The adult incontinence market continues to offer huge potential for product manufacturers. The rapidly aging population across the globe, coupled with rising rates of health conditions that can come with increased risks of urinary incontinence, are fueling growth in this market.

“Age is not the only contributing factor; obesity, PTSD, prostate surgeries, child birth and other factors increase the incidences of incontinence and usually require a different approach and a variety of product formats to manage the conditions,” says Svetlana Uduslivaia, head of Home & Tech Americas at Euromonitor International.

This wide range of incontinence sufferers has opened up opportunities for manufacturers to innovate in this space, and they are continuing to improve absorbency levels, odor control, skin friendliness and breathability in new products. These new developments in pads, disposable underwear, adult diapers and other products have allowed manufacturers to grow and reach new customers. Factors such as increasing awareness and understanding of various incontinence conditions, normalization and better access to products are contributing to this growth.

“Overall trends are somewhat similar to what has been happening in the past few years – product innovation with focus on discretion, comfort, and aesthetics; innovation and marketing aimed at a wider audience, as opposed to only focusing on elderly; younger women and men are in focus too,” Uduslivaia explains.

Global retail sales of adult incontinence products reached nearly $9 billion in 2018 and are projected to reach nearly $14 billion in 2023 (USD fixed 2018 exchange rate, real/constant value, retail sales price), according to new data from Euromonitor. Meanwhile, away-from-home (institutional sales) reached $4.6 billion in 2018 and are projected to bring over $5 billion in 2023 (at manufacturer selling price, or MSP), while Rx/reimbursement sales reached $3.1 billion and will likely approach $3.7 billion in 2023.

Incontinence Evolution
Bulky, uncomfortable adult diapers are relics of the past. Manufacturers have recognized that today’s incontinence sufferer is more than just the elderly woman at a nursing home, but are also younger people who still have very active lifestyles, and who seek products that will allow them to lead normal lives while managing their individual conditions. 

Over the last decade, incontinence products have spread out from the healthcare segment into mainstream consumer products, explains Bart Van Malderen, CEO and chairman of Belgium-based Drylock Technologies. “Anything other than heavy incontinence is no longer seen as a life and/or career changing disorder. People subject to it wish to continue their standard personal, professional and social life,” he adds.

The key to this, he says, is discretion. Incontinence products should not leak, not be observed under clothing and not release any odor. “Modern products with state-of-the-art design allow for all of this. In addition to this, there’s also a ‘feel good’ factor, hence products in gender specific designs with either delicate female or strong male prints, all combined with soft and colorful inner and outer sheets,” Van Malderen adds.

Technological improvements have allowed adult incontinence products to become thinner and better performing. According to Van Malderen, the first phase of technology consisted simply in increasing superabsorbent content while slightly reducing fluff content. Now, breakthrough technologies such as Drylock’s Magical Tubes or P&G’s channeled core allow products to become even thinner and at the same time more ventilating, while improving absorption and protection. “Products now really look, feel and fit like normal underwear,” he adds.

Drylock’s Magical Tubes technology, which first launched in baby diapers in 2017, allows for a better absorbing core efficiency, resulting in an overall thinner product, and an improved fit which brings the product closer to the body. Both items result in a significant leakage risk reduction, up to 50% vs. traditional cores, according to Van Malderen, as well as an improved wearing comfort. Magical Tubes technology for adult incontinence products launched last summer and is currently available in Europe, Russia and Brazil.

In the U.S., Kimberly-Clark continues to have a commanding lead in the market. The corporation’s products have retained a nearly 50% marketshare in the U.S., according to data from IRI, a Chicago-based market research firm, in the latest 52 week period ending Jan. 27, Total U.S. Multi-Outlet (Grocery, Drug, Mass Market, Military and Select Club & Dollar Retailers).

Kimberly-Clark’s Depend and Poise brands continue to advance the incontinence category through innovation, and over the last decade, have expanded their range of products to suit a variety of needs. In 2008, K-C launched gender-specific options for better fit and performance, and in 2010 introduced different colors and patterns to provide the most underwear-like experience possible.

Several recent innovations from the Depend brand include Depend Real Fit Briefs and Depend Silhouette Active Fit Briefs, Depend Night Defense Underwear for Women, and Depend Fit-Flex Underwear. Last year, four new sizes were added to its Fit-Flex Underwear for Women, (S,M,L, XL) and three new sizes were added for men (S/M, L, XL) to provide an even better fit, with softer fabric for better comfort. 

K-C’s Poise brand, which includes a range of products for women designed for light to moderate bladder leakage, includes pad-free options like Impressa Bladder Supports to pads and liners. Kubica Guevara Koo, global marketing director, Adult Care, Kimberly-Clark, says the Poise Brand is committed to understanding the different needs of women, and delivering solutions that help them manage bladder leakage in the way that best fits their lifestyle.

