On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Sore skin around a stoma is assessed from photos taken at an appliance change plus video, with antifungals, appliance-compatible topical treatment or, where indicated, antibiotics prescribed; a stoma that has stopped working, turned dark or is bleeding heavily is emergency care.
- What it is: damage to the skin under and around the baseplate: contact with output (the cause in about 3 in 4 cases), moisture and candida, allergy to a wipe or adhesive, folliculitis from shaving, or, rarely, pyoderma gangrenosum in people with inflammatory bowel disease.
- How long: protected peristomal skin heals in 1 to 2 weeks; sore skin that is still breaking down after 2 weeks of a corrected fit and barrier products needs the appliance remeasured and the diagnosis rechecked.
- Fit, not cream: ordinary creams leave a greasy film that stops the baseplate sticking and cause more leaks; stoma-specific barrier films, powders and seals protect without breaking the seal, and the aperture is cut to within 2 to 3 mm of the stoma.
- Blockage: a stoma that stops working with cramping pain, a swollen abdomen or vomiting can mean a blockage, which is not a skin problem and not an online consultation: seek emergency care.
- Emergency: call 112 for severe abdominal pain with repeated vomiting and no output, a stoma that has turned dark, dusky or black, heavy bleeding, or redness spreading fast around the stoma with fever.
Some stoma problems are not skin problems. If your stoma has stopped working and you have cramping pain, a swollen abdomen or vomiting, that can be a blockage: seek emergency care, and call 112 if you are in severe pain or vomiting repeatedly. Do the same urgently if the stoma itself turns dark, dusky or black, if there is heavy bleeding, or if redness around it spreads fast with fever. This page, and online care, are for the skin around the stoma.
Can an online doctor help with stoma skin problems?
Yes, for most of them. Sore, red, weeping or itchy skin around a stoma is visible, so it suits photo and video assessment: a doctor can usually identify irritation from leaking output, a fungal rash, folliculitis or a product reaction, and prescribe treatment where needed. Appliance fitting, and problems with the stoma itself, still belong with in-person and stoma-nurse care.[1]
Living with a colostomy, ileostomy or urostomy involves enough logistics without adding a clinic trip every time the skin flares. Mobi Doctor exists for exactly this kind of problem: real, visible, uncomfortable, and very often solvable from home.
How an online consultation helps with stoma care
- Support without the journey: travelling with a leaking or freshly changed appliance is the last thing sore skin needs. You are assessed from home, at a time you choose, evenings and weekends included.
- A cause, not just a cream: the doctor works out why the skin is breaking down: leakage, fit, moisture, infection or a product reaction, because each has a different fix and the wrong cream can make bags stop sticking.
- Works alongside your stoma nurse: the consultation complements stoma-nurse care rather than replacing it, and tells you clearly which problems belong with whom.
- Help wherever you are: if you have moved country, are travelling, or are between services and have no stoma nurse to call, an online doctor bridges the gap and helps you find the local route back into specialist care.
📷 Before your appointment, on your own terms: at a routine appliance change, after cleaning gently with warm water, take two photos in good light: one of the skin right around the stoma, and one from further back showing the whole area the baseplate covers. A photo of the back of the used baseplate helps too: where output has crept under it shows exactly where the seal fails. Only the skin around the stoma needs to be in frame, and photos are shared privately with the doctor.
What the doctor checks in an online stoma care consultation
The assessment is practical and unhurried. The doctor will typically go through:
- Where exactly the skin is sore: soreness that mirrors where output pools points to leakage; a rash reaching only as far as the adhesive points to the products; redness at hair follicles points to folliculitis.
- What the damage looks like: raw, weeping irritation, an itchy rash with small satellite spots (typical of candida), pimple-like bumps, or an ulcer, which is a different and more urgent conversation.[2]
- Your appliance routine: what system you use, how often you change it, how long a seal actually lasts, and whether leaks are becoming more frequent.
- Fit and body changes: weight gain or loss, a bulge around the stoma that could be a hernia, and skin creases that open under the baseplate when you sit or stand.
