An exploratory study of the effects of the pH of synthetic urine on skin integrity in healthy participants.

Sofoklis Koudounas, Dan L. Bader, David Voegeli

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Background: Incontinence-associated dermatitis (IAD) develops from prolonged exposure of skin to urine and/or stool and represents a common complication in older adults, reducing the quality of life. Increased pH is an important etiologic factor of IAD, however, the relationship between urinary pH and skin barrier disruption remains unclear.
Objective: To examine the effects of synthetic urine (s-urine) at various pH on transepidermal water loss (TEWL), stratum corneum hydration (SCH) and skin surface pH.
Methods: S-urine solutions (pH 5.0-9.0) were applied to the volar forearms of 15 healthy participants for 2 hrs, with another site serving as the untreated control. Measurements of TEWL, SCH and skin surface pH were obtained at baseline and after each challenge. Skin buffering capacity was also examined in 5 volunteers by recording skin pH at baseline, after 2 hrs exposure and every 5 mins for 40 mins.
Results: TEWL and SCH were increased following exposure to s-urine compared to baseline values. Although there was tendency for pH to an increase after exposure, further investigation showed that changes are only temporal as pH value is restored to baseline within 5 mins. There were no significant differences between solutions.
Conclusions: This study revealed that urine disrupts healthy skin integrity; however, its effects are not pH dependent. Transient changes were observed on the acid mantle of the skin due to its innate buffering capacity. Future studies need to examine the effects of urine combined with bacteria responsible for pH elevation in patients with urinary incontinence.
Original languageEnglish
JournalSkin Pharmacology and Physiology
Early online date28 Jan 2022
Publication statusPublished - 28 Jan 2022

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