“As we look at today’s market, one of the most powerful improvements has been the increasing awareness and conversations around incontinence,” says Koo. “By breaking down the stigmas associated with bladder leakage, our Poise and Depend brands are empowering consumers to seek answers and products to help them live their lives with confidence.”

According to Koo, the need for adult incontinence is growing across markets globally as aging populations expand and awareness is on the rise. “There are big opportunities in younger generations as well, especially amongst women,” she says. “Given the high incidence of bladder leakage, a key opportunity is to grow our brands in developing countries as we break down category-related stigmas through increased awareness and education around incontinence.”

Procter & Gamble, which re-entered the market in 2014, has been on an upward swing in the U.S. According to the IRI data, P&G’s products increased market share by over 2% in the last year, reaching nearly a 14% share in the U.S. In dollar sales terms, the company realized a 25% surge for its Always Discreet and Always Discreet Boutique products combined.

At the time of the initial launch, Always Discreet offered pads that were 45% thinner than the leading competitive pads, according to Selin Waltz, R&D Always Discreet senior engineer. The Discreet line also includes underwear, as well as liners, which were recently upgraded to be the only incontinence liners to offer leakguards to help stop leaks where they happen most – on the side.

P&G gave consumers a new option in incontinence protection in 2017 with Always Discreet Boutique. The line of bladder leak underwear looks, feels and fits like real, pretty underwear, and was specially designed to help women with bladder leaks get the reliable protection they need in a comfortable, feminine and fashionable bladder leak underwear, Waltz says. P&G’s patented “Channeled Core” technology in the line helps enable an efficient absorption system (protection without the bulk). “Rather than absorbing leaks in one spot (where the leak hits), this core is engineered to redistribute the liquid across the full length of the core,” she explains. “This means absorbency power can be spread more thinly across the full length of the core giving consumers a smooth and comfortable fit even when there’s fluid in it.”

P&G research has found that one in three women over age 18 have some level on incontinence. When it entered the market in 2014, only one in nine women were buying in the incontinence category, and that number has narrowed to one in six, according to Always Discreet brand manager Karen Knight. “Women are starting to realize that the AI category isn’t just about big, bulky diapers and that options exist to protect her and also help her feel feminine and confident,” she says. “For the past 30 years, the bladder leak protection category has been perceived as old and dated, and the products currently available are known to most as adult diapers.”

In fact, according to P&G’s research, two in three women who have tried bladder leak underwear avoid wearing them all together even when they know they need them. Always Discreet spoke to thousands of women while developing and enhancing Boutique, and they believed bladder leak protection can either be pretty or it can be protective—it can’t be both. 

“Real women told us that bulky bladder leak products can erode their confidence and femininity, and 77% of women say wearing their current bladder leak underwear makes them feel older than they would like to feel,” says Knight. “Always Discreet also learned that younger women feel embarrassed wearing bladder leak underwear, while older women feel that bladder leak underwear is too bulky. Always Discreet Boutique’s line of bladder leak underwear was launched in 2017 to change the way the world thinks about bladder leak protection.”

Meanwhile, global hygiene producer Essity has been enhancing its full range of incontinence products on an ongoing base, partly facilitated by the availability of new materials.

“In the last decade we have seen incontinence products become even more leakage secure, more discreet and comfortable for the user, easier to handle for the caregiver and having a lower environmental footprint. All aspects important for self-management and care efficiency in continence care,” says Hans Bergh, global brand director, TENA. “On top of this we have seen improvements in materials available and Essity’s technological knowledge in this area has advanced, which makes it possible to find the right materials and composition of materials to secure good quality of the product.”

Recent initiatives from the company include product improvements promoting skin health. TENA ProSkin Technology features a new  patented three-dimensional technical solution to quickly wick fluids away; helping to maintain the skin’s natural protection. According to Essity, the best way to help prevent skin damage due to incontinence is to keep the skin dry, and the patented ProSkin Technology minimizes the potential for skin to get overhydrated.

Another new product from Essity was developed with help from more than 700 hundred caregivers and nursing home residents. The TENA Complete + Care line, which was introduced in the U.S. last year, offers affordable protection, powered by some of the best TENA technology with 41% more absorption where it matters most. TENA Complete + Care’s DuoLock Core Technology, a patent-pending two core technology, allows for even distribution of super absorbent polymer (SAP) and pulp for an even and thinner large core. The smaller core under big core design acts as a reservoir to wick away and lock in moisture; helping to keep skin drier and the wearer more comfortable. The technology helps provide better incontinence care as its higher SAP concentration in the small core provides improved absorption capacity.

