Foolproof equipment is necessary to have; i.e., there must be no leakage. Yeast conditions are common; therefore, it is advisable to have a micro-granulated anti-fungal powder on hand whenever you see a reddened area. The removal of the adhesive disc—the skin barrier—again should be done gently pulling on the skin and not the barrier. This prevents one pulling off the cornified layers of skin. One can pull out the hair follicles by the roots, which leaves the area wet and weepy if proper care is not taken. Hair should be removed by either cutting with scissors or an electric razor. Extra care should be used when using a regular razor. It will shave off the roots of the hair. If one does have small weepy areas, a quality ostomy powder should cover them.
One must be re-measured after surgery for the right opening in the barrier, and if he/she is not, we will see a crusty wart like looking skin, often bleeding and oh so tender. Then someone will cut a larger size opening to accommodate this. Wrong! It should be a smaller size to press down the "dishpan hands" skin. This is where skin has been exposed to urine so that it becomes water logged. In some cases, one may have to go to surgery—for it is so tender—and have it shaved off to the skin level.
Then immediately, one must re-measure an exact sized barrier and check continually to make sure it is correct. Crystals are usually on the stoma, not on the skin. However, use of full strength vinegar in the pouch, sloshed over the stoma once or twice a day will prevent this. Crystals show up as white deposits on the stoma. Again, let me stress for the urinary stoma—cements, pastes and adhesives cause problems. One must have a correct fitting barrier with proper adhesion.
However, skin problems are not as bad as those of the person with an ileostomy are. If one finds a reaction, use one of the high quality skin barriers around the stoma, which will prevent this and provide a better seal.
