You are not alone in thinking that the skin around your colostomy should be exposed to air. Many people who come to the outpatient clinic ask me this question. I want to assure you, as I do them, that a wafer change once or twice weekly with good skin care is enough to keep your skin healthy. This is because products are designed to help maintain skin health. For example, the tapes used on the wafers are “breathable,” having holes in them to allow for air to reach the skin. 

Additionally, the tan or cream colored portion of the wafer is formulated to be gentle to the skin. Many people call this the “waxy” part of the wafer. Actually, this part of the wafer is made of hydrocolloids and tackifiers. The hydrocolloids work to absorb moisture like sweat or water from stoma output. The tackifiers make this part of the wafer sticky or “tacky,” so the wafer adheres well to the skin. Each manufacturer has proprietary recipes for their wafers, so it’s not unusual for some individuals to find one wafer more friendly to their skin than others. Also, manufacturers work to continuously improve and develop new wafer materials to make the products more skin friendly. A good example is Hollister’s “Ceraplus” products. These are specially formulated to contain ceramides, which are waxy components found in healthy skin.

To provide more time without the wafer on your skin, shower once or twice a week without the wafer on. Many people tell me that the days they shower without their pouches on are the best days of the week.

If you still feel like you would like to leave the wafer off for some time, since you have a colostomy this might be possible to do without making a mess. Many individuals with colostomies have a predictable bowel movement schedule. For example, they may have only one BM per day and it occurs shortly after breakfast. Others may have two BMs, but also at predictable intervals. If this applies to you, you can perform your pouch change shortly after a BM and leave the wafer off for a short time before replacing it. 

Also, you might consider learning to manage your bowels using irrigation. Colostomy irrigation involves a daily tap water enema into the colostomy. Over a few weeks, the colon gets used to being emptied at the same time every day with the irrigation. After performing the irrigation, a small pouch or “stoma cap” covers the stoma. Many who irrigate find it to be liberating, because they don’t have to be concerned about dealing with their pouch throughout the day. If you would like to try irrigation, contact your stoma nurse. They can teach you the process and help you order the correct supplies.