pH in Cosmetic Products/Topical Formulations
Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.
Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
The Relation of pH and Skin Cleansing
Jürgen Blaak · Peter Staib
Research and Development and Regulatory Affairs, Kneipp GmbH, Würzburg, Germany
What Is Already Known?
■ A lot of work has been done to understand the im-
pact of cleanser on skin surface pH. Skin surface pH
is stated to increase up to +3.0 units and pH recov-
ery requires several hours. Cleansing-induced alter-
ation of the slightly acidic skin surface pH decreas-
es epidermal barrier function.
■ Different negative effects on skin microflora and
antimicrobial defence mechanisms are described
after skin cleansing due to a neutral-to-alkaline
product pH.
■ Especially in skin conditions with enhanced skin
surface pH, and therefore negatively affected epi-
dermal barrier function and skin microflora,
maintaining and stabilizing of the slightly acidic
skin surface pH are crucial to keep skin
healthiness.
■ Providing the market with acidic skin care and
cleansing products is an important challenge
within the cosmetic industry for the future. How-
ever, further research is required to understand
the interrelation between product pH level, sur-
factant composition and cutaneous physiology,
especially epidermal barrier function and skin
microflora.
What Does This Text Add?
■ The present article reviews the current research
state on the topic “pH and skin cleansing,” includ-
ing novel results and strategies regarding acidic
skin care and cleansing for specific skin conditions.
■ All relevant skin conditions and disorders with skin
surface pH alterations are listed, and linked to ben-
efit from cosmetic products with a given pH of 4–5.
■ The interrelation of the given product pH and the
used surfactants is discussed and defined as re-
quired research for the future, to raise skin cleans-
ing product compatibility.
Abstract
Several epidermal barrier functions, like skin barrier re-
generation and antimicrobial response, are related to the
acidic nature of the skin surface pH (ss-pH). However, the
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epidermal acidification is known to be fragile and it is
commonly accepted that cosmetic products, especially
soaps and skin cleansing products, can induce significant
changes in ss-pH. As a consequence, epidermal barrier
function and skin microflora are affected negatively. ss-
pH even increases after a single washing procedure or
after rinsing the skin with water alone. The skin pH recov-
ery needs time up to several hours before it can reach the
physiological level. For cosmetic-relevant skin condi-
tions, skin disorders and specific consumer groups, main-
taining of the acidic ss-pH is beneficial for epidermal
physiology and cutaneous microflora. In this context,
cleansing and skin care products with a pH level of 4.0–5.0
may be helpful. In addition, combining the acidic product
pH level with the ideal mix of surfactants, thereby en-
hancing product compatibility and minimizing skin irrita-
tion and intolerance, is a major challenge for the future.
Beyond innovative cleansing technology, further multi-
faceted cosmetic research is a prerequisite to get deeper
knowledge on the interrelation of product pH level, sur-
factant composition and corneobiology.
© 2018 S. Karger AG, Basel
Skin cleansing is generally understood as remov-
ing dirt from the skin surface, whereby dirt in-
cludes dust, sebum, sweat, residues of cosmetics
and pollutants carried by air. Furthermore, body
odour regulation or inhibition and physical relax-
ation or pleasure are also reasons for skin cleans-
ing applications, for example, shower or bath.
From a historical point of view, vegetable oils and
potash were used to produce soap by Sumerians.
Since 2500 B.C., skin cleansing has changed enor-
mously from being a process that was only for re-
moving dirt. Skin cleansing became part of me-
dicinal washing in the 19th century and later was
integrated into the daily body care routine. Now-
adays, skin care and skin cleansing are areas that
are increasingly overshadowing each other. As a
milestone in the history of skin cleansing, the pro-
hibition of using soap on eczematous skin by der-
matologists, in Germany known as “Seifenver-
bot,” should be mentioned [1]. Since then the im-
pH and Skin Cleansing
Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.
Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
pact of skin cleansing products on skin and skin
surface pH (ss-pH) was the topic of a number of
clinical studies and research is still going on. To-
day, the advantage of acidic synthetic detergents
compared to alkaline rinse-off products is com-
monly accepted, especially in skin disorders or
skin conditions with disturbed epidermal acidifi-
