Tips for Avoiding Peristomal Itching (and What to Do if You Already Feel Itchy)

Itchy skin around the stoma , or peristomal skin, may be a frequent problem, but shouldn’t be considered normal. Learn about common causes of peristomal itching and what you can do about it.

Get tips to prevent itchy peristomal skin.

Itchy peristomal skin, a condition known as pruritus, can be chronic and difficult to treat. Some people experience itching even with healthy looking skin. Nevertheless, there’s plenty you can do to help prevent or deal with this common problem.

Understanding peristomal itching

To better understand peristomal itching, we surveyed stoma care nurses and their patients. The goal was to compare their experiences with this issue. The results were somewhat surprising:

• Peristomal itching was reported by 87 percent of people with stomas, yet 36 percent of the time the skin appeared healthy – free of breakdown, redness, or rash*
• 71 percent of nurse respondents recall a time when patients reported peristomal pruritus, yet the skin was intact and free of redness*
• Nurses encourage patients to report itchy peristomal skin, however, patients did not commonly tell their healthcare providers*

There are many potential causes of peristomal itching, however, two conditions known to cause it are candidiasis (a fungal skin infection) and dermatitis.

About candidiasis

Candidiasis is a fungal skin infection that is known to cause severe itching. Candidiasis can usually happen when the peristomal skin is warm and moist. It can also be a result of stoma fluid leakage under the barrier or some medications such as an antibiotic.

Here are some tips for avoiding candidiasis:

• Reduce moisture by making sure your pouching system fits properly around your stoma
• Dry off your pouching system promptly after showering, bathing, swimming, or any exposure to water
• Use anti-fungal powder to absorb moisture from broken skin and treat the fungal infection. When using anti-fungal powder, make sure to brush off the excess before applying your pouching system. Stop using powder once the skin is healed, is no longer moist to the touch and the rash is resolved
• Do not use anti-fungal cream under your pouching system as the pouching system won't adhere
• Address and resolve any leakage issues with your stoma care nurse

About dermatitis

Dermatitis, also known as irritant dermatitis, may be caused by an irritant to the skin – such as those in soaps, lotions, and other products. Or it can originate from your skin being exposed to your stomal output due to leakage. Allergic dermatitis is caused by a reaction to a specific irritant or allergen.

Here are some prevention tips:

• Make sure you are using the correct size opening for your pouching system. Use a stoma measuring guide periodically to see if your stoma size or shape has changed
• Work with your stoma care nurse to find the best products for you. A convex skin barrier (instead of a flat one) or a barrier ring, when needed, can help ensure a good fit and prevent leakage
• Make sure you keep your skin care routine simple. Less is better when caring for the skin around your stoma. For most people, water is sufficient for cleaning it
• Address any leakage issues with your stoma care nurse

Other causes of peristomal itching

There may be other causes of peristomal itching, some of which don’t result in visible signs of skin damage. While leakage remains a top contributor to itching, our survey shows that heat and humidity can contribute to itching as well. Also, dryness is a common cause of itchy skin around the stoma with otherwise healthy looking skin. If you experience itching, a simple and easy first step is to remove and replace your pouch – nearly 79 percent of our survey respondents said this reduced the itchiness.

If you have consistent peristomal skin itching, think you may have candidiasis or a form of dermatitis, or suspect you have any other peristomal skin complication, contact your stoma care nurse.

*Based on a survey of 164 patients. Consumer Survey of Pruritus, 2016 Hollister data on file.