A programmable epidermal microfluidic valving system for wearable biofluid management and contextual biomarker analysis

Multifunctional laser-induced graphene circuits and laser-printed nanomaterials toward non-invasive human kidney function monitoring

Faced with the increasing prevalence of chronic kidney disease (CKD), portable monitoring of CKD-related biomarkers such as potassium ion (K+), creatinine (Cre), and lactic acid (Lac) levels in sweat has shown tremendous potential for early diagnosis. However, a rapidly manufacturable portable device integrating multiple CKD-related biomarker sensors for ease of sweat testing use has yet to be reported. Here, a portable electrochemical sensor integrated with multifunctional laser-induced graphene (LIG) circuits and laser-printed nanomaterials based working electrodes fabricated by fully automatic laser manufacturing is proposed for non-invasive human kidney function monitoring. The sensor comprises a two-electrode LIG circuit for K+ sensing, a three-electrode LIG circuit with a Kelvin compensating connection for Cre and Lac sensing, and a printed circuit board based portable electrochemical workstation. The working electrodes containing Cu and Cu2O nanoparticles fabricated by two-step laser printing show good sensitivity and selectivity toward Cre and Lac sensing. The sensor circuits are fabricated by generating a hydrophilic-hydrophobic interface on a patterned LIG through laser. This sensor recruited rapid laser manufacturing and integrated with multifunctional LIG circuits and laser-printed nanomaterials based working electrodes, which is a potential kidney function monitoring solution for healthy people and kidney disease patients.

Hybrid Integration of Wearable Devices for Physiological Monitoring

Wearable devices can provide timely, user-friendly, non- or minimally invasive, and continuous monitoring of human health. Recently, multidisciplinary scientific communities have made significant progress regarding fully integrated wearable devices such as sweat wearable sensors, saliva sensors, and wound sensors. However, the translation of these wearables into markets has been slow due to several reasons associated with the poor system-level performance of integrated wearables. The wearability consideration for wearable devices compromises many properties of the wearables. Besides, the limited power capacity of wearables hinders continuous monitoring for extended duration. Furthermore, peak-power operations for intensive computations can quickly create thermal issues in the compact form factor that interfere with wearability and sensor operations. Moreover, wearable devices are constantly subjected to environmental, mechanical, chemical, and electrical interferences and variables that can invalidate the collected data. This generates the need for sophisticated data analytics to contextually identify, include, and exclude data points per multisensor fusion to enable accurate data interpretation. This review synthesizes the challenges surrounding the wearable device integration from three aspects in terms of hardware, energy, and data, focuses on a discussion about hybrid integration of wearable devices, and seeks to provide comprehensive guidance for designing fully functional and stable wearable devices.

Role of wearable electrochemical biosensors in monitoring renal function biomarkers in sweat: a review

Real-time detection of renal biomarkers is crucial for immediate and continuous monitoring of kidney function, facilitating early diagnosis and intervention in kidney-related disorders. This proactive approach enables timely adjustments in treatment plans, particularly in critical situations, and enhances overall patient care. Wearable devices emerge as a promising solution, enabling non-invasive and real-time data collection. This comprehensive review investigates numerous types of wearable sensors designed to detect kidney biomarkers in body fluids such as sweat. It critically evaluates the precision, dependability, and user-friendliness of these devices, contemplating their seamless integration into daily life for continuous health tracking. The review highlights the potential influence of wearable technology on individualized renal healthcare and its role in preventative medicine while also addressing challenges and future directions. The review's goal is to provide guidance to academics, healthcare professionals, and technologists working on wearable solutions for renal biomarker detection by compiling the body of current knowledge and advancements.

Nature-Inspired Superhydrophilic Biosponge as Structural Beneficial Platform for Sweating Analysis Patch

Perspiration plays a pivotal role not only in thermoregulation but also in reflecting the body's internal state and its response to external stimuli. The up-to-date skin-based wearable platforms have facilitated the monitoring and simultaneous analysis of sweat, offering valuable physiological insights. Unlike conventional passive sweating, dynamic normal perspiration, which occurs during various activities and rest periods, necessitates a more reliable method of collection to accurately capture its real-time fluctuations. An innovative microfluidic patch incorporating a hierarchical superhydrophilic biosponge, poise to significantly improve the efficiency capture of dynamic sweat is introduced. The seamlessly integrated biosponge microchannel showcases exceptional absorption capabilities, efficiently capturing non-sensitive sweat exuding from the skin surface, mitigating sample loss and minimizing sweat volatilization. Furthermore, the incorporation of sweat-rate sensors alongside a suite of functional electrochemical sensors endows the patch of uninterrupted monitoring and analysis of dynamic sweat during various activities, stress events, high-energy intake, and other scenarios.

