A well-functioning stoma relies on having strong and healthy skin around it. When the skin around a stoma becomes diseased or develops a rash, it affects the function of the stoma. Skin problems often result in the stoma appliance not adhering properly, leading to leaks of urine or faeces onto the skin. The leakage itself exacerbates the skin problem, creating a vicious cycle. Below are the most common causes of rash around a stoma:
The most common cause of rash around a stoma is chemical damage. Urine or faeces leakage onto the skin can cause a rash. Leakage can be due to poorly fitted equipment, fistulas, and scar changes leading to uneven skin. Many users also experience weight gain after surgery, which can also cause leakage from the stoma. Additionally, there can be direct leakage from the stoma itself.
Damage from external factors can cause a rash. This can include friction from the equipment, belts that apply pressure, and failure to use adhesive removers resulting in skin tearing. Improper removal of hair around the stoma can also cause a rash.
Stoma users often experience infections in the skin around the stoma. These can include bacterial infections such as impetigo or folliculitis. Additionally, viral infections like herpes, warts, or molluscum contagiosum can occur. Yeast infections are also not uncommon among stoma users.
A skin disorder can develop around a stoma. Patients with psoriasis, seborrheic dermatitis, and atopic eczema can experience a rash around their stoma. Approximately 20% of rashes around a stoma are due to an underlying skin disorder. Many stoma users question whether the rash is caused by an allergy to stoma products. Less than 1% of users are allergic to stoma products, so allergy is not a common cause of rash around a stoma.
Changes in skin colour around a stoma are not uncommon. Post-inflammatory hyperpigmentation, which means increased pigment in the skin after inflammation, is very common. Some individuals develop a red/pink skin colour due to blood vessel growth in the skin. Others may experience changes in skin colour or growths due to urine leakage onto the skin. A few patients may experience immunological reactions in the skin around the stoma, where the body's own defence system attacks the skin. This can be seen in conditions such as Crohn's disease, which affects the skin, or very rarely, in a condition called pyoderma gangrenosum, which causes painful sores.
Stoma users experiencing troublesome rashes should contact their stoma nurse or doctor for prompt and appropriate assistance.