cation [2]. Various intrinsic and extrinsic altera-
tions of the physiological ss-pH are evaluated and
described to reduce epidermal barrier function
[2, 3]. Important exogenous factors are occlusive
dressings, topical irritants, skin care products and
skin cleanser, which is the focus of this study. Be-
sides cleansing effects on ss-pH, this chapter re-
views related studies regarding the general as-
pects of skin cleansing and surfactants impact,
epidermal barrier functions and involvement of
the skin microflora.
General Aspects on Skin Cleansing
Skin cleansing products are not only developed to
remove unwanted materials from the skin but are
also part of our daily skin care routine. When they
are skin compatible, they do not compromise cor-
neobiology and are safe for the consumer in gen-
eral. On the other hand, interactions between the
epidermal barrier (i.e., stratum corneum [SC])
and cleansing products are widely evaluated, es-
pecially regarding surfactants. This discrepancy
between positive and negative effects, also known
as cleansing paradox [4], implicates thoughtful
and purposeful usage of skin cleansing products,
especially for cosmetic-relevant skin conditions
and skin disorders.
Investigations on this topic can be divided into
studies on single surfactants or a combination
thereof via exposure models (in vitro; in vivo) and
the clinical evaluation of cleanser as a finished
product in a (nearly) real-life setting. Indepen-
dent from this differentiation, the level of impair-
ment at least depends on type, concentration and/
or mix of surfactants, the used exposure model,
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measured skin parameter, application frequency
and duration, cleansing conditions, as well as skin
type and skin condition.
To understand the impact of skin cleansing on
SC, it is important to reflect the skin penetration
behaviour of surfactants. Surfactants are basic
compounds of skin cleansing products because of
their detergent and foaming properties. Nowa-
days the “surfactant monomer skin penetration
model” is more and more reviewed. Formerly, it
was supposed that surfactant monomers can pen-
etrate in the epidermis, whereas micelles are too
large, and hence skin irritation would be mainly
linked to the critical micelle concentration [5, 6].
Meanwhile, however, it was shown that depend-
ing on the size, surfactant micelles can also pen-
etrate in the epidermis, likely via aqueous pores
[7, 8]. This finding may explain the irritative ef-
fects of cleansing products with a typical concen-
tration of surfactants (5–15 wt%) in which almost
all surfactants are ordered in micelles, whereas
monomers are scarce. In short, cleansing prod-
ucts interact with the outermost layer of the skin
due to the penetration of surfactant monomers
and micelles. The risk for skin barrier irritation
increases dose-dependently at elevated surfactant
concentrations [6–8].
Due to their physicochemical properties, sur-
factants can interact with several functional and/
or structural components of the epidermis. The
impact of surfactants is described and roughly di-
vided by Jackson et al. [9] into interactions with
epidermal (a) lipids, (b) proteins, (c) living cells
and (d) neuroreceptors. It was demonstrated by
Froebe et al. [10], that cleansing products remove
useful lipids from the outermost skin layer, a
phenomenon known as delipidation or degreas-
ing [11]. The impact on epidermal lipids by sur-
factants is characterized by disruption, solubili-
zation and disorganization of SC lipids [10, 12,
13]. Recently, it was clarified that sodium lauryl
sulfate damages the epidermal barrier by modify-
ing the SC long lamellar structure, and that
charged surfactants could be incorporated into
134
Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.
Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
the lipid bilayer structure [12], thereby causing
bilayer destabilization and increased SC perme-
ability [14]. The impact on SC lipids has often
been raised to be the main harmful cleansing ef-
fect, but nowadays the interaction between sur-
factants and epidermal proteins is also accepted
as key mechanism in skin irritation and epider-
mal barrier damage [11]. Cleanser surfactants in-
teract with SC proteins (i.e., keratin), and thus
cause proteins to denature [15], resulting in SC
swelling [16]. In addition to keratin denatur-
ation, surfactants are also able to damage func-
tional proteins, like enzymes, which lead to im-
paired SC lipid and protein maturation, reduced
bilayer formation, dysbalanced desquamation,
altered keratinocyte differentiation and abnor-
mal antioxidative defence [6, 9]. In general, the
extent of interaction between surfactants and SC
proteins depends on net charge and head-/polar-
group size [14]. Due to their ability to permeate,
