An Exploratory Study of the Effects of the PH of Synthetic Urine on Skin Integrity in Healthy Participants

Overview

Journal Skin Pharmacol Physiol

Publisher Karger

Specialties Dermatology
Pharmacology
Physiology

Date 2022 Jan 30

PMID 35093947

Authors

Sofoklis Koudounas

Dan L Bader

David Voegeli

Affiliations

Soon will be listed here.

Abstract

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: The aim of this study is to examine the effects of synthetic urine (s-urine) at various pHs 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 h, with another site serving as the untreated control. Measurements of TEWL, SCH, and skin surface pH were obtained at baseline (BL) and after each challenge. Skin buffering capacity was also examined in 5 volunteers by recording skin pH at BL, after 2 h exposure and every 5 min for 40 min.

Results: TEWL and SCH were increased following exposure to s-urine compared to BL values. Although there was a tendency for pH to increase after exposure, further investigation showed that changes are only temporal as pH value is restored to BL 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.

Citing Articles

Selective detection of urease-producing bacteria on the genital skin surface in patients with incontinence-associated dermatitis.

Kohta M, Koyanagi H, Inagaki Y, Nishikawa K, Kobayashi N, Tamura S Int Wound J. 2023; 20(8):3289-3297.

PMID: 37095598 PMC: 10502248. DOI: 10.1111/iwj.14209.

Bacterial invasion into the epidermis of rats with sodium lauryl sulphate-irritated skin increases damage and induces incontinence-associated dermatitis.

Koudounas S, Minematsu T, Mugita Y, Nakai A, Tobe H, Takizawa C Int Wound J. 2022; 20(1):191-200.

PMID: 35916389 PMC: 9797936. DOI: 10.1111/iwj.13864.

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