Ostomy itching is a common issue that can affect people with a colostomy, ileostomy, or urostomy, but persistent itching is often a sign that something may be wrong. Regardless of what's causing the issues, identifying the underlying cause is an important part of effective ostomy care. Here, we'll go over more details on why itchy peristomal skin occurs, how to treat and prevent it, and more.
Quick Overview: Ostomy Itching
- Occasional itching around the stoma can be normal, but persistent itching often indicates skin irritation or another underlying issue.
- Common causes include leakage, moisture buildup, poorly fitting barriers, allergies, dermatitis, fungal infections, and dry skin.
- Relieving ostomy itching starts with identifying the cause, improving your pouch fit, and protecting irritated peristomal skin.
- Preventing itchy skin involves good ostomy care, maintaining a proper barrier seal, and monitoring your skin during every pouch change.
- Contact your healthcare provider or WOC nurse if itching is severe, doesn't improve, or is accompanied by redness, skin breakdown, drainage, or signs of infection.
Is Ostomy Itching Normal?
When living with an ostomy, it's normal for you to experience itchy skin from time to time. The skin around your stoma can become sensitive with the wrong ostomy bag or products, which may contribute to peristomal itching. However, while occasional itching can be normal, it shouldn't be constant. Brief itching may occur as the skin adjusts after surgery, when the adhesive is removed, or if the skin is slightly dry. To determine whether it's normal or there's a sign of skin damage, it's important to regularly check your skin health and see your doctor if itchiness continues and is accompanied by any of the following symptoms:
- Redness or discoloration around the stoma
- Burning or stinging sensations
- Rash or small bumps on the peristomal skin
- Dry, flaky, or peeling skin
- Swelling around the stoma
- Moist, weeping, or oozing skin
- Pain or tenderness during pouch changes
- Skin breakdown, sores, or ulcers
- Bleeding from irritated skin
- Frequent leakage from the ostomy barrier
- Changes in how well the skin barrier adheres
- Unpleasant odor caused by leakage or infection
- White patches or satellite lesions (common with fungal infections)
- Warmth around the affected area
- Persistent discomfort that doesn't improve after changing the pouching system
If these symptoms persist, worsen, or are accompanied by signs of infection, it's important to contact your healthcare provider or wound, ostomy, and continence (WOC) nurse for evaluation and treatment.
What Causes Ostomy Itching?
Ostomy itching is usually a sign that the skin around your stoma is irritated. If you experience itching or dryness, it's important to try to identify the cause to help prevent more serious stoma or skin complications and make everyday ostomy care more comfortable. Some of the most common causes of itchy skin around the stoma include the following:
Leakage and Skin Exposure
One of the most common causes of itchiness when living with a stoma is leakage. If stool or urine comes into contact with peristomal skin, the digestive enzymes and other compounds can irritate and damage healthy skin. Even small leaks beneath the skin barrier can trigger itching before other symptoms become noticeable.
Moisture Build-Up
Excess moisture trapped beneath the barrier can also lead to issues. Sweat from hot weather, exercise, or humidity may become trapped, softening the skin and making it more susceptible to irritation. Moisture can also reduce the adhesive's ability to maintain a secure seal, increasing the risk of leakage.
An Improperly Fitting Ostomy Barrier
A well-fitting skin barrier is essential for protecting the skin around your stoma. If the opening is cut too large, waste can come into contact with the surrounding skin. If it's too small, the barrier may rub against the stoma itself. Changes in your body shape, weight, or stoma size over time can also affect how well your pouching system fits, leading to irritation and itching.
Allergic Reactions
Some people develop allergies or sensitivities to products used during ostomy care. Allergic reactions often cause itching along with redness, swelling, or a rash that appears wherever the product touches the skin. If you notice any symptoms of allergies or skin irritation around your stoma, it's important to contact your doctor.
Contact Dermatitis
Contact dermatitis is one of the most common skin conditions affecting people with an ostomy. It occurs when the skin becomes inflamed after exposure to an irritant or allergen. There are two main types:
- Irritant contact dermatitis: Caused by repeated exposure to stool, urine, moisture, adhesives, or friction.
- Allergic contact dermatitis: Caused by an allergic reaction to adhesives, skin care products, or other materials used during ostomy care.
