9 Essential Skin Care Tips for Ostomates

Editorially reviewed by: A to Zen Therapies Editorial Team in accordance with our Editorial Policy.

A well-fitting pouch, healthy peristomal skin and access to specialist support can make everyday stoma care more comfortable and predictable.

Living with a stoma can involve a period of physical and emotional adjustment. Learning how to change a pouch, protect the surrounding skin, manage different foods and prepare for work, travel or exercise may initially feel overwhelming.

With appropriate education and support, however, many people return to active and fulfilling lives. The goal of ostomy care is not to create a complicated routine. It is to maintain a secure pouch seal, protect the skin and recognise problems early.

A stoma-care nurse should remain the primary source of personalised advice. Products and routines that work well for one ostomate may not suit another, particularly when stoma type, output, abdominal contours and skin sensitivity differ.

Quick Answer

Effective ostomy skin care involves gently cleaning and thoroughly drying the skin, using a correctly fitted pouching system, responding promptly to leakage and asking a stoma nurse about persistent redness, soreness or adhesion problems.

Dietary and hydration requirements depend on whether someone has a colostomy, ileostomy or urostomy. Sudden changes in output, severe abdominal pain, vomiting, significant bleeding or signs of dehydration require prompt medical advice.

⭐ What Is Peristomal Skin?

Peristomal skin is the skin immediately surrounding a stoma. It should generally look similar to the skin elsewhere on the abdomen. Persistent redness, broken skin, burning, weeping or soreness may indicate leakage, friction, sensitivity to a product or another condition requiring assessment.

Key Takeaways

• A stoma is a surgically created opening that allows stool or urine to leave the body.

• Colostomies, ileostomies and urostomies have different functions and care considerations.

• Healthy peristomal skin should not remain persistently sore, wet or broken.

• Leakage is one of the most common causes of skin irritation.

• Warm water is often sufficient for cleaning the area.

• Perfumed wipes, oily products and moisturisers can interfere with pouch adhesion.

• A pouch opening that is too large exposes the skin to output.

• Persistent leakage should prompt a pouch-fitting review rather than repeated use of additional products.

• Ileostomates can be at increased risk of dehydration and salt loss.

• Supplements, including fish oil and probiotics, do not replace individual dietary advice.

• Ongoing pain, swelling, bleeding or sudden output changes require professional assessment.

Table of Contents

1. What Is an Ostomy?

2. Why Does the Skin Around a Stoma Become Sore?

3. Nine Practical Ostomy Skin-Care Tips

4. Diet and Hydration With a Stoma

5. Clothing, Exercise, Swimming and Travel

6. Supplements and Fish Oil

7. Emotional Adjustment and Support

8. When to Contact a Stoma Nurse or Doctor

9. How A to Zen Therapies Can Help

10. Frequently Asked Questions

    
    

What Is an Ostomy?

An ostomy is a surgically created opening in the abdomen. The opening itself is called a stoma. It allows stool or urine to leave the body when the usual route is unavailable or needs to rest.

Common types include:

• Colostomy: Part of the large bowel is brought through the abdominal wall.

• Ileostomy: Part of the small bowel is brought through the abdominal wall.

• Urostomy: Urine is diverted through an opening in the abdomen.

A stoma may be temporary or permanent. The reasons for surgery can include bowel or bladder cancer, inflammatory bowel disease, diverticular disease, bowel obstruction, injury or congenital conditions.

The NHS colostomy overview explains what the procedure involves and what people may expect during recovery. Readers preparing for life following surgery may also find our guide to post-hospital care useful.

Why Does the Skin Around a Stoma Become Sore?

The stoma itself is normally moist and pink or red. Because it contains many small blood vessels, slight spotting can sometimes occur during gentle cleaning. The surrounding skin, however, should generally remain intact and resemble the rest of the abdominal skin.

Common causes of peristomal irritation include:

• Stool or urine leaking beneath the baseplate

• An opening cut too widely around the stoma

• Frequent or forceful pouch removal

• Adhesive-related skin injury

• Sensitivity to a particular product

• Sweat or moisture affecting adhesion

• Changes in stoma shape or abdominal contours

• Fungal or bacterial infection

• Pre-existing skin conditions

• Granulomas or other tissue changes

The Royal Free London’s colostomy guidance identifies leakage, allergy, frequent pouch changes and template size among the possible causes of sore skin.

