If a rash seems to develop with small, painful pimples or pustules rather than a more diffuse irritation, it could be caused by an infection in the hair follicles in the skin around your stoma.
Infection in the hair follicles can develop if you shave the hair in the area around your ostomy too often or incorrectly (e.g. not using a clean, sharp razor, shaving against the direction of the hair growth etc.), or if you tear off the adhesive plate with force, tearing out hair as well. In most cases, scissors or an electric shaver will work better for the skin than a razor.
If your skin is wet and bumpy
Rashes (area of reddening, usually itchy) or with red or purple patches or with white substance over affected areas could be signs a fungal infection. If you have diabetes or lowered immune system, you could be especially at risk for this.
Dark and moist areas are particularly prone to fungal infections, so the most effective prevention is to keep the peristomal skin clean and dry when changing the pouch.
If your skin is bleeding
Start by carefully examining where the bleeding is coming from. Bleeding from the skin around your stoma could be a sign of a contact reaction, and may require treatment or preventive measures, and you must seek advice from your stoma care nurse.
However, a little bleeding from the ostomy itself is not necessarily alarming. The ostomy tissue bleeds easily, similar to gums when flossing or brushing.
Are you having an allergic reaction?
First of all: An allergic reaction is a very rare reaction. However, if you do have one, the skin would likely be quite irritated or possibly itchy in the entire area exposed to the irritant.
Start by looking at the cleaning products you use. Do you ever use perfume, soaps with moisturisers, fragrances or oils? Perhaps alcohol-based cleansing products? Try avoiding these products completely, and wash the peristomal skin gently using water only for some time.
You could also be allergic to some of the supporting products you use, such as sprays, wipes or pastes, possibly even to components of your pouching system – so if the problem persists, talk to your stoma care nurse about alternatives.