The 4-Step Peristomal Hygiene Routine for Healthy Ostomy Skin
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Sore, red, itchy skin around a stoma is the single most common problem people with an ostomy face — and clinicians agree most of it is preventable. A 2025 international protocol published in the Journal of Wound, Ostomy & Continence Nursing distils healthy stoma skin down to four simple habits: Cleanse, Assess, Secure, Support. Here’s how to build them into your pouch-change routine.
What is peristomal skin, and why does it matter?
Peristomal skin is the area of skin immediately surrounding your stoma — the skin your pouch baseplate sticks to. When it stays healthy, your pouch seals reliably and comfortably. When it becomes damaged, pouches leak, wear time drops, and a frustrating cycle of irritation and further leaks begins. Damage to this skin is called a peristomal skin complication (PSC), and it is one of the most frequent — yet most avoidable — challenges in ostomy care.
The 4-step peristomal hygiene routine
1. Cleanse — water first, keep it simple
Clean the skin around your stoma with plain warm water and a soft cloth or gauze at every pouch change. Avoid ordinary soaps, moisturising body washes, baby wipes and alcohol wipes: they leave behind oils, fragrance and residue that stop your baseplate adhering. Pat — don’t rub — the skin completely dry before you apply a fresh pouch. Adhesive sticks to dry skin, not damp skin.
2. Assess — look at the skin every single change
Every pouch change is a free skin check. Look at the peristomal skin for redness, itching, a rash, weeping or broken areas. Healthy peristomal skin looks the same as the skin on the rest of your abdomen. Catching a small change early — before the skin breaks down — is the difference between a quick adjustment and weeks of painful, leak-prone damage. If you’re not sure what you’re seeing, photograph it and show your stoma nurse.
3. Secure — a snug, correctly-sized fit
The opening in your baseplate should match the size and shape of your stoma closely. Any gap between the baseplate and the stoma lets output sit on the skin — the number-one cause of irritation and leaks. In the first weeks and months after surgery your stoma shrinks as swelling settles, so re-measure regularly and adjust your cut-to-fit or moulding accordingly. On uneven skin, a barrier ring, seal or paste can fill dips and create a flat, reliable surface.
4. Support — protect the barrier between changes
Help the skin defend itself. A skin-barrier film lays down a protective layer that shields against output and adhesive stripping; barrier rings and belts add security where a flat baseplate struggles. Just as important: don’t change your pouch more often than you need to. Over-cleaning and frequent removal strip away the healthy outer skin you’re trying to protect. Change on a planned schedule and when there’s a genuine leak — not “just in case.”
When should you see a stoma nurse?
Contact your stoma care nurse or doctor promptly if you notice any of the following, as they need proper assessment rather than home management alone:
- Skin that is broken, weeping, bleeding or increasingly painful
- A rash, blisters, or raised bumps that spread
- Leaks that keep happening despite a correctly-sized, well-fitted pouch
- Any change in the colour of the stoma itself (it should be pink/red and moist)
- Skin problems that don’t improve within a few days of adjusting your routine
Products that support healthy peristomal skin
The right supplies make this routine easier to keep up. At EMIS+ we stock the essentials Singapore ostomates rely on:
- Ostomy pouches & baseplates in cut-to-fit and mouldable options
- Barrier films, rings, seals and pastes to secure and protect the skin
- Wound & skin care supplies for irritated or broken skin
Browse the full range at emis.asia, Singapore’s trusted source for ostomy and wound care.
Frequently asked questions
What are peristomal skin complications?
Peristomal skin complications (PSCs) are problems affecting the skin around a stoma, such as redness, irritation, rashes, and broken or weeping skin. They are the most common complication in ostomy care and are usually caused by output leaking onto the skin, poorly fitted pouches, or harsh cleansing. Most PSCs are preventable with a consistent skin-care routine.
How should I clean the skin around my stoma?
Use plain warm water and a soft cloth or gauze at each pouch change, then pat the skin completely dry before applying a new pouch. Avoid soaps, moisturising washes, baby wipes and alcohol wipes, because their oils and residue prevent the baseplate from sticking.
Can I use soap or wipes on my stoma?
It’s best to avoid them. Most soaps and baby wipes contain oils, fragrances or moisturisers that leave a film on the skin and reduce how well your baseplate adheres, which can lead to leaks. Plain water is enough for routine cleaning.
How do I know if my ostomy baseplate fits correctly?
The baseplate opening should closely match the size and shape of your stoma with no skin showing between the stoma and the baseplate. Gaps allow output to reach the skin and cause irritation. Because a new stoma shrinks over the first few months, re-measure regularly and adjust the size.
Why does the skin around my stoma keep getting irritated?
The most common reason is output leaking onto the skin because of a gap or poor fit, but harsh cleansing, changing the pouch too often, and adhesive sensitivity can also contribute. Reviewing the fit, using a barrier film or ring, and cleaning gently often resolves it. Persistent irritation should be checked by a stoma nurse.
How often should I change my ostomy pouch?
Follow the schedule your stoma nurse recommends for your product, and change when there is a genuine leak. Changing more often than necessary “just in case” can strip the healthy outer layer of skin and actually cause irritation.
Reviewed by the EMIS+ Care Team. This article is general information and is not a substitute for individual advice from your stoma care nurse or doctor.
Source: Beitz JM, Isaac D, Villa G, Schwartzberg DM, de Paula MB, Jones F, Milne C. Peristomal Hygiene: A Protocol of Care to Address a Global Crisis in Ostomy Care. Journal of Wound, Ostomy & Continence Nursing. 2025. doi:10.1097/WON.0000000000001287.