- Your output: loose, high-volume output (typical with an ileostomy) is far more corrosive to skin than formed output, and changes how aggressive protection needs to be.[1]
- Products in use: barrier films, rings, pastes, powders, wipes and anything else touching the skin, including creams that may be stopping the appliance from sticking.
- Whole-person context: how long you have had the stoma, why it was formed, other conditions such as diabetes or inflammatory bowel disease, and whether you currently have stoma-nurse support at all.
Why is the skin around my stoma sore?
The most common cause by far is output leaking onto skin that was never designed to be in contact with it: digestive output is irritant, and even a few hours under a lifted seal can leave skin raw and weeping. Behind leakage sit fit problems: an aperture cut too large, body shape changed by weight or a hernia, or creases that break the seal.[1] None of this means you are managing your stoma badly; skin trouble affects a large share of people with a stoma at some point.
Leakage and fit, the usual suspects
When output repeatedly reaches the same patch of skin, that patch becomes red, moist and sore, and a sore, uneven surface then holds the next baseplate even less well, so the problem feeds itself. The way out is rarely a stronger cream: it is restoring the seal: an aperture trimmed to the stoma's current size, a barrier ring or paste to fill dips and creases, and sometimes a convex baseplate fitted with stoma-nurse guidance. Frequent aggressive changes add their own damage, called skin stripping, which gentle removal technique and adhesive remover spray prevent.
Rashes, infections and rarer causes
Constant warmth and moisture under a baseplate suit candida perfectly: an itchy, red rash with small spots scattered beyond its edge, treated with antifungals rather than barrier products alone.[2] Folliculitis, infected hair follicles from repeated adhesive pulls, shows as small pimples and settles with careful shaving technique and treatment where needed.[5] True allergy to modern appliance materials is rarer than people assume, but it does occur, and a rash that consistently matches the adhesive footprint raises it.[4] And one rare condition matters out of proportion to its frequency: a rapidly enlarging, painful ulcer with a purple edge may be pyoderma gangrenosum, seen particularly alongside inflammatory bowel disease; it needs specialist care promptly, not more barrier cream.[3]
Stoma nurse or doctor: who should you contact?
For appliance choice, fitting, templates, convexity and product samples, a stoma care nurse is the right expert, and nothing online replaces that hands-on service. A doctor comes in when skin needs diagnosis and prescription treatment: infected or rash-like skin, soreness that persists despite a good seal, or an ulcer. The two work best together, and an online consultation slots in when you need medical eyes on the skin quickly, or when you are between stoma services: after moving country, while travelling, or waiting for a first appointment.
If you are not sure which side of that line your problem sits on, that is itself a fair question for the consultation: the doctor will treat what is medical and point the rest, specifically, to the right service near you.
Which stoma skin problem is yours?
This is the framework the doctors use, aligned with the cited guidance:[1][2]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Raw, weeping skin where output pools under the seal | Refit: aperture resized, barrier ring or paste, protective film; stoma-nurse input on the appliance | Usually yes, alongside stoma-nurse support | If skin keeps breaking down despite a corrected fit |
| Itchy red rash with small outlying spots under the baseplate | Antifungal treatment for likely candida, plus moisture control | Usually yes | If the rash fails a full treatment course |
| Pimple-like bumps at hair follicles around the stoma | Gentler hair removal, warm compresses; treatment if spreading | Usually yes | If it worsens or the area becomes hot and painful |
| Rash matching exactly where the adhesive sits | Review of products; trial change of appliance brand with stoma-nurse help | Often, case-dependent | Persistent cases may need specialist patch testing in person |
| Enlarging painful ulcer, purple edge, or a hard lump; stoma dark or not working, with pain or vomiting | Prompt specialist or emergency assessment | No: assessment and referral only | Always; call 112 for severe pain, repeated vomiting or a black stoma |
Not sure which row is your skin? A doctor can tell you in one consultation.
