Peristomal skin complications interfere with stoma appliance use and negatively affect patient quality of life. To find an alternative to long-term peristomal skin treatment involving corticosteroid products, a prospective study was conducted to compare the effect of a German chamomile solution to topical steroids on peristomal skin lesions in colostomy patients. Persons seeking care for the treatment of a peristomal skin lesion were assigned to a treatment regimen of once-a-day hydrocortisone 1% ointment (n = 36) or twice-a-day chamomile compress (n = 36) application. Treatments were assigned by matching patient demographic, history, and skin condition variables. At baseline, no significant differences between the variables were observed. Forty-two (42) of the 72 patients were female. Most participants had their stoma for more than 1 year (18.14 months in the chamomile and 17.69 months in the steroid group). Lesions were assessed every 3 days for a maximum of 28 days. Lesions healed significantly faster in the chamomile than in the hydrocortisone group (mean time to healing 8.89 ± 4.89 and 14.53 ± 7.6 days, respectively; P = 0.001). Stoma patient symptoms (pain and itching) also resolved more expediently in the chamomile than in the hydrocortisone group. Because corticosteroids are nonspecific anti-inflammatory agents, herbal extract use can prevent the side effects of long-term topical corticosteroid use. The results of this study suggest that German chamomile can be recommended to relieve itching and inflammation and that twice-daily application facilitates healing of peristomal skin lesions. Methods to facilitate the application of topical treatments without interfering with appliance adhesion or necessitating frequent appliance removal should be refined. Additional randomized studies are needed to confirm the results of this study.