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Case Series/Study
There is now a large body of evidence indicating that skin with a high pH is likely to break down more easily from external insults (body fluids, germs) than skin with an intact acid mantle, with normal skin existing at a median value of 5-6. Skin can become alkaline from prolonged exposure to body fluids, and it is proposed that alkaline skin can be washed with mildly acidic skin and wound cleanser to return it to a more normal pH. We described here in vitro results on skin whose pH can be changed by exposure to urine and then changed again to a more skin-friendly value by exposure to an acidic, evidence-based wound cleanser.
Methods:
We obtained reconstructed epidermis, exposed it to prolonged urine, and measured skin pH over time. We then exposed the urine-exposed skin, once its pH had settled to a steady alkaline state, to a mildly acidic cleanser and measured the resultant skin pH over time.
Results:
We observed that the initial pH of the skin was significantly elevated after urine exposure, even after washing the skin with neutral saline post-urine exposure. The pH of the alkaline skin, when exposed to the mildly acidic cleanser, over time, returned to an acidic pH very close to the original pH of the skin.
Discussion:
It should be possible to adjust the pH of the skin using external cleansing agents. While this would seem common-sensical, it still behooves scientists to test the hypothesis by real-life testing. Such a pH change implies that vulnerable and at-risk alkaline skin can be brought back to an acidic range over time. The implications of this for skin healing are important, as skin cleansing with effective acidifying agents can likely be used to reduce the occurrence of catastrophic skin damage, such as Moisture-associated Skin Damage and the associated Hospital-Acquired Pressure Ulcers.