Living with an ostomy means introducing new products into your routine. You'll need a pouching system, adhesive, and skin barriers to help manage stoma output and maximize your comfort throughout the day. While there are hundreds of different ostomy products to choose from, it's important to find options that help protect the skin around your stoma while creating a strong seal. For those with sensitive peristomal skin, this can be a challenge. However, the right ostomy skin barrier is out there and can make all the difference in preventing irritation, leaks, and discomfort. Here, we'll help you find some of the best skin barrier products for sensitive skin and a few other tips to care for your stoma.
Understanding Peristomal Skin Sensitivity
The peristomal skin is the area of the skin that surrounds the stoma. Ideally, this should look and feel just like the rest of the skin on your abdomen. However, it can easily become irritated since it's constantly exposed to adhesives, moisture, and occasional output from your stoma. Peristomal skin irritation is normal and is nothing to worry about, but it can be uncomfortable. Regardless of the type of ostomy, the products you use are one of the best ways to help prevent leakage and protect your skin. Still, it's important to understand what's causing the skin problems in the first place. A few common causes of peristomal skin irritation include:
- Leakage of output onto the skin
- Frequent removal of adhesive barriers
- Incorrect or harsh removal of barriers
- Allergic reactions to adhesives or barrier ingredients
- Friction from ill-fitting appliances
- Improper skin barrier fit
- Sweating under the barrier
- Use of scented soaps or lotions
- Prolonged wear time
- Long-term skin trauma from accessories
- Infections or fungal growth in moist environments
Typically, signs of irritation are quite noticeable and may require help from your healthcare provider or ostomy nurse. The most common include:
- Redness
- Rash
- Burning
- Itching
- Pain or tenderness around the stoma
- Skin that weeps, oozes, or bleeds
- Skin breakdown
- Ulceration
If you're experiencing any of the above, it could be a sign that your skin barrier isn't working for you or that you may need extra protection. Talk to your ostomy nurse for recommendations or additional techniques to help soothe irritated skin.
Factors to Consider When Choosing Skin Barriers
When browsing through ostomy barrier options, it's good to be diligent about your choice. The skin barrier is one of the most important parts of a pouching system, as it helps protect your skin from stoma output and keeps the pouch securely in place. Luckily, there are several different types of barriers that you can choose from. The best option for you will depend on things such as sensitivity, stoma, and even output. Some considerations include:
- If you have a round stoma that doesn't change in size, a pre-sized skin barrier may be a good option.
- If your stoma is oval or is still changing in size, cut-to-fit skin barriers can provide more customization and a stronger seal.
- If your stoma doesn't stick out or your abdominal skin is quite soft, a convex skin barrier will adhere well to the area.
- If your stoma sticks out from the abdomen, or if you have a parastomal hernia, or a deep abdominal crease or fold, flat skin barriers adhere well to the peristomal skin.
- If your output is more liquid or soft, you'll want to find a skin barrier resistant to liquid stomal output.
- If your output is more formed, a skin barrier with gentle adhesion will help with the more frequent changes necessary.
If you're unsure about your stoma characteristics and which barrier would work best, ask your doctor or ostomy nurse for recommendations.
Key Features to Look for in Skin Barriers to Reduce Irritation
Choosing between all the different skin barrier options can be a bit overwhelming, but there are some features to look for if you have particularly sensitive skin. You should focus on ingredients that promote skin health (i.e., hypoallergenic and latex-free) and find something that will form a secure seal around your stoma. Some other tips include:
- Look for ostomy products that have been designed specifically for sensitive skin.
- Find skin barriers that help wick away moisture and keep the skin dry.
- Look for barriers that move with your body, as these are less likely to tug at the skin.
- Always choose fragrance-free ostomy products.
- Find a barrier that allows for airflow while remaining secure enough to prevent leaks.
- Opt for a barrier that works well with seals, rings, powders, and pastes to give you more control over fit and protection.
Some studies also found that ostomy barriers with ceramide, a natural lipid that helps maintain the skin barrier, were significantly less disruptive to the peristomal skin.
The Best Ostomy Skin Barriers for Sensitive Peristomal Skin
Although it's important to try different products and see what works with your skin, there are a few notable options that ostomates with sensitive skin may prefer. The following barriers are highly rated to help reduce peristomal skin problems without compromising continence. The following products are sorted into two categories: flat and convex ostomy skin barriers.
Flat Ostomy Skin Barriers
Flat skin barriers are designed to sit evenly against the skin without any curve or pressure. They work best for ostomates with a stoma that protrudes above the skin surface and those with smooth, even peristomal skin. People with sensitive skin often prefer flat barriers because they don’t exert additional pressure on the area. Some also find they're a bit easier to apply, but this can also be a personal preference. Some great options for flat barriers include:
- SenSura® Mio Flex Barriers
- SenSura® Flex Barriers
- New Image™ FormaFlex™ Barriers
- Pouchkins™ SoftFlex™ Pediatric Barrer
Convex Ostomy Skin Barriers
Convex skin barriers are slightly domed or curved outward to apply gentle pressure around the stoma. This helps encourage a recessed or flush stoma to protrude slightly, allowing better drainage into the pouch. Convex barriers are ideal for ostomates with stomas that sit at or below skin level, or when the surrounding skin has irregularities like dips, folds, or scarring. They create a more reliable seal and can help prevent leakage and skin irritation. However, because they press into the skin, they may not be as good of an option for people with sensitive skin. Still, a few good options include:
- SenSura® Mio Convex Flip Barriers
- New Image™ CeraPlus™ Barriers
- SUR-FIT Natura™ ConvaTec Moldable Technology Skin Barrier
Other Tips for Managing Sensitive Peristomal Skin
Although choosing the right skin barrier is one of the most important aspects of protecting your stoma and reducing irritation, there are a few other things you can do to keep peristomal skin healthy. Some of the most effective tips for cleaning and caring for peristomal skin include the following:
- Clean the skin around your stoma with warm water and a soft cloth
- Avoid using soaps that contain oils, perfumes, or moisturizers
- Pat the area dry completely before applying any new appliance
- Change your pouch at the first sign of leakage
- Assess your barrier and seal if you feel discomfort
- Use skin wipes or barriers sparingly (overuse can lead to a build-up and worsen irritation)
- Try using a barrier ring
- Consider barrier paste to help secure the seal
- Never rip off the skin barrier; remove it gently using wipes or sprays as needed
- Give your skin some time to breathe every now and then
When to Switch Skin Barriers
Unfortunately, during the first few months after your surgery, you'll likely need to undergo some trial and error to find the best ostomy products for your needs. If you notice that skin issues persist despite optimal peristomal skin care, it's probably time to re-evaluate your barrier. Common signs of an issue are things like:
- Recurring skin breakdown
- Frequent leaks
- Allergic reactions
- Adhesive sensitivity
- Poor fit
Remember, you can customize your ostomy supplies, and there are tons of different brands or styles to choose from. In fact, most ostomy manufacturers offer free samples to help you try a few out before committing to a large order. If you're struggling with ostomy care for your stoma, talk to your doctor today. You can also browse the high-quality ostomy products available at Byram Healthcare. With discreet, timely delivery, we aim to help make life with an ostomy as easy and carefree as possible.