the SC surfactants can reach stratum granulo-
sum, spinosum and basale, that is, living cells. In-
teraction with epidermal cells (keratinocytes,
Langerhans cells) can result in cell membrane
perturbation, cell stimulation and cell lysis, fol-
lowed by the release of several proinflammatory
mediators, like interleukins or tumour necrosis
factor alpha [9]. Effects of surfactants on neuro-
receptors are also listed by Jackson et al. [9] and
described as sensory irritation due to interaction
with the chemical sensitive type-C nociceptor.
Nevertheless, this type of interaction requires rel-
ative deep surfactant permeation through all epi-
dermal cell layers. The described effects on the
molecular level may result in severe functional
and structural changes, which are clinically visi-
ble or perceptible as dryness, tightness, irritation,
redness and itch. In addition to type, combina-
tion and concentration of surfactants, the cleans-
er’s pH, which is the point of focus in this study,
is another key factor that contributes to skin ir-
ritation and SC damage, which is reviewed in the
following sections.
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Skin pH and Corneobiology
Over more than 120 years ago the acidic nature
of the skin surface was discovered, and later in
1928 established as “acid mantle” by Schade and
Marchionini. Just about 10 years ago, 2 research
groups defined the physiological ss-pH as just
below 5 [17, 18]. In the last 2 decades, a lot of in-
vestigations were performed on the process of
skin surface and SC acidification and the rele-
vance thereof for epidermal barrier physiology.
At least 3 epidermal barrier functions are associ-
ated with skin surface acidification and dis-
cussed in the following paragraph [19]: SC integ-
rity/cohesion, SC recovery and antimicrobial re-
sistance.
Skin pH and Epidermal Barrier Function
The cutaneous desquamation process depends on
the activity of different kallikrein-related pepti-
dases [20], such as kallikrein-5 (KLK5) and kalli-
krein-7 (KLK7). This process is closely related to
the degradation of corneodesmosomes, like des-
moglein 1, desmocollin 1 and corneodesmosin,
by KLK5 and KLK7 [21]. Both these serine prote-
ases are characterized by a slightly basic pH opti-
mum but they showed to be still active at acidic
pH conditions [22]. The epidermal serine prote-
ase regulation is reviewed by Ovaere et al. [23],
where desquamation is described as enzyme con-
trol of KLK5 and KLK7 via acidic pH by reducing
activity but not completely inhibiting these 2 pro-
teases. Consequently, the epidermal desquama-
tion process and in turn SC integrity/cohesion, is
maintained and balanced through a pH below 5.
In addition, SC recovery and regeneration are
also closely related to the slightly acidic ss-pH
[24]. Skin barrier restoration is mainly associated
with the 2 lipid-processing hydrolases
β-glucocerebrosidase and acid sphingomyelin-
ase, which exhibit an acidic pH optimum to trans-
fer polar lipids, such as glucosylceramide and
sphingomyelin, to the non-polar barrier lipid bi-
layer [25, 26]. As a result, SC recovery is delayed
pH and Skin Cleansing
Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.
Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
after exposure of a neutral or alkaline pH-buff-
ered solution to experimentally damaged SC [24,
27].
Skin pH and Microflora
Since the beginning of research on the “acid man-
tle,” the interaction between ss-pH and skin mi-
croflora, especially bacteria, was a major topic of
dermatological investigations. Over the years, the
relevance of the physiological acidic ss-pH as a
regulating factor and antimicrobial barrier has
been demonstrated by many in vitro and in vivo
investigations. The growth of the resident micro-
organism Staphylococcus epidermidis is inhibited
at alkaline in vitro conditions (pH 8.5) compared
to pH 5.5 [28]. This observation is in line with
that made by Lambers et al. [17], detecting in vi-
tro higher growth of S. epidermidis under pH 4.7
and growth inhibition at neutral pH conditions,
whereas the pathogenic bacterium S. aureus was
strongly inhibited at pH 4.7. Similar results were
shown for the pathogenic Propionibacterium
acnes, the growth of which was strongly inhibited
at pH values below 5.5 [28, 29]. The relationship
between ss-pH and skin microflora was also sup-
ported in vivo by a cross-over study using alkaline
soap compared to a pH 5.5 syndet. The growth of
P. acnes was increased after soap usage and re-
duced after 4-week syndet application [30]. To
verify these results, and especially to demonstrate
that the pH itself and not the chemical composi-
tion of the cleansing product impacts bacterial
growth, 2 succeeding in vivo studies were per-
formed. The impact on ss-pH and skin microflora
under long-term usage of 2 syndets was com-