Techy Solutions
According to Bergh, the digital revolution has reached elderly and incontinence care. “Digital continence assessments are becoming more and more common in the developed world; something that didn’t exist just 10 years ago,” he says. “And, there is still some way to go: we haven’t seen the full integration of systems yet, with more devices being connected and less time spent operating different systems or platforms. Going forward the Internet-of-Things will also expand into incontinence care to provide digitally enabled decision support tools, care recommendation, etc.”

For its part, the company offers TENA Identifi, which integrates an innovative data logging and transmitting device with the disposable TENA Identifi Sensor Wear to electronically track resident voiding patterns in real-time. Over a 72-hour assessment period, TENA Identifi tracks the voiding patterns and volume at each product change, then graphically converts the data into actionable, evidence-based reports that provide a good base for appropriate product selection. This, in turn, empowers staff and caregivers to make more informed decisions on individual continence care without having to rely on manual recording processes.

Another new technology in incontinence care recently launched in the U.S. Triple W, founded in 2015, bills its product DFree as an alternative to disposable diapers and pads for some people with bladder control issues.

DFree, which stands for “diaper-free,” is the world’s first connected health wearable device for people who suffer from incontinence. DFree tracks the progression of bladder size using a non-invasive and non-harmful ultrasound sensor. DFree will help seniors, children and disabled people who need to manage incontinence by predicting when their bladder is full and notifying them when it’s the right time to go to the bathroom. The device is designed to help people with incontinence improve quality of life and enable independence, as well as help reduce the burden for the caregivers.

The lightweight and portable DFree device may be discreetly clipped onto belt or clothing while the non-invasive ultrasound sensor is secured to the lower abdomen with medical tape. The sensor uses non-harmful ultrasound technology to monitor the change in bladder size and predicts urination timing using a patented algorithm. DFree connects via Bluetooth to a smartphone or tablet and sends notifications via the DFree app, informing the individual or caregiver when it’s time to go to the bathroom. The user sets the threshold of when they want to be notified such as when their bladder is 65%, 70% or 85% full.

“Health services globally are struggling with the burden of growing and aging populations and continue to put more emphasis on patients and caregivers to monitor their own well-being,” says Ty Takayanagi, VP of Marketing, Triple W. “Therefore, we believe that a self-monitoring device like DFree will play a significant role in the future of our society. With DFree, people facing bladder control issues have the option of a convenient, cost-effective and an environmentally-friendly alternative to disposable diapers or pads or medications – giving them freedom to live an active lifestyle and peace of mind from accidents.”

Triple W provides two versions of DFree. DFree Personal is designed for use by individuals and family care providers. The device sends notifications to a phone or tablet to inform when the user or family member needs to go to the bathroom. Meanwhile, DFree Professional is designed for use by hospitals, nursing homes and in-home care agencies. DFree Professional pairs with a base station to upload a patient’s urination status to the cloud to enable remote monitoring by physicians, nurses and professional care providers.

“DFree helps to prevent urinary leaks,” says Takayanagi. “With DFree, people who need to manage the challenge of a loss of bladder control can confidently go about their daily activities knowing they’ll have ample time to get to the bathroom on time. The device gives them more independence to live an active lifestyle and do the things they love to do.”

In January at the Consumer Electronics Show (CES) in Las Vegas, Triple W won the “Best of CES Award” for the Digital Health and Fitness Category. This category recognizes companies that have demonstrated a product exhibiting the most innovative use of technology to improve users’ health and well-being.

Wrap It Up
For its role in the incontinence market, Infiana offers engineered film solutions for light incontinence products as well as films for diaper closure tapes. Infiana’s personal care product portfolio has been extensively overhauled and consolidated into a special product line, CareLINE, available as Classic and Premium films, according to Michael Pirner, vice president Personal Care Segment, Infiana.

The new product families represent Infiana’s complete range of specialty films for the Personal Care segment, and offer several highly innovative solutions. CareLINE Light is the world’s lightest and thinnest pouch film, with half the material of a normal film and a target grammage of just 10 gsm. Meanwhile, CareLINE Discreet is the world’s quietest pouch film, generating just half the audible noise of conventional packaging. The secret behind CareLINE Discreet lies in its unique material and sealing method. CareLINE Discreet features a tight seem via linear sealing with two continuous sealing strips. An adjustable peel effect through a two-phase system consists of a sealable polyethylene matrix and islands of polybutene to reduce the actively sealable surface area.

“The elderly population tends to enjoy a healthier, more active lifestyle today, so better protection, thinner products and comfort and flexibility are trends we see in the market,” Pirnir says. “Incontinence product manufacturers are also taking advantage of new packaging styles with vibrant colors and design graphics as incontinence products have become considerably less taboo. The previous institutional-style image of adult incontinence product offerings has definitely begun to change, and we expect this trend to continue in the future. These trends influence growth opportunities for premium products worldwide but also in developed regions where growth rates are usually low.”