Medical Oncologist
CION Cancer Clinics
Skin problems around a urostomy | CION Cancer Clinics
Sore skin around a urostomy is almost always caused by urine reaching the skin, and the fix is a bag that fits closely enough to keep it off. A red ring next to the stoma, redness at one edge, an itchy spotty rash and gritty white crusts each point to a different cause. This page explains what each pattern means, what to do at the next change, and when skin trouble needs same-day attention. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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The short answer
Why is the skin around my urostomy sore, and what fixes it?
Sore skin around a urostomy is almost always caused by urine reaching the skin, and the fix is a bag that fits closely enough to keep it off. Redness, itching and burning in a ring around the stoma mean the opening is too big, the base has lifted, or the bag is being left on too long. Correct the fit and most skin settles within days.
Why urine is so hard on skin
Urine is wet, slightly acid and constant. Skin that stays damp softens, then breaks, then weeps, and weeping skin will not hold an adhesive. That starts a cycle: sore skin causes leaks, and leaks make the skin worse. Breaking the cycle means getting the seal right, not adding creams.
What is normal and what is not
Faint pinkness under the base that fades within an hour of a change is normal. Skin that stays red, itches, burns, weeps, bleeds, or develops white crusts or a rash with small spots is not, and each of those has a specific cause and a specific fix.
The stoma itself is a separate matter. It has no nerves, does not feel sore, and is meant to be moist and red. This page is about the skin around it.
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When skin trouble needs same-day attention
Redness that is spreading outwards beyond the base, the area feeling hot and swollen, pus, or a fever alongside any of these can mean an infection in the skin or deeper, and needs your surgical team the same day. So does a stoma that has turned dark, grey or black, or skin that has split open around it. Do not cover any of these with a fresh bag and wait for the next planned change.
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The six skin problems stoma nurses see most, and what each means
A red ring right next to the stoma
Urine is sitting on skin between the stoma and the opening. The hole is too big, or the stoma has shrunk since it was cut. Re-measure and cut closer.
Redness at one edge only
The base is lifting there and urine is creeping under it. Usually a fold, a dip or a crease when you sit. The answer is a different base shape, a convex base, or a belt, fitted by a nurse.
Itchy rash with small red spots
Most often a fungal rash, which loves warm, damp, covered skin. It spreads outward and itches more than it burns. Your doctor may prescribe an antifungal powder; creams stop the bag sticking.
White or grey gritty crusts
Urine crystals forming on damp skin or on the stoma itself. A sign that urine is too concentrated or is pooling. Drink more, and ask your nurse about a dilute vinegar wipe at change time.
Redness exactly the shape of the base
A reaction to the adhesive or to a wipe or spray you are using. Changing to a different make usually settles it.
Suspect it if
- It began after switching products
- The skin nearest the stoma is fine
Sore hair follicles
Small painful red bumps where hairs are pulled at each change. Trim the hair with scissors rather than shaving, and peel the base off slowly.
At the next change
What to do at home before you call anyone
Look, in good light
Take a photo of the skin with the bag off. Where exactly is the redness: next to the stoma, at one edge, or the shape of the whole base? That answers most of the question.
Re-measure the stoma
Use the card that came in the box. If the opening you have been cutting is larger than the stoma, that is the cause. Cut the next one so almost no skin shows.
Clean, and dry completely
Plain water only. No antiseptic, no scented soap, no oil. Pat until the skin is dry to the touch, then hold the bag and gauze against the stoma while you wait for a dry moment.
Powder and seal, if you have it
On skin that is weeping, a light dusting of stoma powder, the excess brushed off, then a barrier film over it, gives the adhesive something dry to hold. Only use what a nurse has advised.
Change sooner for a while
Until the skin heals, change more often than usual so urine never pools under a softened base. Then send the photo to your stoma nurse and describe what you changed.
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Commonly believed
Four things families do for sore skin that make it worse
"Put Boroline or coconut oil on it, like any other sore skin."
Any grease or moisturiser stops the adhesive sticking. The base lifts, urine reaches the skin, and the soreness spreads. Skin under a stoma base needs to be clean, dry and covered with the bag, not softened. Powder and a barrier film that dries clear are the only things that go under the base.
"Leave the bag off for a few hours to let the skin breathe."
With a urostomy there is no quiet interval. Urine flows constantly, and a few hours uncovered means a few hours of urine on already damaged skin. Healing happens under a well-fitted bag, not in open air.