Highly deformable and strongly magnetic semi-interpenetrating hydrogels based on alginate or cellulose

The effective implementation of many of the applications of magnetic hydrogels requires the development of innovative systems capable of withstanding a substantial load of magnetic particles to ensure exceptional responsiveness, without compromising their reliability and stability. To address this challenge, double-network hydrogels have emerged as a promising foundation, thanks to their extraordinary mechanical deformability and toughness. Here, we report a semi-interpenetrating polymer networks (SIPNs) approach to create diverse magnetic SIPNs hydrogels based on alginate or cellulose, exhibiting remarkable deformability under certain stresses. Achieving strong responsiveness to magnetic fields is a key objective, and this characteristic is realized by the incorporation of highly magnetic iron microparticles at moderately large concentrations into the polymer network. Remarkably, the SIPNs hydrogels developed in this research accommodate high loadings of magnetic particles without significantly compromising their physical properties. This feature is essential for their use in applications that demand robust responsiveness to applied magnetic fields and overall stability, such as a hydrogel luminescent oxygen sensor controlled by magnetic fields that we designed and tested as proof-of-concept. These findings underscore the potential and versatility of magnetic SIPNs hydrogels based on carbohydrate biopolymers as fundamental components in driving the progress of advanced hydrogels for diverse practical implementations.

Skin-Interfaced Bifluidic Paper-Based Device for Quantitative Sweat Analysis

The erratic, intermittent, and unpredictable nature of sweat production, resulting from physiological or psychological fluctuations, poses intricacies to consistently and accurately sample and evaluate sweat biomarkers. Skin-interfaced microfluidic devices that rely on colorimetric mechanisms for semi-quantitative detection are particularly susceptible to these inaccuracies due to variations in sweat secretion rate or instantaneous volume. This work introduces a skin-interfaced colorimetric bifluidic sweat device with two synchronous channels to quantify sweat rate and biomarkers in real-time, even during uncertain sweat activities. In the proposed bifluidic-distance metric approach, with one channel to measure sweat rate and quantify collected sweat volume, the other channel can provide an accurate analysis of the biomarkers based on the collected sweat volume. The closed channel design also reduces evaporation and resists contamination from the external environment. The feasibility of the device is highlighted in a proof-of-the-concept demonstration to analyze sweat chloride for evaluating hydration status and sweat glucose for assessing glucose levels. The low-cost yet highly accurate device provides opportunities for clinical sweat analysis and disease screening in remote and low-resource settings. The developed device platform can be facilely adapted for the other biomarkers when corresponding colorimetric reagents are exploited.

Harvesting and manipulating sweat and interstitial fluid in microfluidic devices

Microfluidic devices began to be used to facilitate sweat and interstitial fluid (ISF) sensing in the mid-2010s. Since then, numerous prototypes involving microfluidics have been developed in different form factors for sensing biomarkers found in these fluids under in vitro, ex vivo, and in vivo (on-body) settings. These devices transport and manipulate biofluids using microfluidic channels composed of silicone, polymer, paper, or fiber. Fluid flow transport and sample management can be achieved by controlling the flow rate, surface morphology of the channel, and rate of fluid evaporation. Although many devices have been developed for estimating sweat rate, electrolyte, and metabolite levels, only a handful have been able to proceed beyond laboratory testing and reach the stage of clinical trials and commercialization. To further this technology, this review reports on the utilization of microfluidics towards sweat and ISF management and transport. The review is distinguished from other recent reviews by focusing on microfluidic principles of sweat and ISF generation, transport, extraction, and management. Challenges and prospects are highlighted, with a discussion on how to transition such prototypes towards personalized healthcare monitoring systems.

