Leakage and Skin Irritation: The Complete Guide to Ostomy Belts, Barrier Rings, Brava Strips, and Pouching Systems

Over the past 17 years, some of the most common problems I hear about are skin irritation and leakage with an ostomy bag. The ostomy belt I make helps significantly, but there are a few more tricks that will really help improve your overall quality of life too. I wanted to break down the top five things I've learned that will help you the most.

1. Ostomy Support Belts

An ostomy belt is a fitted band worn around the waist that holds your pouching system securely against your body. It doesn't touch your skin seal at all. Its job is entirely about managing the outside weight of the pouch once it fills, so it doesn't pull at the wafer, swing during movement, or work the seal loose over the course of a day. The benefit is direct: less tugging on your barrier means fewer opportunities for that barrier to lift or fail early, which is where leakage and skin irritation usually start. It's also the difference between noticing your ostomy all day and just moving normally: sports, physical work, travel, or just chasing your kids around.

Shop HIRO Performance Horizontal | Shop HIRO Performance Vertical

2. Barrier Rings

A barrier ring is a moldable ring of skin protectant material that sits directly around your stoma, underneath your wafer. If your abdomen has any unevenness (a scar, a skin fold, a slight dip near the stoma) a flat wafer alone can leave tiny gaps where output creeps underneath and undermines your seal. A barrier ring fills those gaps, and most can be stretched, cut, or stacked to build up exactly the amount of fill your body needs.

The benefit here is a flatter, more even surface for your barrier to adhere to. A ring that's too thin won't fully close the gap it's meant to fill; one stacked too thick can create new pressure points. Getting the thickness right usually takes a few tries. Hollister's Adapt rings, pictured above, are a well known example of this category, and most major ostomy brands make some version of a moldable ring.

See Hollister's Adapt Barrier Rings

3. Brava Strips

Strips do a related but different job than rings. They also fill in the area around the stoma, but a bit further out than a ring does. They're great for helping irritated skin recover, and they help secure the flange better. They generally sit closer to the edge of the flange, but still underneath it, and they work especially well when you swim or shower: helping keep a nice, secure seal even with water working against it. They come in different shapes: straight for square barriers, curved for round ones, Y shaped for extra reinforcement near skin folds. Coloplast's Brava line, pictured above, is probably the most recognized version of these.

Strips are especially useful if you've got scar tissue, a crevice, or any area where the skin isn't perfectly flat: anywhere that tends to get irritated or hold moisture. Covering that area with a strip first gives the flange a solid, even surface to stick to, and helps a barrier ring stay properly seated instead of shifting around an uneven spot. That combination keeps the whole setup from lifting or coming loose, and it's noticeably more comfortable to wear if that patch of skin has already been irritated.

See Coloplast's Brava Accessories

4. Ostomy Pouching Systems

A one piece system has the skin barrier and the pouch fused together as a single unit: when you change your pouch, you're also redoing your skin seal every time. A two piece system, like Hollister's CeraPlus line pictured above, separates those two jobs: the barrier (flange) stays on your skin, and the pouch clicks on and off of it independently through a small plastic coupling ring. That coupling ring does more than just connect the two pieces. It also helps hold the flange securely against your skin. In my opinion, the small increase in size compared to a one piece system is well worth the extra secure fit it gives you.

The benefit of a two piece system is real flexibility. If you just need to swap the pouch, you can unsnap it and snap a new one on without touching the seal underneath at all. With a one piece system, you're forced to remove the entire thing any time you need to change it, which matters even more if you're using a closed pouch rather than a drainable one. That's actually one of my strongest general recommendations regardless of which system you use: use a drainable pouch. It means you're not forced to remove and reapply everything just to empty it. You can simply drain it and keep going. Personally, I prefer the two piece setup. It's a bit more comfortable, and the coupling where the bag meets the flange acts almost like a joint, giving the whole system a little give instead of everything being rigidly fused together.

See Hollister's CeraPlus Two Piece Systems

5. The Problem of Wearing Your Ostomy Pouch

Here's the underlying problem that all four of the products above are responding to, in one way or another: a full ostomy pouch has real weight and momentum. As it fills, gravity pulls it downward and away from your body. Every step, bend, or twist adds extra tugging at the one thing holding it all in place, the adhesive seal on your skin. That constant low level pulling is what gradually works a barrier loose, opens tiny gaps at the edges, and eventually causes leakage or irritation, even with a perfectly applied barrier and the best rings and strips available.

Rings and strips protect and reinforce the seal itself. A good pouching system determines how convenient it is to manage day to day. But none of those address the actual mechanical problem: something has to carry the weight of the pouch so it isn't hanging entirely off your skin. That's the specific problem an ostomy belt solves, and it's the reason I built one in the first place, not to replace any of the products above, but to take the physical load off of them so they can do their job without fighting gravity and movement all day long.

How I Actually Apply Mine

This is the part I get asked about the most, so I want to walk through it step by step. This is the exact layering method I've landed on after years of adjusting it.

1. Prep the flange first, before you're anywhere near the stoma. Take the double sided adhesive and place it on the back of the flange, then set the whole thing aside. I like to do this prep work ahead of time (get it ready and leave it under the sink or wherever you're going to change) so it's not one more thing to fumble with once you're actually cleaned up and ready.

2. Get clean. I usually take a shower right before a change. Clean, dry skin is the foundation everything else sticks to. Any leftover oil, lotion, or moisture on the skin will undercut adhesion no matter how good the products themselves are.

