Peristomal Pruritis – when itch leads to scratch

Mr Paris Purnell1
1Hollister Incorporated, Libertyville, United States

Itching, also known as pruritus, is the uncomfortable sensation causing the desire to scratch. When it’s acute (time-limited), it may just cause a temporary annoyance. When chronic, pruritis may be difficult to treat and have more severe impact  on the individual (Bautista DM, Wilson SR & Hoon MA, 2014).  The physiology of chronic itch is a topic of interest to scientists who are investigating the neural mechanisms. NIH has funded researchers at locations such as Washington University in St. Louis, and University of California, Berkeley where they have “Centers for the Study of Itch”.

Little is published in the literature about peristomal pruritus  except in relationship to certain skin conditions such as candidiasis and dermatitis. A common cause of peristomal skin complications is leakage of stool or urine onto the skin.

However, people with ostomies often report peristomal skin itching with no visible signs of skin complications, leakage, or skin deterioration. Skin complications aren’t always visible. Skin can itch even if it looks healthy. When asked about how often they felt the need to scratch, one study found 87% of people living with a stoma experienced peristomal itching. Nearly 3 in 5 people said they felt the need to scratch at least occasionally. About 16% of those said they experienced this feeling “frequently” or “very frequently”. Now for the healthcare professional’s perspective. Among stoma care nurses that were surveyed, over 95% have had patients reported pruritus. Of those stoma care nurses, 27% said pruritus was the primary reason for the patient’s visit. When asked how bothersome this condition was for their patients, 7 in 10 nurses reported it was at least moderately bothersome – particularly in warmer weather.

This presentation will examine peristomal pruritis in the absence of causation and discusses how an evidenced ceramide-infused barrier may have positive outcomes.


Paris Purnell has spoken on a variety of ostomy-related topics at international conferences and local events as well as extensively published. His main focus has been the use of convexity with the stoma patient and he was instrumental in developing new guidelines for Patient Assessment for convexity which have been validated internationally. He is also focused on developing educational programs for developing countries to develop the ET Nurse role in Asia, Middle East, and Latin America.


This conference is proudly hosted by the Australian Association of Stomal Therapy Nurses:

One of the Association's major objectives is the promotion of quality care for a wide range of people with specific needs. These needs may be related to ostomy construction, urinary or faecal incontinence, wounds with or without tube insertion and breast surgery.

Patients/clients across the life span are provided with preventative, acute, rehabilitative and continuing care as required. Another objective is the maintenance and improvement of professional standards in relation to Stomal Therapy Nursing Practice to the highest degree possible. Recognition of the need for and encouragement of the development of specialist expertise in the field of Stomal Therapy Nursing underpins the Standards for Stomal Therapy Nursing Practice.

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