A Bifunctional Wearable Sensor Based on a Nanoporous Membrane for Simultaneous Detection of Sweat Lactate and Temperature

Wearable sensors for non-invasive, real-time detection of sweat lactate have far-reaching implications in the fields of health care and exercise physiological responses. Here, we propose a wearable electrochemical sensor with gold nanoelectrode arrays fabricated on the nanoporous polycarbonate (PC) membrane by encapsulating lactate oxidase (LOx) in chitosan (CS) hydrogel for detecting body temperature and sweat lactate concurrently. Flexible gold nanoporous electrodes not only enhance electrode area but also offer a nanoconfined space to accelerate the catalytic reaction of LOx and control substrate concentration on the surface of LOx to decrease substrate inhibition. The proposed sensor has a long durability of 13 days and better selectivity for the detection of sweat lactate over a wide linear range (0.01-35 mM) with a low detection limit (0.144 μM). Furthermore, temperature-dependent transmembrane currents passing through the sensor are used to estimate body temperature. We then use multiple linear regression to adjust the effect of temperature on lactate detection and succeed in monitoring lactate molecules in sweat and body temperature during exercise.

Flexible Electrohydrodynamic Fluid-Driven Valveless Water Pump via Immiscible Interface

The conventional electrohydrodynamic (EHD) pump is limited to pumping functional and dielectric liquids, which restricts its applications in fields like microfluidics, food safety, and materials production. In this study, we present a flexible water pump driven by EHD fluid, achieved by integrating valveless elements into the fluidic channel. Our approach leverages the water-EHD interface to propel the immiscible aqueous liquid and reciprocate this process using the nozzle-diffuser system. All components of the water pump are digitally fabricated and assembled. The valveless parts are created using a laser cutting machine. Additionally, we develop a model for the EHD pump and nozzle-diffuser system to predict the generated flow rate, considering factors such as the asymmetrical performance of the EHD pump, pulse frequency, applied voltage, and structural parameters. Finally, we experimentally characterize the flow rates of both the EHD pump and water pump and apply the newly developed device to air bubble manipulation and droplet generation. This research broadens the range of specialized liquids pumped by EHD pumps to include other aqueous liquids or mixtures.

Stretchable and Smart Wettable Sensing Patch with Guided Liquid Flow for Multiplexed in Situ Perspiration Analysis

Stretchable sweat sensors have become a personalized wearable platform for continuous, noninvasive health monitoring through conformal integration with the human body. Typically, these devices are coupled with soft microfluidic systems to control sweat flow during advanced analysis processes. However, the implementation of these soft microfluidic devices is limited by their high fabrication costs and the need for skin adhesives to block natural perspiration. To overcome these limitations, a stretchable and smart wettable patch has been proposed for multiplexed in situ perspiration analysis. The patch includes a porous membrane in the form of a patterned microfoam and a nanofiber layer laminate, which extracts sweat selectively from the skin and directs its continuous flow across the device. The integrated electrochemical sensor array measures multiple biomarkers simultaneously such as pH, K+, and Na+. The soft sensing patch comprises compliant materials and structures that allow deformability of up to 50% strain, which enables a stable and seamless interface with the curvilinear human body. During continuous physical exercise, the device has demonstrated a special operating mode by actively accumulating sweat from the skin for multiplex electrochemical analysis of biomarker profiles. The smart wettable membrane provides an affordable solution to address the sampling challenges of in situ perspiration analysis.

Conductive and Eco-friendly Biomaterials-based Hydrogels for Noninvasive Epidermal Sensors: A Review

As noninvasive wearable electronic devices, epidermal sensors enable continuous, real-time, and remote monitoring of various human physiological parameters. Conductive biomaterials-based hydrogels as sensor matrix materials have good biocompatibility, biodegradability, and efficient stimulus response capabilities and are widely applied in motion monitoring, healthcare, and human-machine interaction. However, biomass hydrogel-based epidermal sensing devices still need excellent mechanical properties, prolonged stability, multifunctionality, and extensive practicality. Therefore, this paper reviews the common biomass hydrogel materials for epidermal sensing (proteins, polysaccharides, polyphenols, etc.) and the various types of noninvasive sensing devices (strain/pressure sensors, temperature sensors, glucose sensors, electrocardiograms, etc.). Moreover, this review focuses on the strategies of scholars to enhance sensor properties, such as strength, conductivity, stability, adhesion, and self-healing ability. This work will guide the preparation and optimization of high-performance biomaterials-based hydrogel epidermal sensors.

Microfluidic-Based Non-Invasive Wearable Biosensors for Real-Time Monitoring of Sweat Biomarkers

Wearable biosensors are attracting great interest thanks to their high potential for providing clinical-diagnostic information in real time, exploiting non-invasive sampling of biofluids. In this context, sweat has been demonstrated to contain physiologically relevant biomarkers, even if it has not been exhaustively exploited till now. This biofluid has started to gain attention thanks to the applications offered by wearable biosensors, as it is easily collectable and can be used for continuous monitoring of some parameters. Several studies have reported electrochemical and optical biosensing strategies integrated with flexible, biocompatible, and innovative materials as platforms for biospecific recognition reactions. Furthermore, sampling systems as well as the transport of fluids by microfluidics have been implemented into portable and compact biosensors to improve the wearability of the overall analytical device. In this review, we report and discuss recent pioneering works about the development of sweat sensing technologies, focusing on opportunities and open issues that can be decisive for their applications in routine-personalized healthcare practices.