pared: pH 5.5 vs. 7.0 [31] and pH 5.5 vs. 8.5 [32].
Regarding skin bacteria adhesion, it was shown
that the dissociation of resident bacteria is en-
hanced after treatment with an alkaline solution
(pH 11.0) compared to an acidic solution (pH 3.0)
[17], thereby confirming that early results from
1942 were confirmed [33]. Aside pH-dependent
regulation of bacterial growth and adhesion, the
slightly acidic skin surface also provides skin de-
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fence by supporting antimicrobial peptide pro-
duction and activity [34], whereas interaction be-
tween epidermal cells, resident microflora, im-
mune response and ss-pH is still not fully
understood. Summarizing this section, it be-
comes clear that ss-pH matters significantly in
corneobiology by maintaining SC formation, reg-
ulating desquamation, supporting SC regenera-
tion and maintaining a healthy skin microflora by
affecting bacterial growth, adhesion and antimi-
crobial defence.
The Role of pH in Skin Cleansing
Factors influencing ss-pH can be categorized into
3 classes: (1) endogenous factors, unrelated to
pathological situations; (2) endogenous factors,
related to pathological features and (3) exogenous
factors [19]. As exogenous factors, occlusive
dressings, skin irritants, topical antibacterials,
cosmetic products and the soaps and skin cleans-
ing products discussed here are known to influ-
ence ss-pH [2].
A literature survey performed by the “skin
cleansing” group of the German Society for Scien-
tific and Applied Cosmetics in 2013 demonstrated
that the influence of skin cleansing on ss-pH has
been intensively evaluated, especially in the last 4
decades [35]. However, they stated out the diffi-
culty of comparing these investigations due to
marked differences in the experimental setting,
used devices, time points, statistics and applied
product amounts, wherefore final conclusions
should be made carefully (Table 1). Regarding the
impact of skin cleansing on ss-pH, it appears to be
important to differentiate between “pH shift” (ss-
pH change in units after washing procedure) and
“pH recovery” (time required to reach baseline ss-
pH). Interestingly it was shown that even washing
the skin with tap water can increase ss-pH up to
approximation +1.0 unit [35, 36]. To evaluate
product pH effects on ss-pH shift, measurements
were taken by Gfatter et al. [36] before and 10 min
136
Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.
Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
after single standardized washing and the highest
pH shift was shown for the alkaline soap (pH 9.5)
group (+0.453 units). Moreover, a solid and liquid
acidic syndet (pH 5.5) was tested, resulting in low-
er pH shift (+0.294 and +0.291) immediately after
washing. Recovery time for the ss-pH was not as-
sessed. A vastly higher pH shift after single soap
usage was shown by Tamburic [37], where 5 soaps
(pH 10.2–10.5) increased the ss-pH for more than
+2.0 units. The same work demonstrated a pH
shift of up to +0.5 units after usage of 3 more acid-
ic products (pH 6.9–7.5). In case of the alkaline
soaps, ss-pH recovery was not reached on the lat-
est measurement time point: after 60 min. A dou-
ble-blind comparative study was initiated by Barel
et al. [38] to evaluate long-term cleansing effects
under normal home-use conditions in 2 product
groups: soap (pH 9.6) versus syndet (pH 6.9). Dif-
ferent biophysical measurements were taken be-
fore, during (every 2 weeks) and after usage (week
10). Regarding ss-pH measurement, a significant
increase (up to +0.6 units) was noticed on the up-
per arm, neck and legs after 10 consecutive weeks
of washing in the soap group. Another study com-
pared soap and syndet, noticing a pH shift of +1.7
units (soap, pH 9.1) and +0.8 units (syndet, pH
5.5) directly after a single standardized hand
washing procedure [39]. Furthermore, recovery of
the baseline ss-pH was reached 1 h after the wash-
ing procedure for the syndet area, but ss-pH was
still enhanced 1 h after using the alkaline soap
(+0.4 units). A further study compared 6 com-
mercially available cleansers to identify their im-
pact on different skin parameters [40]. After sin-
gle product use, ss-pH changes significantly in all
test sites: +2.1 to 2.4 units (soap types), +1.3 (com-
bar) and +1.0 units (syndet). Additionally, after 90
min, ss-pH was decreased to the normality inter-
val, but baseline level was still not restored.
Based on the literature survey from Assmus et
al. [35], pH shift is stated to range between ±0.0
[41] and +3.0 [42] units and pH recovery time
varies from 45 min [41] to 8 h [43] and 12 h, re-
spectively, in a repetitive cleansing procedure
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Table 1. Relevant investigations from the last two decades on skin surface pH influenced by a single washing proce-
dure

