Which statement best describes management of peristomal dermatitis?

• A. Determine and treat cause
• B. Crusting technique
• C. Domeboro Astringent or Burrow's solution
• D. Off-label: Flonase to treat skin irritation

Answer: (D)

Managing peristomal dermatitis centers on identifying and addressing the cause of the skin irritation. The peristomal area reacts to moisture, leakage, friction, adhesive contact, and possible infection. The best approach is to assess why the skin is irritated and then intervene to stop the irritant from contacting the skin and to repair the skin barrier. This means reviewing the ostomy pouching system for a proper fit and seal, preventing leakage, using protective skin barriers or barrier rings as needed, and choosing gentle, skin-friendly cleansing and drying practices. If irritation arises from an adhesive allergy or sensitivity, switch to a different adhesive or non-adherent barrier and, if necessary, test for allergy. If there are signs of Infection—such as persistent redness, itching with satellite lesions, or oozing—treat the underlying infection with the appropriate antifungal or antibiotic therapy. While astringent solutions may be used in some cases to manage oozing, they do not address the root cause and are not the primary strategy. Topical Flonase is not appropriate for skin irritation, as it is a nasal corticosteroid and not a skin treatment.