Ostomy Paste: What It Is and How to Use It

Ostomy paste (also called stoma or barrier paste) is a thick, skin-friendly filler used around a stoma to even out creases, scars and dips so the pouch baseplate can seal more reliably. It is not a glue and is not applied on the stoma itself. A stoma care nurse can advise whether paste is appropriate and how to use it with your particular appliance.

What ostomy paste is

Ostomy paste is a soft, mouldable barrier product for the skin immediately around a stoma (the peristomal skin). It fills small hollows, folds, suture lines and other irregularities so a pouch baseplate can sit flush. A more even surface makes it harder for stool or urine to track under the adhesive, which is a frequent cause of leaks and sore skin.

Paste is an accessory, not a substitute for a well-fitted appliance, and it does not stick the pouch on by itself. Most pastes use hydrocolloid or similar barrier materials. Some contain alcohol, which helps the paste spread and then become tacky as the alcohol evaporates. Alcohol-free pastes are also available and may be more comfortable on tender or broken skin.

Formulations differ. Use the instructions supplied with the product you have been given, and ask your stoma care nurse before combining techniques meant for different accessories.

How paste compares with rings, powder and films

Barrier rings (sometimes called seals) are pre-shaped, dough-like circles that can be stretched or moulded around the stoma. They fill and seal in a similar way; some people find them less messy than paste. Protective powder is a fine dust for moist, weepy skin. Excess powder is usually brushed off before the pouch goes on, and powder does not fill creases. Barrier films leave a thin protective coat on intact skin.

These accessories are sometimes used together, but stacking too many layers can stop the baseplate adhering. Combinations are best planned in clinic.

When paste is commonly used

Paste is typically considered when peristomal skin is not flat. Examples include abdominal creases that deepen on sitting, a shallow dip beside the stoma, scarring or folds after surgery, and small gaps at the inner edge of a cut-to-fit baseplate. It is also used, with other measures, when a stoma sits slightly recessed.

Ileostomies and urostomies produce liquid output, so a tiny channel under the adhesive can leak quickly. Paste is therefore discussed often with these stomas. It is also used with a colostomy when body contour makes a seal difficult.

Paste will not fix every leak. Ongoing problems may mean the baseplate opening is the wrong size, that a different pouch shape or a convex appliance is needed, that a hernia or weight change has altered the abdomen, or that the skin is too wet for adhesives to hold. Those issues need clinical review, not ever-larger amounts of paste.

Do not keep layering paste over moist, eroded or infected skin. Broken skin needs assessment. Alcohol-containing paste can sting sharply on open areas.

How paste is typically used

There is no single method that suits every stoma and product. The steps below reflect approaches commonly taught in stoma clinics. They are not a personal treatment protocol. A stoma care nurse should demonstrate technique on your own abdomen.

Preparing the skin

Remove the old pouch as usual. Clean the skin with water, or with the cleanser your nurse has recommended, and dry it thoroughly. Lift old paste residue gently; hard rubbing damages skin. If the skin is intact, some people apply a barrier film first, provided it does not leave the surface greasy or damp.

Do not coat the stoma. Paste belongs on the surrounding skin or on the adhesive side of the baseplate, never in the stoma opening.

Applying the paste

A small amount is usually enough. A thin bead around the planned opening, or modest filling of visible creases, is then smoothed so the paste sits level with the skin rather than in a ridge. A slightly damp finger or a cotton bud can help; water reduces stickiness on the fingertip.

If the paste contains alcohol, it is often left briefly to become tacky before the pouch is applied. Applying the baseplate too soon can cause it to slide. Alcohol-free pastes may need a different pause; follow the product instructions.

Some people place paste on the back of the baseplate instead of, or as well as, on the skin. The aim is to occupy gaps. Paste that squeezes inward towards the stoma or out from the adhesive edge can undermine the seal and is usually wiped away.

Do not pack paste into deep cavities or try to ‘build up’ a markedly retracted stoma unless a clinician has shown you how. Convexity or another approach may be more suitable.

Fitting the pouch

The baseplate opening should still match the stoma: close enough to protect skin, without rubbing the stoma. Paste does not change that sizing rule. After fitting, check comfort and alignment. If output appears under the adhesive soon afterwards, note where and in which posture the leak starts - that pattern helps clinic staff.

Practical points and common difficulties

A little paste goes a long way. Large quantities can create a slippery film, ooze onto clothing, or leave a ring of residue that is hard to clean. Needing more and more paste to get through the day usually means the appliance fit needs review.

Recap tubes promptly so the nozzle does not dry out. Do not put hardened, separated or expired paste on the skin.

On hairy skin, paste and adhesive may pull at removal; trimming hair as your nurse advises can help. Paste is not a treatment for folliculitis, fungal infection or allergy.

Heat, sweat and exercise challenge any seal. Paste can improve contour but will not stick to soaking wet skin. Some people prefer a mouldable ring because it is tidier; that is a reasonable choice, not a failure.

Do not replace ostomy paste with household adhesives, denture fixatives or food products. They are not formulated for peristomal skin and can cause injury.

Safety and when to seek help

Contact your stoma care nurse or another clinician if leaks continue despite careful use of paste; if skin becomes red, broken, painful, itchy or weeping; if paste stings severely or a rash appears where it sits; if the stoma changes in size, height or colour, or a bulge develops; or if you are unsure which accessories are compatible with your pouch.

New medicines, cancer treatment, steroids and weight change can all alter skin and output. Mainstream ostomy care emphasises a correctly sized appliance, dry intact skin, and early review of leaks. There is no good evidence that household acids or similar substances improve paste, and they can harm skin.

Always follow personal advice from your stoma care nurse or clinician.

The bottom line

Ostomy paste is a filler that helps a pouch baseplate seal over uneven skin around a colostomy, ileostomy or urostomy. Used sparingly on clean, dry skin, it can reduce leaks for some people. It is not glue, not a cure for a poorly fitting appliance, and not for use on the stoma itself. If leaks or soreness persist, arrange a review with your stoma care nurse rather than adding more product.