Changes in ss-pH after single application Description of subjects Year Reference

pH shift n = 40 (10 per product) 1997 [36]

+0.20 ss-pH units (water) Age: 2 weeks to 16 months
+0.29 ss-pH units (detergents) Sex: f/m
+0.45 ss-pH units (alkaline soap) Skin: infant skin

pH recovery
Recovery time was not assessed
pH shift n=8 1999 [37]
+0.5 ss-pH units (product pH: 6.9–7.5) Age: 17–40
+2.0 ss-pH units (product pH: 10.2–10.5) Sex: f
Skin: healthy skin
pH recovery
ss-pH was restored after 60 min (product pH: 6.9–7.5)
ss-pH was still enhanced after 60 min (product pH: 10.2–10.5)
pH shift n = 48 2007 [39]
+1.7 ss-pH units (soap) Age: 17–59
+0.8 ss-pH units (syndet) Sex: f
Skin: healthy skin
pH recovery
ss-pH was restored 60 min. after washing (syndet)
ss-pH was still enhanced after 60 min (soap)
pH shift n = 120 (20 per product) 2010 [40]
+2.1 to 2.4 ss-pH units (soap types) Age: 20–25
+1.0 and + 1.3 ss-pH units (syndet and combar) Sex: f/m
Skin: healthy skin
pH recovery
ss-pH was still enhanced after 90 min (all products)
pH shift n = 63 2013 [35]
+1.07 ss-pH units (water) Age: 40–65
+1.23 ss-pH units (syndet: pH 7.0) Sex: f/m
+1.03 to +1.17 ss-pH units (syndet: pH 4.5) Skin: healthy skin

pH recovery
Recovery time was not assessed

ss-pH, skin surface pH; f, female; m, male.

[44]. It becomes clear that pH shift and pH recov-
ery are closely linked to the given pH value of the
used cleansing product. Furthermore, it is shown
that the impact of the product pH on ss-pH is also
influenced by the product ingredients, especially
by the composition of surfactants [35]. In this
multicentre study, the test products were devel-
oped on 2 types of surfactant systems. For one of
these, 2 products were adjusted to a pH of 4.5 and
7.0. The third product, with the different surfac-
tant system, was adjusted to pH 4.5. After single
application, ss-pH was significantly increased in
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pH and Skin Cleansing 137

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Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.

Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
all test sites, with the highest pH shift after wash-
ing with the pH neutral cleanser (+1.23 units). In-
terestingly, the 2 products with the pH of 4.5 were
significantly different in their impact on ss-pH,
an observation that led to the conclusion that
both issues affect ss-pH: product pH and the giv-
en surfactants [35]. However, the interrelation of
formulation (surfactant) chemistry, product pH
and ss-pH in the context of skin irritation is not
yet clarified and direct or indirect impact of the
formulation pH is not differentiated and evalu-
ated in detail [14]. A first step to evaluate direct
pH effects was provided by Ananthapadmanab-
han et al. [45], since they have demonstrated that
the pH of a buffered solution itself induces skin
irritation and therefore SC damage may be a
function of pH, also in the absence of surfactants.
In detail, SC protein swelling is enhanced and lip-
id fluidity is reduced at alkaline pH buffer appli-
cation (pH 10.0) compared to slightly acidic con-
ditions (pH 4.0 and pH 6.5). The relation between
skin cleansing and SC function is also supported
by a controlled, long-term cleansing study, ac-
companied by biophysical measurements to ob-
jectivate the impact on SC physiology parameter.
Focusing on the water-treated control site, it was
shown that a 21-day washing procedure with wa-
ter only significantly increases ss-pH from ap-
proximately pH 4.8 to almost 5.1 [46]. In addi-
tion, the increased ss-pH was accompanied by a
slightly enhanced transepidermal water loss and
significantly reduced SC hydration. Regarding SC
functional assessment, a slight decrease in SC in-
tegrity and a significant decrease in SC cohesion
was observed. This study confirms the impact of
skin cleansing on epidermal barrier function, that
is, SC integrity/cohesion, and the relation thereof
to cleansing-induced changes in ss-pH.
In summary, skin cleansing attended by using
soaps and pH neutral to alkaline syndets leads to
an ss-pH shift of up to +3.0 pH units and could be
followed by an ss-pH recovery time over many
hours; such ss-pH shifts can occur after single
washing procedure [35]. In addition, repeated
138
Surber C, Abels C, Maibach H (eds): pH of the Skin: Issues and Challenges.
Curr Probl Dermatol. Basel, Karger, 2018, vol 54, pp 132–142 (DOI: 10.1159/000489527)
washing per day or long-term usage over weeks
can exacerbate ss-pH changes [39, 44]. Moreover,
cleansing-induced ss-pH enhancement is nega-
tively correlated to several epidermal barrier
functions, especially SC integrity/cohesion, re-
covery and skin microflora, including antimicro-
bial defence. From a clinical perspective, changes
in ss-pH may reduce epidermal barrier function,
which in turn is usually followed by dryness, (af-
ter-wash) tightness, scaling, roughness, redness,
itch and low-grade inflammation [14]. Further-
more, a positive significant correlation between
cleansing product pH and skin irritation index
was also demonstrated [47].
Conclusion
Concerning compatibility of skin cleansing prod-
ucts, replacement of alkaline soaps by slightly
acidic syndets in the late 1950s was the most im-
portant development step taken with regard to
shifting focus from just rinsing skin to removing
dirt. Nowadays, skin cleansing has become more
and more a part of the daily body care routine. A
lot of work has been done to understand the im-
pact of cleansers on ss-pH shift and recovery, and
also to clarify the consequences of ss-pH changes
on various skin parameters, like SC hydration,
epidermal barrier function and skin microflora
(Table 2).
It is well known that perturbation of the slight-
ly acidic ss-pH by cleansing products with a given
pH higher than 5.5 decreases epidermal barrier
function by negatively influencing essential en-
zyme cascades within the SC [35]. A pH shift of
+0.5 units already results in functional SC abnor-
malities, for example, reduced SC cohesion [48].
Moreover, different negative effects on skin mi-
croflora are postulated after cleansing-induced
increase in ss-pH, like reduced growth of resident
microflora, increase in pathogenic flora coloniza-
tion, loss of bacteria adhesion to the skin surface
and impact on antimicrobial defence mecha-
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Table 2. Impact of cleansing on skin function and structure

Affected part Alteration in skin function Reviewed in

Skin surface pH Increase of skin surface pH [35]