Access and Management of Sweat for Non-Invasive Biomarker Monitoring: A Comprehensive Review

Sweat is an important biofluid presents in the body since it regulates the internal body temperature, and it is relatively easy to access on the skin unlike other biofluids and contains several biomarkers that are also present in the blood. Although sweat sensing devices have recently displayed tremendous progress, most of the emerging devices primarily focus on the sensor development, integration with electronics, wearability, and data from in vitro studies and short-term on-body trials during exercise. To further the advances in sweat sensing technology, this review aims to present a comprehensive report on the approaches to access and manage sweat from the skin toward improved sweat collection and sensing. It is begun by delineating the sweat secretion mechanism through the skin, and the historical perspective of sweat, followed by a detailed discussion on the mechanisms governing sweat generation and management on the skin. It is concluded by presenting the advanced applications of sweat sensing, supported by a discussion of robust, extended-operation epidermal wearable devices aiming to strengthen personalized healthcare monitoring systems.

Dual detection of human motion and glucose in sweat with polydopamine and glucose oxidase doped self-healing nanocomposite hydrogels

The detection of human motion and sweat composition are important for human health or sports training, so it is necessary to develop flexible sensors for monitoring exercise processes and sweat detection. Mussel secretion of adhesion proteins enables self-healing of byssus and adhesion to surfaces. We prepared Au nanoparticles@polydopamine (AuNPs@PDA) nanomaterials based on mussel-inspired chemistry and compounded them with polyvinyl alcohol (PVA) hydrogels to obtain PVA/AuNPs@PDA self-healing nanocomposite hydrogels. Dopamine (DA) was coated on the surface of AuNPs to obtain AuNPs based composite (AuNPs@PDA) and the AuNPs@PDA was implanted into the PVA hydrogels to obtain nanocomposite hydrogel through facile freeze-thaw cycle. Glucose oxidase (GOD) was added to the hydrogel matrix to achieve specific detection of glucose in sweat. The obtained hydrogels exhibit high deformability (573.7 %), excellent mechanical strength (550.3 KPa) and self-healing properties (85.1 %). The PVA/AuNPs@PDA hydrogel sensors exhibit quick response time (185.0 ms), wide strain sensing range (0-500 %), superior stability and anti-fatigue properties in motion detection. The detection of glucose had wide concentration detection range (1.0 μmol/L-200.0 μmol/L), low detection limits (0.9 μmol/L) and high sensitivity (24.4 μA/mM). This work proposes a reference method in dual detection of human exercise and sweat composition analysis.

Enhancing On-Skin Analysis: A Microfluidic Device and Smartphone Imaging Module for Real-Time Quantitative Detection of Multianalytes in Sweat

Wearable sweat sensors present exciting opportunities for advancing personal health monitoring and noninvasive biomarker measurements. However, existing sensors often fall short in accurate detection of low analyte volumes and concentrations and lack multimodal sensing capabilities. Herein, we present a highly portable four-channel microfluidic device capable of conducting simultaneous sweat sampling and fluorometric sensing of potential biomarkers, such as l-Tyr, l-Trp, Crt, and NH4+, specifically designed for kidney disease monitoring. Our microfluidic device seamlessly integrates with smartphones, facilitating easy data retrieval and analysis. The core of the sensing array is a novel fluorometric solid-state mechanism utilizing carbon polymer dots derived from dopamine, catechol, and o-phenylenediamine monomers embedded in gelatin hydrogels. The sensors exhibit exceptional performance, offering linear ranges of 5-275, 6-170, 4-220, and 5-170 μM, with impressively low detection limits of 1.5, 1.2, 1.3, and 1.4 μM for l-Tyr, l-Trp, Crt, and NH4+, respectively. Through meticulous optimization of operational variables, comprising the temperature, sample volume, and assay time, we achieved the best performance of the device. Furthermore, the sensors exhibited remarkable selectivity, effectively distinguishing between biologically similar species and other potential biological compounds found in sweat. Our evaluation also extended to monitoring kidney diseases in patients and healthy individuals, showcasing the device's utility in world scenarios. Promising results showcase the potential of low-cost, multidiagnostic microfluidic sensor arrays, especially with synthetic skin integration, for enhanced disease detection and healthcare outcomes.

