Your stoma and peristomal skin
What is a stoma?
First things first, let us have a proper introduction to stoma and what it actually is. A stoma is a surgically created opening in your abdominal wall that allows your bowel or urinary system to function differently. Unlike a wound, a stoma is a living tissue made from your own intestinal lining. It usually appears red, moist, and slightly raised — similar to the inside of your mouth.
Note: It is important to remember that your stoma itself doesn’t cause pain or feel sensation. However, the skin around it (called peristomal skin) is highly sensitive, and requires thorough care.
Why peristomal skin needs special care
And why does peristomal skin need special care? The skin around your stoma endures pressure that normal skin doesn’t. Your baseplate creates constant adhesion, which generates pressure and traps moisture underneath. Chemical exposure from stool or urine may also leak beneath the pouch and damage the skin barrier. Each pouch change means mechanical stress as you remove the adhesive. The warm, closed environment under the baseplate leads to moisture build-up. Also, the pH digestive output is very different from your skin’s natural pH.
These make peristomal skin far more vulnerable to irritation, breakdown, and infection than skin elsewhere on your body. This is why a consistent, gentle stoma skincare routine is so important.
Signs of healthy vs. irritated peristomal skin
Healthy skin around your stoma should have a similar texture and colour to the skin elsewhere on your body. It may be slightly pink immediately after you remove your pouch, but this pink tone should fade quickly. Beyond that, make sure you see no redness, no rash, no swelling, and no broken areas. Overall, the skin should be dry and intact that’s ready for your next pouch.
Signs your skin needs attention
Pay attention to your skin every time you change your pouch. Early warning signs matter as they’re often the easiest to treat. Watch for redness that doesn’t fade or a pink tone that lasts longer than usual. Notice any itchiness or burning sensations around your stoma. Look for any visible rash, especially with raised bumps and pustules. If you see weeping or oozing from the skin, or swelling around the stoma, it’s worth noting. You might also spot cracks, bleeding, or open sores.
In some cases, white flaky patches may appear — that’s often a sign of fungal infection. Occasionally, an unpleasant smell that goes beyond the normal stool odour may occur.
The key is catching these symptoms early. Minor irritation is manageable and responsive to treatment. But if you ignore the early signs of an infected stoma, there’s a high chance that they may grow into bigger problems.
How to care for your stoma: Your daily stoma skin care routine
Step 1. Gentle cleansing
Clean your skin every time you change your pouch. For most people, that’s 1-3 times a week with a closed pouch, or more often if you use a drainable system. All you need to do in this step is to use lukewarm water. Using soft cloth or cotton wool, gently wash around your stoma. Don’t scrub or rub — a gentle wash is all you need.
If you feel like you need a cleanser, make sure it’s pH-neutral, fragrance-free, and free of oils and moisturizing agents. Water, however, is best recommended as soaps, fragrances, and moisturizers can damage your skin’s protective barrier and interfere with how well your adhesive sticks. Your skin already has natural oils that protect it — avoid stripping those away.
Step 2. Thorough drying
Moisture is one of the leading causes of skin irritation around your stoma, and your baseplate is where moisture troubles usually start. After you’ve cleaned your skin, gently pat it dry with a clean, soft cloth. Don’t rub the skin to avoid minor damage. If you have time, let it air dry for thirty to sixty seconds. This gives you extra assurance that it’s fully dry.
Pay special attention to the creases and folds around the abdomen as moisture loves to hide in those places. Your skin needs to be completely dry before you apply your new baseplate. If the skin isn’t fully dry, you’ll get poor adhesion and trapped moisture underneath which causes irritation.
Step 3. Regular skin inspection
Every pouch change is your chance to check in with your skin. Look at the whole area your baseplate covers. Check behind the adhesive you’ve just removed and compare it to how it looked last time. Early detection of sore skin around your stoma makes treatment easier and healing faster. You’re the expert on your own skin — you know what’s normal for you.
Step 4. Allow skin breathing time
Whenever you can, give your skin a break from the adhesive. Try for 15-30 minutes between removing one pouch and applying the next — some people like to do this once a week. These short breaks might seem small, but they are impactful. Your skin gets air circulation, moisture can evaporate, and everything settles down. Even brief breathing time may improve your skin health significantly.
How to heal irritated peristomal skin
If your skin is already irritated, take these steps immediately.
Identify the cause
When your skin is sore, there’s usually a reason. First, check how your baseplate fits. Is the hole the right size for your stoma? It shouldn’t be too loose (which exposes skin to output) or too tight (which restricts circulation). Follow the “not too loose, not too tight” rule.
Next, inspect the back of your removed adhesive. If you see stool or urine underneath, that’s your answer — output is reaching your skin, which is often the #1 cause of irritation. Pay attention to how you’re removing your pouch as well. If you’re peeling it off forcefully, you’re causing micro-tears in the skin and damaging the protective barrier. Instead, peel slowly and gently, or use an adhesive removal spray to make the process easier.
Finally, think about whether you’ve switched products recently as new adhesives, cleansers, or accessories can also trigger irritation. If so, go back to what was working while your skin heals.
Immediate care for sore skin
Here’s what to do right now. Stop using any new products while your skin heals. If you’re experiencing leaking, change your pouch more frequently. Use only water for cleansing — keep it as simple as possible. Make sure your skin is completely dry in between changes. Let your skin get as much air exposure as possible between pouch applications.
