fit of your appliance, so your aperture size may need adjusting during this period.
Stoma granulomas
Moving on, stoma granulomas are small red lumps that appear at the edge of the stoma or on the stoma itself. They're caused by friction, usually from a baseplate that's slightly too large, which makes the edge rub against the stoma. They can bleed, which may look alarming, and may prevent your bag from sealing properly.
If you notice granulomas, check your template size first, but don't be tempted to cut it more, as this can make things worse. Your stoma care nurse can treat them, usually with silver nitrate, and will help you get the fit right to prevent them returning.
Leaks
Leaks are covered in detail in our dedicated stoma leakage article, but briefly speaking they're common, they're frustrating, and they're rarely something you just have to accept. Poor fit is the most frequent cause: either the aperture size, the baseplate type, or both. Changes in weight, abdominal contours, and stoma size after surgery can all affect fit over time.
If leaks are a regular occurrence, speak to your stoma care nurse. There are products designed specifically to help with problematic skin profiles: including convex baseplates for a flat or inverted stoma, barrier rings to fill skin folds and dips, and ostomy belts for added security.
To find products that best suit your needs, feel free to refer to our product page.
Stoma ballooning
Stoma ballooning happens when wind builds up inside the pouch faster than the filter can release it, often because the filter has become wet or blocked. The bag puffs up, which can be uncomfortable and pull at the seal.
A few things that can help is to avoid gas-producing foods like fizzy drinks, onions, cabbage, and beans; skipping meals; and chewing gum. If your bag has a filter cover, try removing it or covering only half. If ballooning keeps happening, your stoma care nurse may be able to try a different pouch with a more effective filter.
Parastomal hernia
We also have a dedicated stoma hernia guide on this, but a parastomal hernia develops when part of the bowel pushes through a weakness in the abdominal muscle wall, creating a bulge around the stoma. It can range from a small, barely noticeable swelling to something a lot bigger. While some people experience discomfort or a dragging sensation; others don't feel much at all.
Muscle pain around the stoma alongside a visible bulge is worth getting assessed. Risk factors include heavy lifting, weight gain, smoking, and having had multiple abdominal surgeries. Wearing a support garment is often recommended both as prevention and management: your stoma care nurse can measure you for one. In some cases, surgical repair may be considered. Speaking of exercise with a stoma, here's a respective guide for you.
Prolapsed stoma
A prolapsed stoma happens when the bowel extends outward through the stoma, which makes it appear a lot longer than usual. This may look a bit alarming, but it doesn't usually cause pain. The key thing to check is colour as a healthy prolapsed stoma should remain pink or red. If it becomes darker, seek urgent medical attention.
Lying flat can help reduce the size temporarily, and a support garment is often used to manage it day-to-day. Always inform your stoma care nurse if you notice a prolapse, as your appliance size will likely need reviewing.
Constipation (colostomy)
For people with a colostomy, constipation can occasionally be an issue, usually triggered by reduced fluid intake, lower fibre, decreased movement, or new medications. Signs include harder, less frequent output and possible abdominal cramping. Increasing fluids and fibre is usually the first step. If things don't improve within a couple of days, your stoma care nurse can advise on gentle options.
Diarrhoea and loose output
Loose, watery output and diarrhoea can put a lot of pressure on your seal and increase the risk of skin irritation quickly. If you use a closed pouch and output suddenly becomes very loose, switching to a drainable pouch makes management much easier.
Foods that can help thicken output include white rice, white bread, smooth peanut butter, natural yogurt, pasta, and unripe bananas. If loose output continues beyond 48 hours or feels excessive, contact your stoma care nurse: dehydration is a real risk with high liquid output.
FAQ: Stoma bag problems
How do you treat irritated skin around a stoma?
Start with the basics: make sure the skin is clean and dry before applying your appliance, and check that your aperture isn't exposing skin to output. If the skin is already broken or sore, a barrier product or protective wipe can help support recovery, your stoma care nurse can recommend what's appropriate. If irritation persists or looks like it could be a reaction or infection, get it checked rather than waiting.
How do I know if my stoma is infected?
Signs of a stoma infection include redness, warmth, swelling, or unusual discharge around the stoma site. If you're also feeling unwell, running a temperature, or notice your stoma changing colour, seek medical advice as soon as possible. Some symptoms (like folliculitis or a yeast infection) are more minor but still worth treating properly, so don't hesitate to contact your stoma care nurse if something doesn't look or feel right.
What cream is good for skin around a stoma?
This really depends on what's going on with your skin. Barrier creams can protect sore or vulnerable skin, but not all are suitable for use directly under an adhesive baseplate as some can affect adhesion. Your stoma care nurse is the best person to advise on the right product for your specific situation. Avoid using anything on the peristomal skin without checking first, as the wrong product can sometimes make things worse.
How long does a stoma take to heal?
The stoma itself typically stabilises over the first six to eight weeks after surgery, as swelling reduces and the surrounding tissue heals. Peristomal skin, if it's become sore or broken, can improve relatively quickly with the right care (often within a week or two) but this depends on the cause and severity. If your skin isn't improving despite making changes, your stoma care nurse can help identify what's getting in the way.