See available times →Treatment options for stoma skin problems
What you can do yourself
Protect the seal and the skin will usually follow. Check the aperture against your stoma's current size at every change, because stomas change shape for months after surgery and with any weight change; the opening should hug the stoma closely without cutting into it. Clean with warm water and a soft cloth, pat dry thoroughly, and avoid soaps, wipes and creams not made for stoma use: many leave residues that stop adhesives sticking. For dips and creases, barrier rings and paste fill the gaps; for fragile skin, a barrier film gives a protective layer, and the crusting technique (stoma powder dusted on, sealed with barrier film) lets a weepy patch heal under the next baseplate.[1] Remove appliances slowly, supporting the skin, with adhesive remover if changes hurt.
Prescription treatment
A prescription is never issued without a consultation. After looking at the skin properly, the doctor can prescribe an antifungal for candida, a short course of a suitable topical steroid preparation for inflamed, non-infected skin, chosen in forms that do not stop appliances sticking, or antibiotics where there are genuine signs of bacterial infection such as spreading, hot, painful redness; antibiotics are not used for simple irritation, and only prescribed when there are signs of infection.[2] Ulcers, suspected pyoderma gangrenosum and anything needing the appliance system itself rebuilt are referred, promptly and by name, to specialist and stoma-nurse services.[3]
When stoma skin problems are handled online, and when you need in-person care
Treated online: leakage-related skin irritation, including practical refitting advice alongside your stoma supplies service; likely fungal rashes and folliculitis around the stoma; product-reaction reviews; sore skin while you are travelling or between stoma services; and reviews to check healing is on track.
In-person care: suspected pyoderma gangrenosum or any enlarging ulcer, promptly; a possible parastomal hernia, for in-person examination; granulomas and overgrowths on the stoma edge that need hands-on treatment; appliance and convexity refits, to stoma-nurse services; and every emergency pattern: blockage symptoms, a dusky stoma, heavy bleeding, or spreading infection with fever, which belong in hospital care today. Peristomal problems share features with other skin conditions the doctors assess online, including fungal skin infections and intertrigo, and the same honest rule applies to all of them: what cannot be handled remotely gets named, not managed badly online.
When to get in-person care
Seek emergency care, and call 112 if severe, when a stoma stops producing output and you have cramping pain, a swollen abdomen or vomiting; when the stoma turns dark, dusky or black; or when there is heavy or persistent bleeding. Get same-day in-person care if redness around the stoma spreads quickly, feels hot and comes with fever, which can mean cellulitis, or if any wound near the stoma is rapidly enlarging and very painful.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Upload your photos, then speak to a licensed doctor: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Sore skin around a stoma can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about stoma skin problems
Why is the skin around my stoma sore?
Sore skin around a stoma is most often caused by output leaking onto the skin under the baseplate, because the aperture is too large, the body shape has changed, or a crease opens under the seal when you move. Other causes are moisture and a candida rash, an allergy to an adhesive, wipe or spray, folliculitis from shaving the area, over-frequent appliance changes, and rarely pyoderma gangrenosum.
What does a stoma skin problem look like?
Irritated peristomal skin is red, raw, weeping or sore in the exact shape of where output reaches, often crescent-shaped below the stoma. A candida rash is itchy and red with small spots scattered beyond its edge. An allergy mirrors the shape of the baseplate or a wipe. Folliculitis shows small pustules on hairs. Pyoderma gangrenosum is a painful, enlarging ulcer with a purple edge.
Can an online doctor prescribe treatment for sore skin around a stoma?
Yes, after a consultation. A prescription is never issued without one: the doctor examines your photos and history by video first, then prescribes antifungals, appliance-compatible topical treatments or, where indicated, antibiotics for the stoma skin, with the prescription sent to a pharmacy near you. Appliance fit questions are shared with your stoma nurse, who supplies templates and products.
Do I have to show my stoma on camera?
No. Clear photos taken privately before the appointment, at a routine appliance change, are usually enough for a stoma skin assessment, and only the skin around the stoma needs to be in frame. The video call itself can stay face to face while the doctor reviews the pictures, asks about output, leaks and products, and agrees a plan with you.