In many cases, getting back to basics is enough. Your skin will recover on its own with just this simple routine.
Use ostomy skin protectives if needed
If your irritation is moderate to severe, consider using a skin barrier product. Skin barrier products are protective tools (also called “ostomy skin protectives”) that create a protective layer between your skin and the adhesive, or they seal gaps where output may escape.
There are several types of ostomy skin protectives:
- Barrier rings or seals are mouldable rings that fit snugly around your stoma,
- Protective paste creates a caulk-like seal in crevices and folds,
- And sprays or powders can help with adhesion when fitting is tricky.
When should you use them? When skin is visibly irritated or broken. When your stoma shape makes perfect seal difficult. When you have deep creases or folds around your stoma. When leakage keeps happening even though you’re fitting everything correctly.
Specialized treatments for specific conditions
Fungal infections (Candida)
If you’re seeing white patches, feeling intense itching, and the redness just won’t go away despite good hygiene, you might have a fungal infection. This is when you need to reach out to your stoma care nurse or doctor as fungal infections need antifungal treatment. Prevention, however, works well: keep your skin scrupulously clean and dry, and use barrier products to minimize moisture underneath your pouch.
Bacterial infections (Folliculitis)
Painful bumps or pustules that look like pimples around your hair follicles suggest a bacterial infection. In this scenario, don’t shave the area. Instead, use electric clippers or scissors. And when you remove your pouch, avoid aggressive pulling — that can pull out hair and cause infection. Talk to your nurse about antibiotic treatment if infection is present and wait for complete healing before going back to your normal routine.
Allergic reactions
If you’re feeling itchy and redness across the entire area that your pouch touches, you might have an allergic reaction. In that case, stop all new products immediately. Use water only for cleansing for a while. Try switching to fragrance-free, hypoallergenic pouching systems or completely different brands. If the problem persists, talk to your stoma care nurse — they can help identify the cause and suggest products that work for your skin.
Stoma and skincare: When to seek professional help
Reach out to your stoma care nurse or doctor if skin irritation doesn't improve after 3–5 days of careful care. Contact them if you see signs of infection (pus, spreading redness, or warmth). If you're experiencing severe pain or bleeding, that's worth a call. The same goes for fungal or bacterial infections, allergic reactions to products, or recurring leakage that keeps happening even though you're fitting everything correctly. And if anything concerns you, even if you can't quite name why, get in touch. Your healthcare team has tools, products, and expertise you don't have at home.
Key takeaways on stoma skin care
Stoma skincare might feel like a lot to manage when you're first learning, but it quickly becomes routine within a few weeks. The time you invest now in learning the right technique, using products that actually work for you, and staying alert to changes pays off massively in comfort, confidence, and quality of life.
Your skin is more resilient than you might think. With consistent, gentle care and the right support, healthy peristomal skin is absolutely achievable. You have the knowledge now. You have the tools. You have the ability to maintain comfort and confidence in your life with a stoma.
Frequently asked questions (FAQ): Stoma skin care
How do you protect the skin around a stoma?
The best protection comes from consistent, gentle care. Use proper technique—clean with water only and dry thoroughly. Make sure your baseplate hole matches your stoma exactly, following the "not too loose, not too tight" rule. Change your pouch on schedule rather than waiting for leaks. Give your skin airtime between pouch applications. Use barrier products like protective rings, pastes, and seals to prevent irritation. Inspect your skin at every change to catch problems early. Avoid harsh products like soaps, fragrances, oils, and moisturizers. Manage moisture by drying thoroughly and considering moisture-wicking products.
The greatest protection is prevention. A few minutes of attention with each pouch change saves you hours of discomfort and healing later.
What cream is good for skin around stoma?
Most creams and moisturizers are not suitable for peristomal skin. Oils and moisture interfere with adhesive stickiness, and your baseplate won't seal properly on creamed skin. The trapped moisture under the adhesive actually worsens irritation.
For routine care, use water only. For mild irritation, try barrier rings or seals, protective paste designed for ostomy use, and air-drying time. For moderate irritation, use hydrocolloid protective wafers, ostomy-specific barrier sprays, or alginate powders for moisture absorption and healing promotion. For severe irritation, your stoma care nurse should assess you, as you may need topical medications like antifungal or antibacterial treatments.
Never apply regular moisturizer or body cream. Avoid body lotions, fragrance-containing products, oil-based products, talc powder, and hydrocortisone creams without medical guidance. Your stoma care nurse can recommend products specifically formulated for peristomal skin—they won't compromise your seal.
What foods should I avoid with a stoma?
While diet and skincare are separate concerns, what goes in affects skin health indirectly. High-acid foods like citrus fruits, tomato-based products, vinegar, and spicy foods create more irritating output. High-fibre foods like unpeeled vegetables, nuts, seeds, and whole grains can cause urgency and consistency changes. Foods that cause gas and pressure (e.g. beans, cruciferous vegetables, carbonated drinks, and sugar alcohols) increase discomfort. Fatty or greasy foods, high-lactose products (if you're sensitive), and high-sugar items increase output volume.
It’s important to remember that if a food causes irritating output, your peristomal skin bears the consequences. Keep a food diary to identify your personal triggers.
Eating with a stoma isn’t so complicated: can eat a balanced, varied diet with adequate hydration. There's no universal "ostomy diet"—find what works for your body and your skin health.