Persistent irritation should not simply be covered with additional powder, paste or adhesive. The underlying cause needs to be identified.

Nine Practical Ostomy Skin-Care Tips

1. Clean the Area Gently

Warm water is usually sufficient to clean the stoma and surrounding skin. Use a soft cloth or dry wipe and avoid aggressive rubbing.

Perfumed soaps, baby wipes, oils and moisturising cleansers may leave residue or irritate the skin. They can also prevent the pouch from adhering properly. If a cleanser is required, use only one recommended by your stoma-care team.

2. Dry the Skin Thoroughly

The skin should be completely dry before applying a new pouch. Moisture beneath the adhesive can weaken the seal and increase irritation.

Pat rather than rub the area. If the skin is broken, weeping or too painful to dry comfortably, contact a stoma nurse.

3. Check the Pouch Opening

The opening in the baseplate should fit closely around the stoma without cutting or pressing into it. A gap can allow output to contact the skin, while an opening that is too tight may cause pressure or trauma.

Stomas can change size, particularly during the weeks following surgery. Weight changes,

hernias and altered abdominal contours can also affect pouch fit. Ask your stoma nurse how often you should measure your stoma and when to review the template.

4. Respond to Leakage Immediately

Do not leave a leaking pouch in place until the usual change time. Stool—particularly ileostomy output—can irritate skin quickly.

Change the pouch, gently clean the area and look at the back of the removed baseplate. The pattern of output may help identify where the seal failed.

The University Hospitals Birmingham’s ileostomy guidance recommends requesting a stoma-clinic review for persistent or unexplained leakage, itching or other management problems.

5. Remove Adhesives Carefully

Pulling a pouch away quickly can strip the skin’s outer layer. Support the skin with one hand while gradually removing the adhesive with the other.

An adhesive-removal product may be helpful when recommended by the stoma nurse. Check that it is compatible with the pouching system and does not leave an oily residue.

6. Use Barrier Products Only When Appropriate

Barrier films, rings, seals, powders and convex systems can be useful, but more products do not automatically create a better seal.

“Crusting”, which combines stoma powder and barrier film, may sometimes be recommended for moist or damaged skin. It should ideally be demonstrated by a stoma nurse because unnecessary layers can reduce adhesion or conceal a continuing leak.

💡 Expert Tip: When recurring soreness follows the same shape around the stoma, look at the underside of the removed baseplate. Output in the same position can point to a fitting problem that requires adjustment rather than another skin product.

7. Protect Ageing or Fragile Skin

Skin can become thinner and more vulnerable with age, long-term steroid use or certain health conditions. Gentle adhesive removal becomes especially important.

Changes in weight, posture or abdominal shape may also make an established pouching system less effective. Elastic strips or a different baseplate may help, but product changes should be guided by a stoma nurse.

For older people with limited mobility, pressure-related skin damage elsewhere on the body must be considered separately from peristomal irritation. Read How to Prevent Pressure Sores in Immobile Elderly Patients.

8. Keep a Simple Skin and Leakage Record

Record when leakage occurs, what the skin looks like, recent activities and any product changes. Photographs may be useful for showing the stoma nurse how the area changes between appointments, provided they are stored securely.

A record can help identify patterns involving:

• Particular body positions

• Exercise or sweating

• Changes in output

• Delayed pouch changes

• New products

• Weight or body-shape changes

9. Obtain a Professional Pouch-Fitting Review

Frequent leakage is not something an ostomate should simply accept. A specialist can assess the stoma’s height, shape, surrounding folds and abdominal movement.

Commercial suppliers such as shop ostomy supplies may offer access to different pouches, barriers and accessories. However, product selection should be based on clinical suitability rather than advertising or the number of accessories available. Inclusion of a supplier does not constitute a medical endorsement.

📊 Evidence Snapshot

• Leakage beneath the baseplate is a common cause of sore peristomal skin.

• Warm water is generally sufficient for routine cleaning.

• Perfumed or oily products may irritate the skin and reduce adhesion.

• A correctly sized pouch opening helps limit contact between output and skin.

• Persistent soreness or repeated leakage warrants review by a stoma-care nurse.

