It's not uncommon for ostomates to experience skin issues or sensitivity, especially during the first few months following surgery. The peristomal skin is subject to a lot of trauma as your body adapts and you get used to wearing your pouching system. While several common skin issues can develop, allergies are quite rare. Still, they can happen, and when they do, living with an ostomy becomes a little more challenging. To help you better understand any changes in your body, we'll cover everything you need to know about allergies and ostomy care, including how to address contact dermatitis
How Often Do Allergies Affect the Skin Around the Stoma?
Allergic reactions in ostomates are rare, but they can occur. They tend to manifest in less than 1% of people with an ostomy but can leave your skin feeling red and irritated. Oftentimes, allergies will affect the skin that comes in contact with your ostomy products, primarily the skin barrier. This may result in itching and burning or a stinging sensation accompanied by redness. However, peristomal skin irritation can also cause similar degrees of irritation and redness, which various factors can cause. The most common causes of irritation include poor peristomal skin care and hygiene, skin contact with output (stool or urine), and poor fitting ostomy bags. Allergic reactions will also irritate the skin but are a little more difficult to manage at first.
There are also several other common stoma issues and complications that may present similar symptoms. Some of these include things like infections, stenosis, bowel obstruction, prolapsed stoma, parastomal hernias, and more. If you experience any issues or irritation, it's important to see a healthcare professional to better understand what's causing the issue. Your doctor and ostomy nurse may recommend trying new products, gently washing and drying your peristomal skin regularly, and making sure that you have a good seal to prevent unnecessary irritation.
How to Recognize an Allergic Reaction
Allergies occur due to an immune response inside your body. Upon initial exposure to an allergen, the body's immune system may not react. However, with repeated exposure, the immune system can start to recognize the substance as a threat. This recognition triggers an immune response involving T-cells and other immune cells. The next time the skin comes into contact with the allergen, the immune system reacts, causing inflammation and the characteristic symptoms of dermatitis. For ostomates, this can occur immediately or after using a product repeatedly, which leads to an allergic response over time.
As mentioned, several things could be causing the problem. In real causes of allergic dermatitis, these issues won't resolve until you stop using the product you're allergic to. With that being said, the reaction from the allergies is usually limited to the area where direct contact with the allergen was made. It will be the same shape as whatever came in contact with your skin and may present with several symptoms. In addition to the itching and burning mentioned above, you may also notice edema, erythema, bleeding, crust formation, and wounds. Severe allergic reactions create more severe symptoms, which can manifest as raches across other areas of the body. To help reduce the risk of any serious complications, it's important to see your doctor at the first sign of any burning sensation or changes to the skin on your abdomen near the stoma.
It should be noted that allergies are not the same as skin sensitivity. Allergies cause a reaction when a product is applied to the skin. Essentially, they're your immune system reacting to a foreign substance. Sensitivity can develop in ostomates over time and often requires a different approach to help maintain healthy skin.
How to Address Allergic Skin Irritation
Before anything, it's important to understand all the reasons why the skin around your stoma is red, itchy, or irritated. How to care for damage to the skin depends on what the issue is, so it's important to schedule a visit with your doctor if you're not sure. Prioritize skincare and a strong adhesive, and if things don't get better, see your doctor as soon as possible. You may also be referred to a dermatologist for help.
Step 1: The first step your doctor will take to help you determine the allergen is to patch-test your skin. This is often done for ostomy tape, paste, powders, wipes, flanges, and skin barriers to help determine which part of the appliance is causing the issue. Different areas of your skin will be tested to help correctly identify the offending product.
Step 2: If any products cause irritation after direct contact with the skin, your doctor may contact the manufacturer to obtain a list of ingredients used in the product.
Step 3: Individual ingredients may be tested for allergic responses to help pinpoint the exact cause of your allergies, which can help you avoid them in future ostomy care.
Step 4: Use a new pouch material that you're not allergic to, and continue to gently wash the area with warm water (avoiding soaps) until the rash subsides. Your doctor may also recommend a steroid cream or hydrocolloid dressings to help. Oral antihistamines may also be beneficial for certain individuals. If your allergic reaction led to an infection, your doctor may prescribe you with antibiotics or a special spray.
There are several common reasons for redness around your stoma, but that doesn't mean it's normal. Incorrectly applying your ostomy pouch can cause residue to leak out and irritate the skin. However, working with your doctor and ostomy nurse can help you ensure that you're using the right pouching system, which can help reduce the risk of these types of complications.
Choosing the Right Ostomy Pouch
Choosing the right ostomy pouch is an important decision for individuals who have undergone ostomy surgery. The selection depends on various factors, including the type of ostomy (colostomy, ileostomy, or urostomy), stoma size and shape, lifestyle, and personal preferences. Ostomy bags can also come in one-piece and two-piece systems, which can come in either closed-end or drainable bags.
You can always ask your doctor for recommendations, but it may be a good idea to try a few different bags out to see which one fits the best with your lifestyle. This important thing is that you feel comfortable and confident navigating your daily life, so don't be afraid to ask questions and try new products until you find the right one.
Adjusting to Life with an Ostomy
Navigating life with an ostomy can be challenging, especially if you're experiencing an allergic reaction. You'll need to change the ostomy pouch and find something that doesn't cause problems. However, once you do, things will get much easier. Still, there are several myths about living with an ostomy that can make the transition hard. During this time, it's important to remember that after you adapt to the physical changes that follow surgery and find products that don't cause issues with your skin, you'll be able to do everything you did before the surgery. While it's easier said than done, connecting with other ostomates can help.
The best way to adapt and overcome many challenges associated with ostomy surgery is to join an ostomy support group. To find an ostomy support meeting, look at the list of support groups affiliated with The United Ostomy Associations of America (UOAA). UOAA is a national, 501(c)(3) nonprofit organization that supports, empowers, and advocates for people who have had or will have ostomy or continent diversion surgery.
It's also important to ensure that you have all of the ostomy supplies necessary to support your lifestyle. At Byram Healthcare, we’re committed to helping improve the lives of people living with an ostomy and offer a wide range of high-quality, medical-grade ostomy supplies, pouches, and support systems. To get started, check out our ostomy product selection guide today.
