Individuals living with an ostomy face many challenges in maintaining peristomal skin health. One of the main ones being different perceptions of skin health between patients and nurses. There is also widespread variation in the terminology used between healthcare professionals, leading to inconsistencies in approach. These inconsistencies can affect care quality, patient outcomes and perpetuate ritualistic practices that compromise skin health. This can lead to confusion and demotivate patients and practitioners alike. By identifying some of these problems, and exploring the evidence we can develop workable solutions to ultimately improve the quality of care offered and finally address the burden of peristomal skin complications.