Seeing a doctor can help you better understand what's causing it and provide tips on caring for the skin around the stoma.
Fungal (Yeast) Infections
Warm, moist environments beneath the ostomy barrier can create ideal conditions for yeast to grow, particularly Candida. Fungal infections are more likely to occur after antibiotic use, in hot climates, or in people who perspire heavily. In addition to itching, fungal infections may cause:
- Bright red skin
- Small red bumps or "satellite" lesions
- Burning or soreness
- Moist or weeping skin
Frequent Appliance Changes
Changing your pouching system more often than necessary or removing the adhesive too aggressively can damage the outer layer of the skin. Using an adhesive remover and following the recommended wear schedule can help minimize skin damage.
Dry Skin
Not all itching is caused by moisture. In some cases, the skin around the stoma becomes overly dry due to frequent washing, harsh soaps, or exposure to cold, dry weather. Dry skin may feel tight, flaky, or rough and can become itchy even when no rash is present.
Changes in Your Stoma or Body
Other factors such as weight gain or loss, aging, scar tissue, or the development of a parastomal hernia can change the shape of your abdomen or stoma. These changes may affect how well your pouching system fits, increasing the risk of leaks, skin irritation, and ongoing itching. If itching develops after your body changes, it may be time to have your pouching system reassessed by a WOC nurse or healthcare provider.
How to Relieve Ostomy Itching
The most effective way to alleviate issues like itchiness is to identify and address the underlying cause. Although it may be tempting to scratch the itch, try to refrain, as doing so can further damage the skin and increase the risk of infection. Instead, see your doctor and try to:
Improve Your Barrier Fit
A poor-fitting skin barrier is a common cause of ongoing itching. You can improve your fit by measuring your stoma regularly, especially during the months following surgery or after significant weight changes, to ensure the opening is the correct size. If you're experiencing frequent leaks despite proper application, your stoma care nurse may recommend switching to a different type of barrier, such as a convex barrier or barrier ring, for a better seal.
Keep the Skin Clean and Dry
During pouch changes, gently cleanse the skin around your stoma with warm water or a mild cleanser recommended by your healthcare provider. Avoid products containing oils, fragrances, or heavy moisturizers, as these can interfere with the barrier's adhesion. Before applying a new pouch, make sure the skin is completely dry to help the adhesive form a secure seal.
Protect Irritated Skin
If your skin is already irritated, there are a few products designed specifically for ostomy care that can help protect it while it heals. Depending on your needs, your healthcare provider may recommend:
- Skin barrier films or wipes
- Barrier rings or seals
- Ostomy powder for moist or weeping skin
- Adhesive remover wipes or sprays to minimize skin trauma during pouch removal
Always follow product instructions and avoid using powders or creams that are not intended for ostomy care unless directed by your doctor or ostomy nurse.
Treat Allergic Reactions or Infections
If itching is caused by an allergic reaction, switching to a different adhesive or skin barrier product may resolve the problem. However, if you suspect a fungal infection or notice worsening redness, drainage, open sores, or severe discomfort, contact your healthcare provider. They can determine the cause and recommend appropriate treatment, such as prescription antifungal or topical medications.
How to Prevent Ostomy Itching
Proactive ostomy care is the best way to prevent itching, so it's important to utilize practices to help maintain healthy peristomal skin. Some methods to do this include:
- Use a properly fitting pouching system: A good seal and secure fit help prevent leaks and protect the surrounding skin.
- Practice good peristomal skin care: Clean the skin gently during each pouch change and inspect it for early signs of irritation.
- Manage sweat and moisture: Keep the skin as dry as possible, especially after exercising or spending time in hot weather.
- Change your pouching system carefully: Remove adhesives slowly and use adhesive remover if needed to minimize skin trauma.
- Monitor changes in your stoma or body: Weight changes, healing, or a parastomal hernia may affect how your pouching system fits.
- Schedule regular visits with a WOC nurse: Routine assessments can help identify fit issues and prevent recurring skin problems before they become more serious.
Having the right ostomy supplies can also make a significant difference in protecting your skin and preventing future irritation. Byram Healthcare offers a wide selection of high-quality ostomy products from leading manufacturers to help you manage your ostomy with confidence. Contact us today to learn more.
