Ask the Ostomy Nurse
Linda Coulter has been a Certified Wound Ostomy & Continence Nurse for 10 years. In addition to working with hundreds of people with stomas, she has trained several WOC nursing students at the R.B. Turnbull Jr. School of WOC Nursing. Linda has presented nationally and internationally on ostomy related topics. From her home base at University Hospitals’ Ahuja Medical Center, Linda is active in raising Ostomy Awareness, and works to distribute ostomy supplies to people in need throughout the world.
Hair Under Wafer
I was told after surgery not to shave around my stoma, but it hurts something fierce when I pull off the wafer and the hair gets ripped out. What can I do about this problem?
Let’s talk about making removing your wafer more comfortable. Given that the hair around your stoma is being pulled out with each pouch change, minimizing the amount of hair will provide more comfort.
Convex pouching systems can provide a better match between the pouch and the contour of your abdomen around the stoma. By doing so, the pouch will fit better and should leak less. There are many types of convex pouching systems and it can be difficult and confusing to determine the one that will work best for you on your own. Ideally, you should visit your stoma nurse. They can assess your stoma and abdomen and recommend the best pouching system for you. They will also provide you with some products and help you order the correct items from your supplier. However, if you don’t have access to a stoma nurse, there are other ways to help you identify a pouching system that will work for you.
You may have been told not to shave the hair around your stoma using an instrument like a disposable razor. This type of blade can irritate your skin and could easily cut the stoma. Because there are a large number of blood vessels near the surface of the stoma, it can bleed easily. This is especially true if someone is taking blood thinners (anticoagulants) such as heparin, Xarelto or Eliquis.
For many years, each pouch manufacturer used a filter with a similar design: a carbon/charcoal filter, located at the top of the pouch, with a few tiny holes in the plastic of the pouch that allow gas to escape. Again, designs were similar, but exactly which filter they used and how it was attached varied by manufacturer. As stated above, with all of those pouches, people have told me either that the filters don’t work or that they don’t work after a day or so of wearing the pouch.
So how can you safely remove the hair around your stoma? There are two main ways. The first is to trim the hair using mustache or beard clippers. These can be purchased relatively inexpensively from your local pharmacy or online. Use the lowest setting available. Trim the hair by moving the clippers in the direction of the hair growth, which is usually toward the midline. Going in the opposite direction can irritate the hair follicles. When using clippers, avoid using shaving cream or gel, which can leave residue on the skin and prevent the ostomy pouch from adhering well. One trick ostomy nurses use is to apply pectin-based stoma powder to the dry hair. This helps the hair stand up, making it easier to trim.
Additionally, there are two online resources that will help you learn about convexity and identify a pouching system that will work for you. First is the Hollister “Using Convexity” care tip sheet, which provides a nice overview of what convexity is, why it is used, and the types of convexity that are available. To find the sheet, search for “Hollister Care Tips Convexity.” A printable pdf will come near the top of your search results.
The second option is to permanently remove the hair using laser treatment or electrolysis. These target the hair follicles and prevent hair growth. Both techniques are done by professionals and may require multiple sessions to completely remove the hair. Laser hair removal and electrolysis can cause some pain and temporary skin irritation. Sessions cost from $100 to $250 each. Individuals with permanent stomas may find this option more feasible than those with temporary stomas. To help you decide if one of these techniques is right for you, contact a dermatologist.
The second option is to permaneAnother tip to help ease pouch removal is to use a silicone based adhesive remover with each pouch change. These are more effective with shorter hair. Adhesive removers are available in both wipes and spray forms. A wipe with a large amount of fluid in it, like Hollister Universal Adhesive Remover, or a spray will work better than a pad with a less generous amount of liquid. Changing your wafer more frequently, so the hair has less time to grow back, can also make removal less painful.
Before closing, I want to stress two things that you should not do to remove the hair around your stoma. Do not use chemical hair removers. These can irritate the skin and harm the stoma. Also, don’t wax the peristomal skin. Waxing can injure the stoma and burn the skin. Those burns may require special care to provide both proper wound healing and adequate pouch seal.