Bulky diapers may come to mind when the words adult incontinence are uttered, but today’s offerings are so much more than that. Liners, pads, absorbent underwear, internal products and more are available on the market; helping consumers with varying degrees of incontinence manage their conditions. Outside of aging, incontinence can also stem from childbirth, pregnancy, obesity and other causes—people who still have active lifestyles—and these sufferers don’t want incontinence holding them back. “People want normalcy. It’s about social life and going out, for the light incontinence sufferer, which was once a big taboo,” says Bart Van Malderen, CEO of Drylock Technologies. “[With today’s incontinence products] they can still live a normal life.” Van Malderen, whose company makes a full range incontinence products, says today they’re reaching a different type of consumer. “They can still have their freedom, so to speak. As a provider of incontinence solutions, it’s all about more discreet and better performing products.” A number of factors are contributing to the growth of the adult incontinence market. Across the globe, the average life expectancy is rising. Statistics from the World Health Organization show that the global average life expectancy increased by five years between 2000 and 2015, which was the fastest increase since the 1960s. In addition to the rapidly increasing aging population, factors such as consumer education, awareness of products available and growing acceptance of incontinence issues are also driving the market forward.  SCA, a global leader in the hygiene market, is one of the companies hoping education will help consumers find the right products to manage their incontinence issues. “For younger women, especially those that experience little leaks for the first time through pregnancy or childbirth, we respect that they do not only need well performing, discreet and feminine products. They also need knowledge,” says Meta Redstedt, global master brand director, SCA. Thus, the Swedish company has developed a mobile app for consumers that guides them on ways to manage light incontinence and shares exercise tips that help improve pelvic floor muscles. SCA also offers support though its digital TENA web platforms with loyalty/engagement programs, which offer guidance to people using incontinence products in multiple languages. Kimberly-Clark’s Depend and Poise brands, also leaders in the category, are betting on partnerships with celebrities and other well-known faces to help bring awareness to incontinence issues and solutions. The Depend brand is hoping to shed the stigma of incontinence through its partnerships with avid runner and fitness instructor Suzie Haines, actor and firefighter Jon Shin, and entrepreneur and community activist Dyan Lopez who will all be sharing their stories of incontinence throughout 2017. “To help encourage people to continue living the life they want, this year, Depend is celebrating the personal journeys of three individuals who never stopped owning their greatness and continue to live their life to the fullest every day with Depend Underwear,” says Kova Kolondzic, Depend brand manager, Kimberly-Clark. The Poise brand, which tackles light bladder leakage, most recently partnered with celebrity host, actress and fitness enthusiast Brooke Burke-Charvet and women’s health expert Dr. Jessica Shepherd, OBGYN, to help the millions of women affected by bladder leakage find the best solution for their lifestyle and body. Through online videos, the duo is sharing pelvic floor strengthening exercises and other tips on how to strengthen this part of the body. “Despite so many Americans experiencing bladder leakage in one form or another, the conversation is still small,” says Stacey Pomeroy, Poise brand manager, Kimberly-Clark. “That’s why, this year both Poise and Depend have partnered with a number of influencers to help bring the conversation out in the open, empowering the freedom to share, raise awareness and break down barriers that may prevent someone from buying a product specifically designed for bladder leakage - because talking about it, and realizing you’re not alone, is the first step to finding a better solution.” Getting Better In addition to growing awareness of the incontinence options available to consumers, manufacturers are constantly perfecting their portfolios by enhancing their current line up or developing brand new wears that are more comfortable and discreet. On the light incontinence side, SCA has improved its lights by TENA liners assortment. While they’re as thin and soft as typical liners, they can now absorb five times faster, according to Redstedt. The liners feature exclusive Feel Fresh technology that quickly locks in moisture and controls odor. For slightly heavier incontinence issues, SCA recently improved its TENA Lady Pants Discreet range, offering a thinner, more comfortable and discreet pant with a more feminine design. “With the same high leakage security as before, this product is now even more attractive to women who today may be using pads against leakage but in certain situations need a product that stays in place and lasts longer,” she says. Meanwhile, new night protection products from SCA offer superior protection for a long period of time while users are laying down and moving during the night. SCA also recently enhanced its TENA Men line. The upgrade featured a new design for the products’ absorbent protectors, and the assortment is even more masculine and discreet in order to give men more confidence when dealing with urine leeks. “We know from listening to men across the world that men ask for superior protection and discreet performance especially designed to fit men’s needs,” Redstedt says. “Even though up to one in four men over 40 years old experience some form of urine leaks, many don’t know products specifically for men exist so making our products as masculine as possible is a key need for our target audience – both from an emotional and a performance perspective.” K-C’s Depend brand also made some improvements to its men’s line. Depend Real Fit briefs’ premium cotton-like fabric is now more breathable, and a new stylish masculine design comes in grey, black and blue. An improved fit and superabsorbent material also ensures comfort and protection all day, according to Kolondzic. For its part, adhesives specialist H.B. Fuller recently introduced new adhesive technology called Conforma, which helps provide a better fit for adult incontinence