Decrease in pH-related epidermal barrier functions
Epidermal lipids Delipidation of surficial and intercellular lipids [14]
Disorganization of SC lipid lamellae
Epidermal proteins Denaturation of keratins [14]
Damage of functional proteins
Living epidermal cells Cell membrane perturbation and lysis [9]
Cell stimulation and proinflammatory release
Neuroreceptors Chemical irritation [9]
Sensory sensations
Skin microflora Removing resident flora [34]
Changing microflora composition and growth
Decrease in resident bacteria adhesion

nisms [34]. In contrast to Schmid-Wendtner and Table 3. Cosmetic-relevant skin conditions, disorders
Korting [49], who claimed higher irritation po- and consumer groups, benefiting from acidic skin cleans-
ing in particular
tential of cosmetics with a given pH of below 5.0,
other authors recommend developing skin care Group of subjects, characterized by skin surface pH alterations
and cleansing products in the range of pH 4.0 and
5.0 [35, 50]. Skin compatibility of slightly acidic Age groups Newborn
Elderly
skin care and cleansing products was shown by 2
Skin inflammation Atopic dermatitis
recent long-term studies, even in epidermal bar- Seborrheic dermatitis
rier compromised skin [51, 52]. Diaper dermatitis

Especially in skin with enhanced ss-pH, and Skin infection Fungal infections
Bacterial infections
therefore negatively affected epidermal barrier
function and skin microflora, maintaining and Special patient Acne-prone skin
populations Diabetic skin
stabilizing of the slightly acidic ss-pH are crucial Dialysis patients
Ichthyosis
to maintain skin healthiness. Just recently, the
benefits of ss-pH “normalization” by pH 4.0 skin Frequent skin cleansing Wet working people
Sportsmen and athletes
care and cleansing treatment were shown by
Specific skin conditions Sensitive skin
Blaak et al. [51, 53] in aged skin and was support- Xerotic skin
ed by Behm et al. [52] for diabetics and elderly via
topical application of a pH 4.0 w/o emulsion. Re-
versing and stabilizing ss-pH via acidic skin care
and cleansing treatment enhance SC integrity/co- sensitive skin [56] or inflammatory skin disor-
hesion and recovery [51] and could improve SC ders, like atopic dermatitis [57] and acne [58]. In
lipid lamellae, spectrum and ratio as well [54]. addition to these groups, wet working people or
Apart from aged skin, endogenous elevation in athletes are characterized by exogenous elevation
ss-pH is also discussed for newborns’ skin [55], in ss-pH due to frequent washing procedure [49].
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For these cosmetic-relevant skin conditions, skin
disorders and specific consumer groups main-
taining or restoration of SC acidification could
benefit epidermal barrier function, skin microflo-
ra and disease state as well (Table 3). In the con-
text of atopic dermatitis, ss-pH is even described
as “therapeutic goal” and establishing a sufficient
“pH management” seems to be the challenge [57].
Since skin cleansing today is a versatile part of
the daily hygiene routine, the choice of the right
cleanser is not only important for patients with
specific skin conditions but also for consumers
with healthy skin. Therefore, it appears reason-
able to recommend cleansing products with a giv-
en pH of below 5.0 for “normal” healthy skin, and
using more acidic products, that is, pH 4.0, for
specific skin conditions and disorders, character-
ized by disturbed SC acidification. Considering
the research of the last 2 decades, it seems to be a
paradox that the majority of commonly available
skin care and cleansing products still reveal neu-
tral to alkaline product pH values, or at least
above pH 5.0 [39, 47, 50, 59–61]. For that reason,
providing the market with acidic skin care and
cleansing products is an important challenge
within the cosmetic industry for the future. An-
other key challenge for skin cleansing producers
may be the combination of the acidic product pH
between 4.0 and 5.0 with the optimal composition
of surfactants [35] and thereby enhance product
compatibility and minimize skin irritation and
damage. However, further research is required to
understand the interrelation between product pH
level, surfactant composition and cutaneous
physiology, especially epidermal barrier function
and skin microflora. However, the important
message is the cleansing of the skin with respect
to pH.

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