Question: Managing a Rash Under the Ostomy Appliance Flange

I’ve recently developed a red, itchy, pimply rash beneath the flange of my ostomy appliance. Could you advise on how to deal with this issue?

Response: Effective Strategies for Treating Skin Irritation Around the Stoma

Experiencing skin irritation around your stoma, as you’ve described, is often a result of leakage from your ostomy pouch, which leads to stoma output coming into contact with your skin. This situation can be uncomfortable and might affect how well your pouching system works. Here are steps to manage and potentially resolve this irritation:

  1. Inspect the Adhesive: After removing the appliance, examine the adhesive for signs of leakage that could be causing the irritation.
  2. Assess the Fit: Make sure the pouch fits your stoma properly. A well-fitting skin barrier is essential to prevent contact with stoma output. Use the template included with your flange for accurate sizing.
  3. Stoma Positioning: Evaluate your stoma’s position. If it’s flush with or below the skin surface or in a deep fold, you may need a different pouch type or additional accessories. The Coloplast BodyCheck tool can aid in this assessment.
  4. Review Adhesive Erosion: If the adhesive erodes too quickly, consider more frequent changes or using erosion-resistant adhesives.
  5. Manage Infections: Small, painful pimples might indicate an infection in the hair follicles. Shave the area around your ostomy carefully, using scissors or an electric shaver rather than a blade.
  6. Address Fungal Infections: Rash with red or purple patches suggests a fungal infection. Keeping the peristomal skin dry and clean is crucial.
  7. Check for Bleeding: Consult a stoma care nurse if there’s bleeding from the skin around your stoma. Minor bleeding from the stoma is normal.
  8. Allergic Reactions: Though rare, allergic reactions can happen. Avoid irritants like perfumed soaps and use just water for cleaning.

If these steps don’t improve your condition, I recommend consulting with a Nurse Specialized in Wound, Ostomy, and Continence (NSWOC). They can provide personalized advice and support for your ostomy care needs.

Maintaining healthy skin around your stoma is key for both comfort and the effective functioning of your ostomy appliances.

Best regards,

Jo-Ann L. Tremblay
FACEBOOK – Author Jo-Ann L. Tremblay
TWITTER @joanntremblay
Author of “The Self-Coaching Toolbox”, “Better With A Bag Than In A Bag”, “Another BAG Another DAY”, “BAGs Around the World”, “Why Buttercup Wears a BAG!”, “The Sibs Gang Cave of the Golden Heart”,,
Member Ostomy Canada/Medical Lifestyle Advisory Committee Member – Ostomy Lifestyle Expert
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