• Ileostomy output contains digestive enzymes and can damage exposed skin rapidly.

Diet and Hydration With a Stoma

There is no universal “ostomy diet”. Requirements depend on the type of stoma, time since surgery, underlying condition, output and individual tolerance.

Eating With a Colostomy

Many people with a colostomy can gradually return to a varied, balanced diet. Cambridge University Hospitals notes that most people with a colostomy can eat a normal balanced diet, although particular foods may affect wind, odour or consistency differently.

Introducing unfamiliar foods one at a time can make individual reactions easier to identify.

Eating and Drinking With an Ileostomy

People with an ileostomy may lose more fluid and salt because the large bowel is bypassed. Individual hydration requirements can vary significantly, particularly with high output.

Possible signs of dehydration include:

• Increased thirst

• Dry mouth

• Dark or reduced urine

• Dizziness

• Weakness or unusual tiredness

• Headache

• Muscle cramps

• Rapid heartbeat

• Confusion or fainting

The NHS guidance on ileostomy complications advises seeking professional guidance when high output or dehydration symptoms occur.

Simply drinking large quantities of plain water may not always correct the salt and fluid losses associated with a high-output ileostomy. Follow the personalised plan provided by a stoma nurse, surgeon or dietitian.

Foods and Blockage Risk

Some people with an ileostomy may be advised to chew food thoroughly and introduce higher-fibre foods gradually after surgery. Advice varies, so avoid permanently excluding nutritious foods without professional guidance.

A significant reduction or stoppage in output accompanied by cramping, a swollen abdomen or stoma, nausea or vomiting may indicate a blockage. Colostomy UK’s blockage guidance outlines symptoms that require urgent assessment.

For broader information about balanced eating, explore our Nutrition Hub. Nutrition content should supplement—not override—the plan provided by the person’s specialist team.

Food and fluid needs vary by stoma type. A simple diary can help identify individual patterns without imposing unnecessary restrictions.

Clothing, Exercise, Swimming and Travel

Most people do not need specialist clothing. Garments should feel comfortable and should not obstruct the pouch or repeatedly rub against the stoma.

Emptying the pouch before physical activity can improve comfort. People returning to exercise after surgery should follow their surgical team’s guidance, rebuild activity gradually and seek advice before heavy lifting.

Swimming is usually possible once surgical wounds have healed and the healthcare team has confirmed that it is safe. Modern pouches are designed to be water resistant, but additional seals may help some people.

When travelling:

• Carry more supplies than you expect to use.

• Divide supplies between hand luggage and checked baggage.

• Keep pouches away from excessive heat.

• Carry disposal bags and cleaning materials.

• Identify suitable toilets in advance.

• Ask the stoma nurse about dietary or hydration concerns.

• Keep essential medicines and clinical information accessible.

Macmillan explains that having a colostomy, ileostomy or urostomy should not prevent travel, although additional planning may be necessary.

Supplements and Fish Oil

Fish oil contains omega-3 fatty acids, but there is no established evidence that taking a fish-oil supplement protects peristomal skin, controls output or prevents ostomy complications.

Fish oil can affect bleeding risk and interact with certain medicines. Anyone considering it for another health reason should first discuss the product, dose and possible interactions with a pharmacist, dietitian or doctor.

The same caution applies to probiotics, vitamins, minerals and herbal supplements. Ostomates do not automatically need supplements, and absorption can differ according to the surgery performed. Blood tests and an individual dietary assessment are more reliable than assuming a deficiency.

Readers interested in dietary sources of unsaturated fats can read Healthy Fats: Types, Benefits and Nutrition.

Emotional Adjustment and Support

Adapting to a stoma can affect body image, confidence, intimacy, work and social activity. Concern about leakage, odour or access to toilets is understandable, particularly soon after surgery.

Practical education often improves confidence, but emotional support may also be needed. Speak with a stoma nurse, GP or mental-health professional if low mood, anxiety or avoidance persists.

Connecting with other ostomates can reduce isolation and provide practical insight. However, another person’s product, diet or routine may not be appropriate for your stoma.

Our article about how mental health can affect physical wellbeing discusses why emotional and physical recovery should be considered together. Some people also find morning affirmations useful as a personal confidence practice, although they do not replace psychological care.