"Clean it with Dettol so it does not get infected."
Antiseptics and spirit strip the skin, sting broken skin and leave a residue that weakens the seal. The skin around a stoma does not need to be sterile. Plain water, and dryness, do more to prevent infection than any antiseptic.
"It is just his skin type. Nothing can be done."
Almost every case of sore skin around a urostomy has a mechanical cause: the size of the opening, the shape of the base, or how long it stays on. A stoma nurse can usually find it in one visit. Living with raw skin for months is not something to accept.
Being straight with you
What this page cannot tell you
It cannot diagnose a rash from a description. Fungal rashes, adhesive reactions and urine damage can look alike in a photo on a phone, and the treatment for each is different. What this page can do is help you notice the pattern, so you can describe it well and get the right fix faster.
Who this page is not written for
It is about the skin around an ileal conduit, a urostomy with a bag. Skin problems around a bowel stoma have overlapping causes but different fixes, and a catheterisable pouch has its own care. If your stoma passes stool rather than urine, look for the bowel-stoma guidance instead.
When to stop managing at home
If the skin is not clearly better after a few changes done carefully, if it is bleeding or weeping heavily, if the bag will not stay on for a day, or if you have any of the same-day signs above, it is time for a stoma nurse or your surgical team to look. Sore skin that is left is the main reason people stop going out, and it is very fixable.
If your centre has no stoma nurse, call the CION helpline. We will help you find one and get a photo in front of the right person.Questions we are asked
Common questions about skin around a urostomy
How long does sore skin take to heal once the fit is right?
Mild redness usually fades within a few days of urine being kept off it. Skin that has broken or been weeping takes longer, often a couple of weeks, and needs the powder and film method at each change.
Can I use an ordinary antifungal cream from the chemist?
Creams stop the base sticking, so no. If a fungal rash is suspected, your doctor can prescribe an antifungal powder, which goes on dry skin under the base. Do not start or stop any medicine on your own; describe the rash to your nurse or doctor first.
There are white crystals on the stoma itself. Is that dangerous?
Not dangerous, but a sign that urine is too concentrated or is sitting against the stoma. Drink more through the day. Your nurse may show you a dilute vinegar wipe at change time to dissolve them, because a build-up can rub the stoma and cause bleeding.
The skin is fine but the bag still leaks. Why?
Then the problem is in the shape: a crease, a dip, a stoma that sits flat or below the skin, or a base that is the wrong style for your belly. Skin that is still healthy is good news. A nurse can usually solve a shape problem with a convex base, a belt or a different make.
Does sweating in summer make it worse?
Yes. Sweat softens the adhesive and keeps the skin damp, so both leaks and fungal rashes are more common in the hot months. Dry the skin very thoroughly, use a barrier film, change a little more often, and keep a spare bag with you for the afternoon.
Can I put a plaster or gauze over the sore area under the bag?
No. Anything between the skin and the base breaks the seal and traps urine against the sore. Powder and barrier film are the only layers that belong there, because they dry into a surface the adhesive can hold.
Is bleeding from the skin around the stoma serious?
A little blood from raw, weeping skin when the base is peeled off is common and settles as the skin heals. Bleeding that does not stop with gentle pressure, blood coming from inside the stoma into the urine, or bleeding with a fever needs a same-day call to your team.
My mother is embarrassed to show the skin to anyone. What can we do?
A photo, taken by her or a daughter in private, can be sent to the stoma nurse and often answers the question without a visit. Many centres have a female stoma nurse if that is asked for. Sore skin that is hidden gets worse.
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Sources
- American Cancer Society — Urostomy guide
- Macmillan Cancer Support — Urostomy
- Cancer Research UK — Treatment for bladder cancer
- NHS — Bladder cancer: treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Changing a Urostomy Bag: Step by StepThe change routine that keeps urine off the skinUrostomy Supplies in Hyderabad and What They CostPowders, films and convex bases, and where to buy themSmell, Leakage and Confidence With a UrostomyLeaks and sore skin go together; this is the other halfStoma Nurses and Support in HyderabadThe person who can fix a fit problem in one visitComplications and Red FlagsThe signs after any operation that need same-day care
Talk to us
Skin not settling under the bag?
Tell us what it looks like and where you are. We will help you reach a stoma nurse and a surgical oncologist who can look at a photo and check the fit. One helpline serves every CION centre.