Why does my skin keep breaking down under the baseplate?
Almost always because output is repeatedly reaching the same patch of skin around the stoma: the aperture is slightly too large, your body shape or weight has changed, the stoma has shrunk or retracted, or a crease opens under the seal when you sit or move. Sore skin then holds the next baseplate less well, so the leak repeats. Remeasuring, a seal or ring, and sometimes a convex baseplate break the cycle.
Should I put a cream on the sore skin around my stoma?
Usually not an ordinary cream: most leave a greasy film that stops the appliance sticking, which causes more leaks and more damage to the stoma skin. Stoma-specific barrier films, rings and powders protect without breaking the seal, using the crusting technique of powder, dab off, then film. If a medicated cream or antifungal is needed, the doctor chooses one that is compatible with the appliance.
When should I contact my stoma nurse instead of a doctor?
For anything about the appliance itself: fit reviews, templates, convex baseplates, seals, new product samples and routine stoma checks, your stoma nurse is the expert. A doctor is the right call when the skin around the stoma needs a diagnosis or prescription, when infection or a fungal rash is possible, when a wound is enlarging, or when you have no stoma nurse where you are living or travelling.
Is the rash around my stoma a fungal infection?
Quite possibly, if it is itchy, red and shows small spots scattered just beyond the main rash: warmth and moisture under a baseplate are ideal conditions for candida, especially after antibiotics or in diabetes. A fungal rash around a stoma is treated with an appliance-compatible antifungal powder or cream plus better moisture control, and it clears within one to two weeks once the seal is dry.
How long does sore skin around a stoma take to heal?
Once output is kept off it and a barrier is in place, peristomal skin heals within one to two weeks, and a candida rash clears in the same time with an antifungal. Skin still breaking down after two weeks of a corrected fit, or an ulcer that is enlarging rather than shrinking, needs the appliance remeasured, the diagnosis rechecked and sometimes in-person review for pyoderma gangrenosum or a hernia.
What can I do myself to protect the skin around my stoma?
Measure the stoma every few weeks and after weight change and cut the aperture to within 2 to 3 mm, change the appliance at the interval advised rather than more often, warm the baseplate before applying it, use a seal or ring for uneven skin, remove the baseplate gently with adhesive remover, wash with water only, dry fully, and use the crusting technique on any broken stoma skin before the next baseplate.
How can I prevent stoma skin problems coming back?
Prevent recurrent stoma skin problems by keeping the aperture matched to the stoma as it changes, dealing with any leak the day it happens rather than waiting for the next change, managing loose output with diet or medicines, keeping skin folds dry in heat, avoiding soaps, wipes and sprays not designed for stoma skin, not shaving the area with a blade, and booking a fit review with the stoma nurse at least yearly.
Could the sore area around my stoma be something other than irritation?
Yes. A painful ulcer with a purple, undermined edge that enlarges despite protection suggests pyoderma gangrenosum, commoner with Crohn's disease or ulcerative colitis, and needs specialist treatment. A rash mirroring the baseplate shape suggests allergy to an adhesive. Warty thickening suggests chronic urine contact around a urostomy. Each looks different from leak damage on good photos.
Is stoma skin care different in pregnancy, after weight change or in hot weather?
Yes. In pregnancy and with weight gain or loss the abdomen changes shape, so the stoma and its aperture need remeasuring every few weeks and the stoma nurse may suggest a different baseplate. In hot weather and on holiday, sweat shortens appliance wear time and candida is commoner, so change more often, dry the skin fully, and pack extra supplies and antifungal powder.
- Irritant contact dermatitis, DermNet New Zealand Trust, reviewed 2024.
- Candida - skin: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2023.
- Pyoderma gangrenosum, DermNet New Zealand Trust, reviewed 2024.
- Allergic contact dermatitis, DermNet New Zealand Trust, accessed August 2026.
- Folliculitis, DermNet New Zealand Trust, accessed August 2026.
- Colostomy: living with, NHS, National Health Service (UK), reviewed September 2020.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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