Scratching the Surface of Peristomal Skin Itching

If your skin is red or weepy under your skin barrier, or you have annoying itching but no visible signs of skin irritation, you are not alone.

Two clinicians, Ginger Salvadalena, PhD, RN, CWOCN, and Melissa Menier, MS of Hollister Incorporated, conducted two studies to explore how nurses and patients compared in their experiences with the issue of peristomal skin itching (also called pruritus), including in the absence of visible skin problems.^{1, 2}

Participants included 164 people with stomas and 259 ostomy care nurses. Questions to the people with stomas ranged from "What made the itching better or worse," to "Did you ever talk to your healthcare provider about this itching sensation?" Clinicians were asked about the number of patients who reported itching, as well as the common causes of peristomal itching based on their experience.

The research drew these conclusions:

• Peristomal itching was self-reported by 87% of people with stomas; 36% of the time their skin appeared healthy.³
• 71% of the nurses recalled a time when their patients reported peristomal skin itching and the skin was intact and free of redness.⁴
• Nurses encourage patients to report peristomal skin itching, however the people with stomas in this survey did not commonly report their itching to their healthcare providers.⁵

This research has also been the jumping off point for further exploration and conversations around skin health and itching, the often unspoken skin concern.

"I never realized even itching was a problem with my ostomy patients. I never asked them until [this] work about itching," says Joyce Pittman, PhD, ANP-BC, FNP-BC, CWOCN, FAAN, Indiana University Health, Indianapolis, Indiana.

"Itching is interesting. I think that in my practice I haven't paid enough attention to it," adds Janice C. Colwell, RN, MS, CWOCN, FAAN, University of Chicago, Illinois. "I can envision some patients when we take a pouching system off and we're cleaning their skin and they go, 'oh that feels so good.' And I say 'what do you mean?' and they say 'it's so itchy it just feels good when you're just rubbing it.' And I would say, 'Oh,' and I would move on because I didn't know what else I would be able to do for patients."

Now that clinicians are more aware of the problem, they continue to explore ways to help manage itchy peristomal skin, including when the skin looks healthy. If you experience peristomal itching, don't hesitate to report it to your healthcare professional.

^{1, 3, 5} Consumer Survey of Pruritus, Hollister Incorporated, 2016. Data on File.
^{2, 4} Clinician Survey of Pruritus, Hollister Incorporated, 2016. Data on File.