When to Contact a Stoma Nurse or Doctor

Ask a stoma-care nurse for advice about:

• Repeated pouch leakage

• Persistent redness, itching or burning

• Broken, moist or weeping skin

• Difficulty keeping the pouch attached

• A noticeable change in stoma size or shape

• New bulging around the stoma

• Frequent bleeding during pouch changes

• Unexpected or prolonged changes in output

• Questions about food, hydration or products

Seek urgent medical assessment for:

• Severe or worsening abdominal pain

• Vomiting with reduced or absent stoma output

• A markedly swollen abdomen or stoma

• Heavy or persistent bleeding

• A stoma that becomes very dark, black, pale or unusually cold

• Severe dehydration, fainting or confusion

• Fever with spreading redness, discharge or worsening pain

• A sudden high-volume output that cannot be managed using the existing clinical plan

How A to Zen Therapies Can Help

A to Zen Therapies does not provide stoma care, pouch fitting, nutritional management or treatment for peristomal skin complications. These concerns require assessment by a stoma-care nurse, surgeon, GP, dermatologist or specialist dietitian.

Once surgical healing is complete and the treating team has provided clearance, some people may consider relaxing massage or face and head massage for general relaxation and temporary relief from everyday muscular tension.

The therapist must be told about the stoma, recent surgery, hernias, medical appliances and ongoing treatment. Massage should not be applied over the stoma, pouch, irritated skin, recent surgical areas or a suspected parastomal hernia. Complementary therapy cannot treat leakage, infection, bowel obstruction or other ostomy complications.

Readers interested in how different healthcare roles may contribute to recovery can also read Modern Nursing and Holistic Therapies.

Continue Exploring Healthy Living and Recovery

Living confidently with a stoma may involve skin care, nutrition, emotional adjustment, safe activity and professional follow-up. Explore our Skin Health Hub, Nutrition Hub, Senior Wellness Hub and Mental Wellbeing Hub for related evidence-informed guidance.

Frequently Asked Questions

What should healthy skin around a stoma look like?

It should generally resemble the surrounding abdominal skin. Persistent redness, wetness, broken skin, burning or soreness is not something you should simply accept.

Can I use soap around my stoma?

Warm water is usually sufficient. Perfumed, moisturising or oily soaps can irritate the skin and affect adhesion. Follow your stoma nurse’s product advice.

Why does my stoma bleed when I clean it?

Stoma tissue contains many blood vessels, so slight surface spotting may occasionally occur. Persistent, heavy or unexplained bleeding requires professional assessment.

How close should the pouch opening be to the stoma?

It should fit closely without cutting into or constricting the stoma. Follow the measuring guidance provided for your particular pouching system.

What should I do when my pouch leaks?

Change it promptly, clean and dry the skin and check where the seal failed. Repeated leakage requires review by a stoma-care nurse.

Can I put moisturiser around my stoma?

Ordinary moisturisers may prevent adhesion. Do not use one beneath the baseplate unless your stoma nurse recommends a compatible product.

Can I swim with a stoma?

Many ostomates can swim after recovering from surgery. Check that the pouch seal is secure and ask your clinical team about timing after an operation.

Do I need a special diet?

Not necessarily. Many people with a colostomy can eat a balanced diet, while those with an ileostomy may require more individualised guidance about food, fluids and salt.

Does fish oil help ostomy skin?

There is no established evidence that fish oil prevents peristomal skin damage. Ask a clinician or pharmacist before taking supplements.

When should reduced output concern me?

A change should be interpreted according to your normal pattern and stoma type. Reduced

or absent output accompanied by cramping, swelling, nausea or vomiting requires urgent assessment.

Who should assess sore peristomal skin?

A specialist stoma-care nurse is usually the most appropriate first contact. A GP, surgeon, dermatologist or tissue-viability specialist may become involved when necessary.

References

• NHS — Colostomy

• NHS — Complications of an Ileostomy

• Royal Free London — Colostomy Discharge and Skin-Care Guidance

• Colostomy UK — Caring for a Person With a Stoma

• Colostomy UK — Stoma Blockage

• Cambridge University Hospitals — Healthy Eating With a Colostomy

• Macmillan Cancer Support — Travelling With a Stoma