A patient wearing absorptive undergarments is most likely to experience which skin barrier change?

A patient wearing absorptive undergarments is most likely to experience which skin barrier change?

• A. Elevated TEWL (trans-epidermal water loss) and skin pH
• B. Elevated TEWL and reduced skin pH
• C. Elevated perspiration and reduced skin pH
• D. Reduced perspiration and TEWL

Answer: (A)

Moisture and occlusion from absorptive undergarments disrupt the skin barrier, leading to two main changes: the barrier becomes more permeable, so water loss through the skin increases (higher TEWL), and the protective acidic environment is weakened, causing the skin pH to rise (become more alkaline). This combination—increased TEWL with an elevated pH—best fits how prolonged dampness and occlusion from incontinence products affect skin. The presence of moisture alone doesn’t typically raise perspiration, and a healthier barrier would not show reduced TEWL, so those choices don’t align with the maceration and irritation risk seen here.

Moisture and occlusion from absorptive undergarments disrupt the skin barrier, leading to two main changes: the barrier becomes more permeable, so water loss through the skin increases (higher TEWL), and the protective acidic environment is weakened, causing the skin pH to rise (become more alkaline). This combination—increased TEWL with an elevated pH—best fits how prolonged dampness and occlusion from incontinence products affect skin. The presence of moisture alone doesn’t typically raise perspiration, and a healthier barrier would not show reduced TEWL, so those choices don’t align with the maceration and irritation risk seen here.