products. Consumers want discreet and comfortable products to fit their active lifestyles, but body shape and size creates a challenge for absorbent product fit and comfort, the company says. But one key way absorbent product producers are addressing these trends is increasing the use of stretchable materials. H.B. Fuller’s Conforma adhesive enables the look and feel of cotton underwear and allows for control and flexibility in line. The adhesive offers unique stretch and retraction features and is applied with standard hot melt equipment. When paired with an extensible nonwoven it creates a conformable fabric that hugs the curves of the body. “Understanding the market trends driving our customers’ current and future needs inspires us to develop high-performance adhesives,” says Nathan Weaver, global vice president, Hygiene, H.B. Fuller. “Conforma is an example of how H.B. Fuller is driving innovation for the hygiene market in key application areas like stretch. Conformable fabric created from Conforma adhesive becomes an attractive choice, as disposable articles evolve into the soft, stretchable, truly comfortable products of the future.” Coming to America According to statistics from Euromonitor International, unit retail volume of adult incontinence products in North America grew 6% between 2015 and 2016, and the market tracker predicts the region will register a CAGR of 7.5% during the 2016-2021 period. Hygiene product manufacturers are responding to this growth with major investments. Last year, SCA increased its presence in the U.S. with a capital investment at its Bowling Green, KY, site. Kentucky’s governor Matt Bevin made the announcement in the fall and said the investment is expected to create 20 jobs at the location. SCA manufactures TENA products at the site. “We’re proud to have been a part of the Bowling Green community for the past 28 years,” says Russ Johnson, site manager at SCA, said at the time of the announcement. “This latest investment in the facility shows not only confidence in our team members, but also confidence in the ability of this region to continue to provide a top-notch manufacturing workforce. We are very thankful for the efforts of this community that help enable continued growth for our plant.” Also expanding its presence in the U.S. is Drylock Technologies. Last year, the pioneer in private label low-fluff and fluffless hygiene products purchased National Presto Industries’ Eau Claire, WI, facility for $71 million. National Presto, which also has divisions that make ammunition for the military and small kitchen appliances for consumers, says its absorbent products unit was originally formed to acquire the assets of a struggling baby diaper company in 2001. Today, it is a manufacturer of adult incontinence products for institutional and retail distributors. Drylock gained two major customers with the purchase of National Presto—including Walmart—and Van Malderen says he wants to expand, which includes plans to increase exports into South America soon. The U.S. was the next logical step for his company, he adds. “We’ve been growing in Europe. I made the acquisition a few years ago in Russia, and expanded with a second plant in Russia, which has been up and running since August. We have the plants in Czech Republic and Italy. We’ve already been supplying products in the U.S. for a few years, so sooner or later we had to produce locally.” He credits the synergies between the companies as a reason that drew him to National Presto. “Our range complements their range, and theirs complements ours. So it’s really a very nice match.” Domtar has also made some big moves in the incontinence market. The maker of Attends adult incontinence products, as well as private label baby diapers and other hygiene items, purchased Butterfly Health, a maker of body liners for sufferers of accidental bowel leakage, last summer. The liners already use Domtar EAM absorbent core technology, which Domtar purchased in 2012. The company also expanded its footprint with the recent purchase of Home Delivery Incontinent Supplies Co. (HDIS), of Olivette, MO, for a total cash consideration of $45 million with a possible earn-out payment of up to $10 million. HDIS is a national direct-to-consumer provider of adult incontinence and related products that provides customers with high-quality products and a personalized service for all of their incontinence needs. The company has total revenues of approximately $65 million. In its fourth quarter 2016 financial results, Domtar’s personal care segment, which included results from HDIS, reported strong sales momentum, with 10% sales growth year-over-year. Sales in the segment were $242 million, and EBITDA before items was $32 million, up $1 million from the third quarter and flat versus the fourth quarter of 2015. “The fourth quarter marked our highest Personal Care sales and EBITDA of the year, which included the results of our recent HDIS acquisition,” said John D. Williams, president and CEO of Domtar. “We are scaling up our capabilities in the rapidly growing direct-to-consumer channel, while expanding our partner-brand strategy to capture sales growth and higher margins by continuing to differentiate the way we sell our products.” During the company’s earnings call for the quarter, Williams said Domtar’s personal care business is gaining traction in North America and Europe in both adult incontinence and baby care applications and growth is accelerating. A milestone for Domtar’s incontinence segment in 2016 was the re-launch of its product range in the North American health care channel, bringing a new clinical value proposition to market with the Attends brand. “We executed on our launch of retail adult incontinence assortment through our partner brand model with two large retailers, where we have invested in innovation and associated product development,” Williams said. Domtar also completed the installation of new brief and bladder control lines in Europe. “In adult incontinence we continue to make progress on our European capacity expansion plans by extending both our capacity and capabilities on key product platforms,” Williams told investors. “These expansions are going well. Several sizes and SKUs have been qualified and we’ve already begun shipping product for sale. These expansion efforts will continue through the end of 2017. Our businesses are showing their resilience in a competitive market environment and we ended 2017 from a position of strength.” Other expansion news in the U.S. comes