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Even mild peristomal skin complications (PSCs) can have several negative effects. Explore the impact of these problems and what you can do to resolve or avoid them.
Although peristomal skin usually starts out healthy, unfortunately, it often doesn’t always stay that way. Many factors affect the skin and can cause problems. These issues are called peristomal skin complications or PSCs and they can impact your life in several ways.
PSCs can range from mild to moderate to severe. In mild cases, skin is still intact, but there may be redness, itching or discomfort. In severe cases, the skin is broken and there may be weeping, ulcerations, pain and bleeding. Even minor PSCs can result in the following:
Soreness and pain
If the skin around your stoma is damaged, it will probably feel sore. Skin damage around the stoma can also be hard to deal with because you need to place the ostomy pouching system over the irritated area.
If your PSC is due to leakage, redness can progress to open raw skin that weeps or even bleeds. This is often very painful. People with ileostomies are at the highest risk of this happening, which can lead to leakage. This is due to digestive enzymes that make ileostomy output very corrosive. However, regardless of your type of ostomy, a change in your stoma or the shape of your abdomen can make your pouching system not fit as well as it used to, leading to leakage.
A cycle of leakage
Stomal output is corrosive to the skin. In turn, this can make it more difficult to get a good skin barrier fit. If your pouching system doesn’t fit well around your stoma, leakage can result. Compromised adhesion can lead to further leakage and skin damage. Poor adhesion or an ill-fitting skin barrier can lead to very frequent barrier changes, which can lead to skin stripping. It’s a vicious cycle that becomes more difficult to resolve with the severity of the PSC.
Negative impact on your social life
Research suggests that even mild skin complications can have a negative impact on your sense of well-being, especially as it relates to your social life. PSCs can create a fear of leakage and a feeling that your quality of life has been compromised. They also may cause you to isolate yourself or refrain from participating in activities you once enjoyed.
Increased healthcare costs and hospital stays
Having skin complications can also impact your finances, depending on your healthcare coverage and out-of-pocket costs. Studies show that skin problems after ostomy surgery contribute to a higher cost of care. PSCs are also associated with longer stays in the hospital.
An American four-year study* of people with different types of ostomies looked at healthcare cost, time spent in the hospital and readmissions. Compared to those with no skin complications, those that developed a PSC:
Lower quality of life
Health economists measure quality of life by surveying people on how they feel about their own wellbeing in key areas. Results show that people with healthy peristomal skin rate their wellbeing about the same as a person without an ostomy, which is great news.
When peristomal skin problems are present, however, self-reported quality of life declines and ranks similarly to other severe health problems, especially as PSCs worsen. This affirms that PSCs have a significant impact on your quality of life.
The good news
Although PSCs are a common occurrence, there are steps you can take to ensure skin health. In addition to routine care of your peristomal skin, selecting products infused with ceramide has been shown to have a positive impact on peristomal skin health.
Your healthcare team can also educate you in how to maintain healthy peristomal skin. If you do experience a PSC, contact your stoma care nurse immediately.
*Taneja, C., Netsch, D., Rolstad, BZ., Inglese, G., Lamerato, L., Oster, G., Clinicial and Economic Burden of Peristomal Skin Complications in Patients with Recent Ostomies JWOCN 2017 COL. 44, No. 4 Page 350-357.
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