Skin irritation around a stoma can start with something that seems small: a faint itch under the pouch, a slight sting during cleaning, or a red patch that appears after a leak. But peristomal skin can deteriorate quickly if faeces or urine sits against it. A systematic review found that peristomal skin complications affect between 36.3% and 73.4% of people following stoma surgery, which shows how common these problems can be.
The skin around a stoma is called peristomal skin. It should not feel sore, itchy, wet, burning or painful. If it does, it is usually a sign that something needs attention, such as a leak, poor pouch fit, trapped moisture, adhesive damage or irritation from a product.
For mild skin irritation, remove any leaking pouch, clean the skin gently with warm water, dry it completely and check that the pouch opening fits closely around the stoma. If irritation continues, worsens or the skin becomes broken, contact your stoma care nurse.
How to Treat Skin Irritation Around a Stoma
The most important part of treating skin irritation is finding the cause. If the same sore patch keeps returning, look carefully at where it appears. A ring of soreness close to the stoma often suggests output is touching the skin. Redness in the shape of the adhesive may suggest trauma from removal or sensitivity to a product.
When you first notice irritation:
- Remove the pouch gently. Support the skin with one hand and slowly peel the adhesive away with the other.
- Check the back of the pouch. Look for output under the flange or baseplate.
- Clean with warm water only unless advised otherwise. Avoid scrubbing sore skin.
- Dry the skin fully. Even slight dampness can stop the pouch from sealing properly.
- Check the pouch opening. It should sit close to the stoma without rubbing it or leaving surrounding skin exposed.
- Do not patch over a leak. Extra tape may hide the problem while output continues to damage the skin underneath.
In practice, one of the most useful checks is the back of the removed pouch. If the same area of adhesive is repeatedly damp or eroded, it often shows where the seal is failing. This can give a stoma care nurse clearer information than simply saying the pouch “keeps leaking”.
Barrier films, stoma powders and protective seals can be helpful in some situations, but they are not a cure-all. Too much powder or product can prevent the pouch from sticking. If you are unsure how to heal sore skin around a stoma, ask your stoma care nurse before changing products.
Common Causes of Skin Irritation Around a Stoma
Leakage is one of the most common reasons for sore skin around a stoma. Stoma output can be irritating, especially if it sits under the pouch adhesive. Once the skin becomes sore or moist, the pouch may stick less well, which can cause more leakage.
A poorly fitted pouch is another common issue. The stoma can change size after surgery, during weight changes or if the shape of the abdomen changes. Skin folds, scars, swelling, a flush or retracted stoma, and a parastomal hernia can all affect the seal.
A common pattern in home care is soreness returning in the same place, such as one side of the stoma or underneath a skin fold. This often suggests a fit or body-shape issue rather than a general skin problem.
Other causes include removing the pouch too quickly, trapped moisture or sweating, using too much powder or barrier product, sensitivity to adhesives, hair follicle irritation, existing skin conditions, or possible infection.
Itchy skin around a stoma can be an early warning sign. In home-care settings, carers often notice that people mention itching before they see an obvious leak. If itching keeps returning under the same part of the pouch, it is worth checking the seal and discussing it with a stoma care nurse.
How to Prevent Skin Irritation Around a Stoma
Good stoma skin care is built around routine and observation. The aim is to notice small changes before they become painful.
Check the skin at every pouch change. Look for soreness in the same place, damp skin, adhesive residue or signs that output has crept under the baseplate. Empty the pouch before it becomes too heavy, as the weight can pull on the seal.
Regularly remeasure the stoma, especially after surgery, weight changes or changes in abdominal shape. A template that fitted well a few months ago may no longer be right.
Helpful habits include:
- Removing the pouch slowly
- Drying the skin fully before applying a new pouch
- Avoiding unnecessary product layers
- Keeping supplies in a cool, dry place
- Recording repeated leaks or irritation
- Asking for a pouch review if leaks happen often
Small patterns matter. Repeated leaks overnight, after meals or during movement can give your stoma care nurse useful clues. Care teams also often notice that irritation is worse when pouch changes happen under pressure, such as before leaving the house or late at night.
When to Contact Your Stoma Care Nurse, GP or NHS 111
Contact your stoma care nurse or GP if irritation does not improve, keeps returning or prevents the pouch from sticking securely. You should also seek advice if the skin becomes painful, broken, wet, bleeding or weeping.
You should also request a review if you notice frequent pouch leaks, new ulcers, unusual skin growths or a sudden change in the stoma’s size, shape or position. If possible, take a clear photograph during a pouch change so your nurse can see what is happening.
Some symptoms may indicate a serious complication rather than routine skin irritation. Contact NHS 111, ask for an urgent GP appointment or seek urgent medical help if you experience severe abdominal pain, vomiting, signs of dehydration, lots of blood from the stoma or a high temperature.
You should also seek urgent help if your stoma stops producing output for much longer than normal, or if it suddenly becomes very dark, purple or black.
Practical Support With Stoma Care at Home
Skin irritation often becomes worse when small leaks are missed or when a pouch change feels rushed. Families may also feel unsure whether soreness is caused by the appliance, moisture, stoma output or the way the pouch is being removed.
A trained carer can support a calmer routine by helping the person change their pouch at the right time, checking for early signs of leakage and making sure the surrounding skin is fully dry before a new pouch is fitted. They can also record patterns, such as repeated leaks overnight, after meals or during movement, so these can be discussed with a stoma care nurse.
At Secure Healthcare Solutions, our care team often finds that people feel more confident when they have a consistent routine and know when to ask for clinical advice. Our personalised Stoma Care in Wolverhampton helps make daily stoma care feel less stressful while protecting dignity, comfort and independence.
Frequently Asked Questions
What cream is good for irritated skin around a stoma – and can I use Sudocrem?
Avoid ordinary creams including Sudocrem — they prevent the pouch from sticking and can make things worse. The right product depends on the cause. Ask your stoma care nurse before changing anything.
Is red skin around a stoma normal?
Temporary pinkness after removing the pouch may settle quickly. Persistent redness, discolouration, soreness, itching or broken skin is not considered healthy and should be assessed.
How do you treat raw or weeping skin around a stoma?
Raw or weeping skin should be assessed by a stoma care nurse. Avoid applying ordinary creams or dressings without professional advice.
Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9819694/
- https://www.nhs.uk/tests-and-treatments/colostomy/complications-of-a-colostomy/
- https://www.colostomyuk.org/information/stoma-problems/sore-skinleakage/
- https://ascnuk.org/