from Medline, a manufacturer of medical supplies. To help support the growing demand for high-quality products that promote dignity and independence, Medline expanded its adult incontinence product manufacturing facility in Lithia Springs, GA. The 600,000-square foot facility opened in 2011 and has undergone a number of expansions. Medline has end-to-end ownership of products at this facility, which helps ensure quality at every stage, the company says. Moving south, Ontex confirmed in December that it was purchasing the personal hygiene business of Brazilian company Hypermarcas (HM personal hygiene) for R$1 billion ($306.3 million). Following the acquisition announcement, Ontex’s CEO Charles Bouaziz told investors that by integrating Hypermarcas into its business, the Belgian company is growing its presence in adult incontinence, increasing its presence outside of Western Europe, strengthening its branded businesses, achieving attractive returns and synergies and integrating achievable operational and commercial disruptions. In Brazil, HM personal hygiene is the market leader in the adult incontinence category under its established Bigfral brand as well as its newer, value-oriented Adult Max brand, while the business holds the No. 3 position in baby care in Brazil, the fourth largest hygiene market in the world. The inclusion of these brands, which represent about 22-25% of Hypermarcas’ total business, will increase growth in this category from 5.6% to 7% for Ontex. The acquisition of Hypermarcas also strengthens Ontex’s position in the Americas, where it operates a business acquired from Mexico-based Grupo Mabe in 2015. These two businesses will be joined together under Ontex’s America’s division. Studying the Source Research is another area where hygiene manufacturers and suppliers are putting their dollars in support of the adult incontinence market. In May, SCA announced it would financially support the establishment of a new international incontinence research center in Gothenburg, Sweden. The new Gothenburg Continence Research Center (GCRC) was established last year at the Sahlgrenska Academy at University of Gothenburg. About 100 researchers within different disciplines are associated with the center. “We need scientific research that is based on the real needs of incontinent individuals as well as those who give them daily care,” Hans Bergh, global brand director at SCA, said at the time of the announcement. “The new research center will give us new important insights into incontinence care and will help us develop products and services that meet those needs in an even better way.” Ian Milsom, professor of Gynecology and Obstetrics at the university, who is also responsible for the GCRC, says the center will mostly focus its research on urine incontinence, although anal incontinence will also be studied. One of the center’s initial studies focuses on women. “We know today that delivering and pregnancy are factors that influence the risk for urine incontinence in the future,” he says. “So we are working on a prediction modeling system where we are attempting to see if we can prevent women from getting incontinence by selecting women who have had different modes of delivery.” Another study currently in the planning stage looks at the use of containment products, which are used to manage both urine and anal incontinence. “We are doing studies in order to show in a scientific manner the influence of these products on the quality of life when living with incontinence for men and women who have these problems,” Milsom explains. The center plans to study women using these products over the summer, and will study men later in the year. Milsom expects to publish the containment products study sometime in 2018. For its part, adhesives specialist Bostik embarked on a research study on the global adult incontinence market. Christophe Morel-Fourrier, global technical marketing manager, Global Nonwovens Business Unit, Bostik, who headed the project, traveled the globe interviewing experts in the field. “What we really wanted to do was understand more deeply what the adult incontinence market is all about, and the fact that it’s growing faster than the other sub-segments of hygiene,” he explains. By purchasing studies and through his own research, Morel-Fourrier looked at key figures including volumes, growth, value and forecasted growth by region and sub-segments of the market, and also closely examined the needs of the people who wear adult incontinence products. “We’re trying to understand more about who the consumer is, what his or her expectations are, what they want from the product, what is missing and how the design of the product is evolving,” he says. In doing his research, Morel-Fourrier identified and spoke with three types of customers—the mobile adult, the person who is actually using, buying and paying for the product; the bedridden or elderly person in home care or at an institution who uses the product, but who may not actually choose the product; and lastly, the caregiver who uses the product by putting it on the bedridden or elderly person. This customer is the one making the decision to purchase a specific product based on, for example, it being quicker and easier to put on the bedridden or elderly person. “These are the three types of people that manufacturers need to take into account, listen to and satisfy,” he says. One way in which Bostik will use its research is to provide content and knowledge to its customer base, presenting them with a global view of the adult incontinence market. “When you look at all of the raw material producers on a global level, providing this type of knowledge and experience—and being able to commit someone like Christophe to research this market for a year—it’s very dedicated research,” says Courtney Korselt, global communications and insight manager, Global Nonwovens, Bostik. “I think this is what the market can expect from some of the more experienced producers of raw materials of all different types, and this type of dedication and support will help them win and grow.” But, of course, Bostik’s main objective is to use this new knowledge to ensure it is supplying the best possible products for this specific segment of the hygiene industry. “A big focus for us is to see if there is anything more we can do for our customers than what we provide as part of our normal product line,” Korselt says. “From that perspective,” Morel-Fourrier adds, “First things first—first understand, and then act upon.”