What is the difference between a barrier ring and a paste?

Barrier rings are pre-formed, mouldable hydrocolloid or synthetic rings that are applied around the stoma before the pouch baseplate is positioned. Stoma paste, by contrast, is a semi-liquid filler typically applied from a tube to fill uneven contours. Both serve a similar sealing function, but rings generally offer more consistent thickness, are easier to apply without skin contact with solvents, and tend to be preferred for ongoing routine use. Your stoma care nurse can advise which product type suits your stoma profile best.

Can I use a barrier ring with a one-piece pouch system?

Yes. Barrier rings are compatible with both one-piece and two-piece ostomy systems. With a one-piece pouch, the ring is placed directly onto the peristomal skin and the integrated baseplate is then pressed over it. With a two-piece system, the ring sits between the skin and the flange. Correct sizing is important regardless of system type, and a stoma care nurse can help you measure accurately.

How often should a barrier ring be changed?

Barrier rings are typically changed at each pouch change, which for most people is every one to three days depending on stoma output and individual skin characteristics. Some extended-wear rings are designed to last longer, but clinical guidance generally advises inspecting the ring at every change and replacing it if it has dissolved, migrated, or if leakage has occurred. Always follow the advice of your stoma care nurse.

Are barrier rings suitable for all stoma types?

Barrier rings are used across colostomy, ileostomy, and urostomy care, though they are particularly valued in ileostomy management where liquid, enzyme-rich output poses a higher risk of peristomal skin damage. They are also helpful where the stoma is flush, retracted, or located near skin folds. Individual suitability depends on stoma anatomy and personal skin condition, so professional assessment is recommended.

Will using a barrier ring prevent all leaks?

Barrier rings significantly reduce the risk of leakage by creating a more effective seal between the baseplate and the skin, but they do not guarantee that leaks will never occur. Factors such as weight change, hernia, poor stoma siting, or very high-output stomas may still contribute to seal failure. A barrier ring should be considered one component of a broader, holistic approach to pouching — not a standalone solution.

Barrier Rings and Peristomal Skin Protection

Maintaining healthy peristomal skin — the area of skin immediately surrounding a stoma — is one of the central challenges of ostomy management. Even minor, repeated exposure to stomal output can cause irritation, erosion, and pain that compromises both quality of life and the effectiveness of the pouching system. Barrier rings are among the most widely used adjuncts in stoma care for addressing this risk, offering a practical, adaptable means of improving the seal between the skin and the ostomy appliance.

What Are Barrier Rings?

Barrier rings (sometimes called seal rings or mouldable rings) are soft, pliable rings made predominantly from hydrocolloid or synthetic polymer materials. They are designed to be placed directly onto the peristomal skin, surrounding the stoma base, before the pouching system is applied. Once positioned and warmed by body heat, the ring conforms to the contours of the skin, filling any gaps or uneven surfaces that might otherwise allow stomal output to track beneath the baseplate.

They are manufactured in a range of thicknesses and diameters, and many can be hand-moulded — stretched, folded, or layered — to suit individual anatomical variation. This versatility makes them useful in a wide variety of clinical situations.

Why Peristomal Skin Protection Matters

Peristomal skin complications are the most commonly reported problem in ostomy care. Studies suggest that between 30% and 70% of people with a stoma will experience some degree of peristomal skin disorder at some point, ranging from mild erythema to severe erosion, hyperplasia, or fungal infection.

The consequences extend beyond physical discomfort. Damaged skin reduces the adhesive surface available to the baseplate, increasing the likelihood of leakage, which in turn causes further skin damage — a cycle that can be difficult to interrupt. For people with an ileostomy in particular, the proteolytic enzymes and high liquid content of small bowel output render even brief skin contact potentially harmful.

Effective peristomal skin protection is therefore not a cosmetic concern but a clinical priority.

How Barrier Rings Work

Filling Contour Irregularities

The peristomal surface is rarely perfectly flat. Skin folds, scars from the surgical incision, body weight fluctuations, and the natural topography of the abdomen all create contours that a flat baseplate cannot fully bridge. These gaps are the primary entry points for output that migrates beneath the appliance. A barrier ring, being mouldable, fills these irregularities and creates a continuous, even seal.

Absorbing Moisture

Hydrocolloid-based rings absorb small amounts of moisture, including perspiration and minor output, helping to maintain a drier interface between the baseplate and the skin. This absorption capacity also helps the ring maintain adhesion over time, though it does mean the ring will gradually swell and should be inspected at each pouch change.

Buffering Mechanical Stress

The ring also acts as a slight cushion, distributing the mechanical forces exerted by a filling pouch more evenly across the peristomal area. This may reduce the pressure on any single point of contact and help prevent the kind of localised skin breakdown that can develop under a baseplate edge.

Clinical Indications

Barrier rings are recommended in a number of specific circumstances, though they are also used routinely as a preventive measure by many ostomates regardless of anatomical complexity.

Flush or Retracted Stomas

A stoma that sits level with or below the skin surface does not project sufficiently to direct output cleanly into the pouch. This significantly increases the risk of undercutting — where output flows beneath the baseplate. A barrier ring built up around such a stoma can compensate for the lack of protrusion and help channel output appropriately.

Irregular Peristomal Contours

Skin folds, creases near bony prominences, surgical scars, and parastomal hernia all disrupt the flat surface needed for secure appliance adhesion. Barrier rings can be moulded to bridge these features.

High-Output Stomas

Ileostomies, particularly in the period immediately following surgery or during illness, may produce large volumes of liquid output rich in digestive enzymes. The additional seal provided by a barrier ring reduces the risk of this output reaching the peristomal skin.

Existing Peristomal Skin Damage

When peristomal skin is already compromised, achieving a reliable seal becomes both more important and more difficult. A barrier ring can help maintain appliance security while the skin heals, though severe skin problems should always be reviewed by a stoma care nurse or dermatologist.

Application Technique

Correct application is essential to achieving the protective benefits of a barrier ring.

Clean and dry the peristomal skin thoroughly using warm water. Ensure the area is completely dry before applying any product, as moisture will impair adhesion.
Warm the ring briefly between the palms if it feels stiff, to improve pliability.
Mould or size the ring to match the stoma diameter. The inner opening should fit snugly around the stoma base without compressing the stoma itself, which could impair stomal blood flow.
Position the ring flat against the peristomal skin, pressing gently to ensure full contact.
Apply the pouching system over the ring, aligning the baseplate aperture with the stoma, and press firmly from the centre outward to secure adhesion.

Some clinicians recommend double-layering rings in cases of deep skin folds or significant retraction. This should be discussed with a stoma care nurse.

Potential Pitfalls

Barrier rings are generally well tolerated, but a few practical points merit attention. Applying a ring to damp or oily skin will reduce its effectiveness. Rings should not be used as a substitute for an appropriately sized baseplate aperture — if the central hole is too large, the ring will be in contact with stomal output and will degrade rapidly, potentially causing rather than preventing skin contact. Allergic or sensitivity reactions to ring materials, though uncommon, do occur; if persistent skin irritation develops under or around the ring, clinical review is advisable.

The Bottom Line

Barrier rings are a clinically supported, adaptable tool for improving the seal of ostomy appliances and protecting peristomal skin from the harmful effects of stomal output. They are particularly valuable for individuals with flush or retracted stomas, irregular abdominal contours, or high-output ileostomies, though many ostomates incorporate them into routine care as a preventive measure. Correct application technique and appropriate sizing are essential to their effectiveness. As with all aspects of ostomy management, individuals should discuss the use of barrier rings with their stoma care nurse or specialist clinician to determine the most suitable approach for their individual anatomy and pouching system.