3. Apply the barrier strips first, before the flange. Once you're out of the shower and the skin around your stoma is clean and dry, put the barrier strips (I use Brava) around the edges of where your barrier will sit, before you put anything else on. This step surprises people, because most instructions have you apply the flange first and then reinforce the edges with strips afterward. I do it in the opposite order, and here's why.

4. Apply the flange and barrier ring as one unit, on top of the strips. The strips have a strong adhesive (similar to a Tegaderm dressing) that bonds well to skin. Once that layer is down, it creates a much stronger surface for the flange to stick to than bare skin alone. Then the flange (with the barrier ring already attached to the back) goes on top of that.

Why the Order Matters

Flanges themselves are usually a thin, paper tape like material with their own adhesive layer. That adhesive is fine on dry skin, but the moment your body sweats or produces any moisture, it doesn't hold nearly as well. By putting the barrier strips down first, you're giving the flange something much more reliable to bond to than skin alone, and that difference compounds over days of wear.

Early on, when I was going by the standard instructions I'd been given by doctors and nurses (who generally recommended changing the appliance every one to two days, sometimes stretching to two or three), I'd almost always get a leak or some irritation well before that window was up. And once irritation started, it became a bad cycle: red, irritated skin doesn't hold the next appliance well either, so the next change would fail faster too, which meant more frequent changes, which meant more irritation. It compounds in the wrong direction if you don't break the cycle somewhere.

Are you a nurse? Click here for our quick nurse resource guide with sizing help, a printable ostomy belt fitting and order guide, patient welcome coupons, and free demo belts.

Since switching to this layering method, my appliances routinely last five days, and most of the time I get a full week out of one. At that point, I'm not changing it because something failed. I'm changing it because it's simply time for a fresh one. That's a completely different experience than constantly managing leaks, and it's the difference between planning your day around your ostomy and just living your day and letting the ostomy keep up.

The Research Backs This Up

This isn't just my own anecdotal experience. Academic research has looked at outcomes for ostomy belt users specifically. Work published in the Journal of Wound, Ostomy, and Continence Nursing by researchers including Joyce Pittman and Janice Colwell has found that ostomy belt use is associated with reduced leakage and skin irritation, alongside improvements in confidence, mobility, and body image. I was involved in some of the early research in this area during my time at my previous company, so it's a body of work I've followed closely and care about beyond just my own experience.

Pros and Cons

My honest take: I think it's worth using some combination of all of the above (belt, rings, strips, and a well fitted pouching system) rather than relying on just one. Each manufacturer's version has a slightly different adhesive and construction, and no two people's skin reacts to them exactly the same way. What I've described is what's worked best for my own skin over 17 years, but the honest answer is that you have to test a bit to find what your body responds to.

The tradeoff is time: this layered approach takes a few extra minutes per change compared to just applying a one piece system straight out of the package. For me, that's an easy trade: a few extra minutes every five to seven days, in exchange for not thinking about leaks or irritation in between, is worth it. If your skin has historically been more forgiving, or if you're still early post surgery (the UOAA New Ostomy Patient Guide is a great companion) and figuring out your own body's tendencies, you may not need every layer right away. It's worth building up gradually rather than assuming you need the full setup from day one.

Where This Comes From

Most of what I've shared here comes from three places: 17 years of living with an ostomy, conversations with thousands of customers over the years who've shared what works and doesn't work for them, and time spent speaking at UOAA support group meetings and other ostomy community events and conferences. I've also got a circle of friends and fellow athletes with ostomies, and we're constantly comparing notes: what setup someone's using, what's changed for them, what gives them enough peace of mind to stop thinking about their appliance and just go do the activity they actually want to do.

That's really the goal underneath all of this: getting your setup dialed in well enough that you can forget about it and get on with your day.

Frequently Asked Questions

Do I need all of these (belt, ring, strips, and flange) or can I get by with less?
You don't need everything from day one. Many people start with just a flange and belt, and add a ring or strips only if they start noticing leaks or lifting at the edges. Building up gradually, based on what your own skin actually needs, tends to work better than assuming you need the full setup right away.

Can I mix and match brands: for example, use one company's rings with another company's flange?
Generally yes, since rings and strips aren't chemically bonded to a specific flange brand. That said, results can vary, since adhesives differ slightly between manufacturers. If you're trying a new combination, it's worth testing it for a day or two before relying on it for a longer stretch.

How do I know if a barrier ring is too thick or too thin?
Too thin, and you'll likely still get leakage in the area the ring was meant to fill. Too thick, and you may notice new pressure or discomfort around the stoma, or the flange sitting unevenly. It usually takes a couple of changes to dial in the right thickness for your particular body.

Will this layering method work for a two piece system too, or only one piece?
The same logic applies either way. The strips and ring are about the seal between your skin and the flange itself: that part of the setup is the same whether the pouch that clicks onto the flange is one piece or two piece.

How This Connects to What I Build

Barrier rings, strips, and pouching systems are all about the seal itself. An ostomy belt is about the weight and movement of the pouch once it's on. In practice, most people I've talked with over the years end up combining a few of these approaches based on their own body and activity level. There's no single right setup.

Combining this setup with the ostomy belts we make will certainly give you peace of mind, knowing that others with lots of experience have tested this method with success. I'd love to hear any feedback or new methods you've found. Feel free to share your ideas or tips with me too.

Richard