Physiological Changes in Skin Barrier Function in Relation to Occlusion Level, Exposure Time and Climatic Conditions

Abstract

Skin occlusion is a condition encountered with various articles as part of everyday life and resulting changes in skin barrier physiology often remain unnoticed. In the present study we aimed to understand the impact of absorbent feminine hygiene articles, one vapor-permeable and one vapor-impermeable, on skin hydration in response to exposure time and different environmental climatic conditions. Using a forearm model, volunteers were patched with moistened vapor-permeable and -impermeable articles in parallel for 1, 3, and 6 h and under different climatic conditions (i.e. 20°C/30% relative humidity, 25°C/50% relative humidity, 30°C/ 75% relative humidity). The physiological changes in the skin barrier function were measured via skin hydration, evaporation of superficial water (skin surface water loss, SSWL) and relative humidity in the microclimate between skin and occlusive article (RH_mc). The results show that skin hydration, SSWL, and RH_mc under a vapor-permeable article are reduced versus the vapor-impermeable article for all exposure times at 25°C and 50% relative humidity. SSWL and RH_mc decrease from their 1-hour peak values with increasing exposure time, while skin hydration decreases only after 3 h of exposure. Lower environmental temperature (20°C) and lower relative humidity (30%) have little impact on the reduction of SSWL and RH_mc, but more so on the reduction of skin hydration. Higher temperature (30°C) and higher relative humidity (75%) increase RH_mc and skin hydration under both vapor-permeable and -impermeable articles while SSWL is reduced under the vapor-impermeable article under these conditions. In conclusion, vapor-permeability is the key factor for physiological changes in the barrier function of the skin under occlusion, exposure time and climatic conditions being modulating factors. These findings have been integrated into a model of skin hydration under occlusion in the context of absorbent hygiene articles. While current vapor-impermeable articles are effective in reducing the excessive moisture on the skin due to bodily discharge, vapor permeability adds a further measurable benefit in reducing skin overhydration.

Multimodal epidermal devices for hydration monitoring

“…The device and measurement interface are mechanically imperceptible to the user, and therefore compatible for evaluation on any part of the body, in a manner that obviates the need for pressure sensing and offers potential for use in continuous, long-term recordings. The results outlined in the following extend our previously reported platforms for this purpose by (1) integrating both thermal and electrical characterization capabilities into a single measurement system, (2) introducing simple algorithms for extracting a full complement of intrinsic thermal and electrical properties from the measurement data, with good quantitative correspondence to simple models of the skin, and (3) applying the technology in a comprehensive clinical trial, with 20 patients and a variety of skin stimuli, for validation and comparison against clinical standard tools, that is, corneometers. The findings establish the design considerations, the analysis approaches and the capabilities of this technology for use in scenarios ranging from bedside hospital care, to clinical evaluation and study, to at-home diagnostics.…”

“…The skin also serves as a diffusion barrier 1 , both to block penetration of undesired pathogens 2 , and to prevent excessive transepidermal water loss 3 . The outermost part of skin, the stratum corneum, and the immediate underlying tissue, the epidermis, consist of layered collections of avascular, keratinized cells, in an extracellular lipid matrix [4][5][6][7] .…”

Association of sanitary pads and clothing with vulvovaginitis

“…However excessive occlusion and humidity in the area of vulva caused by synthetic underwear, tight pants, menstruation and the use of sanitary pads may have a negative influence on the skin barrier and cause changes in temperature and pH of the region, making the vulva susceptible to vulvovaginal diseases (2)(3)(4) . The most common types of vulvovaginitis in the reproductive age of women are bacterial vaginitis (BV) and vulvovaginal candidiasis (VC), and they usually manifest as vaginal discharge accompanied by bad odour and itching, respectively (5) .…”

“…In Brazil, although these data are only disseminated by non-scientific publications, they reach similar values (7) . Medical-scientific literature, on the other hand, raises a series of questions about the potential risks of long-term use of sanitary pads to women's health (3,9,10) . The most common concern among women is the sanitary pad, which in contact with the vulva increases the local temperature, RESUMO Introdução: A oclusão vulvar e o acúmulo de umidade em decorrência do uso de absorventes higiênicos, roupas íntimas sintéticas e/ou calças justas são considerados fatores de risco para o desenvolvimento de vulvovaginites (VV).…”

“…maintain the natural humidity of the area in contact with the skin, and change vulvar or vaginal pH, causing physiological changes that could favor fungus and bacteria growth; therefore, vaginal infections such as vulvovaginal candidiasis (VC) could install much more easier (3) . Runeman et al (5) performed a study with 58 women used to wear non breathable sanitary pads, with a plastic layer, for three menstrual cycles in between flow days (panty liners).…”