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Recent advances in skin-interfaced wearable sweat sensors enable the noninvasive, real-time monitoring of biochemical signals associated with health and wellness. These wearable platforms leverage microfluidic channels, biochemical sensors, and flexible electronics to enable the continuous analysis of sweat-based biomarkers such as electrolytes, metabolites, and hormones. As this field continues to mature, the potential of low-cost, continuous personalized health monitoring enabled by such wearable sensors holds significant promise for addressing some of the formidable obstacles to delivering comprehensive medical care in under-resourced settings. This Perspective highlights the transformative potential of wearable sweat sensing for providing equitable access to cutting-edge healthcare diagnostics, especially in remote or geographically isolated areas. It examines the current understanding of sweat composition as well as recent innovations in microfluidic device architectures and sensing strategies by showcasing emerging applications and opportunities for innovation. It concludes with a discussion on expanding the utility of wearable sweat sensors for clinically relevant health applications and opportunities for enabling equitable access to innovation to address existing health disparities.

Optical Integration in Wearable, Implantable and Swallowable Healthcare Devices

Recent advances in materials and semiconductor technologies have led to extensive research on optical integration in wearable, implantable, and swallowable health devices. These optical systems utilize the properties of light─intensity, wavelength, polarization, and phase─to monitor and potentially intervene in various biological events. The potential of these devices is greatly enhanced through the use of multifunctional optical materials, adaptable integration processes, advanced optical sensing principles, and optimized artificial intelligence algorithms. This synergy creates many possibilities for clinical applications. This Perspective discusses key opportunities, challenges, and future directions, particularly with respect to sensing modalities, multifunctionality, and the integration of miniaturized optoelectronic devices. We present fundamental insights and illustrative examples of such devices in wearable, implantable, and swallowable forms. The constant pursuit of innovation and the dedicated approach to critical challenges are poised to influence diverse fields.

Advanced Self-Powered Biofuel Cells with Capacitor and Nanogenerator for Biomarker Sensing

Self-powered biofuel cells (BFCs) have evolved for highly sensitive detection of biomarkers such as noncodon micro ribonucleic acids (miRNAs) in the presence of interfering substrates. Self-charging supercapacitive BFCs for in vivo and in vitro cellular microenvironments represent the most prevalent sensing mechanism for diagnosis. Therefore, self-powered biosensing (SPB) with a capacitor and contact separation with a triboelectric nanogenerator (TENG) offers electrochemical and colorimetric dual-mode detection via improved electrical signal intensity. In this review, we discuss three major components: stretchable self-powered BFC design, miRNA sensing, and impedance spectroscopy. A specific focus is given to 1) assembling of sensors for biomarkers, 2) electrical output signal intensification, and 3) role of supercapacitors and nanogenerators in SPBs. We outline the key features of stretchable SPBs and the sequence of miRNA sensing by SPBs. We have emphasized the need of a supercapacitor and nanogenerator for SPBs in the context of advanced assembly of the sensing unit. Finally, we outline the role of impedance spectroscopy in the detection and estimation of biomarkers. We highlight key challenges in SPBs for biomarker sensing, which needs improved sensing accuracy, integration strategies of electrochemical biosensing for in vitro and in vivo microenvironments, and the impact of miRNA sensing on cancer diagnostics. This article attempts a specific focus on the accuracy and limitations of sensing unit for miRNA biomarkers and associated tool for boosting electrical signal intensity for a potential big step further.

A wireless patch for the monitoring of C-reactive protein in sweat

The quantification of protein biomarkers in blood at picomolar-level sensitivity requires labour-intensive incubation and washing steps. Sensing proteins in sweat, which would allow for point-of-care monitoring, is hindered by the typically large interpersonal and intrapersonal variations in its composition. Here we report the design and performance of a wearable and wireless patch for the real-time electrochemical detection of the inflammatory biomarker C-reactive (CRP) protein in sweat. The device integrates iontophoretic sweat extraction, microfluidic channels for sweat sampling and for reagent routing and replacement, and a graphene-based sensor array for quantifying CRP (via an electrode functionalized with anti-CRP capture antibodies-conjugated gold nanoparticles), ionic strength, pH and temperature for the real-time calibration of the CRP sensor. In patients with chronic obstructive pulmonary disease, with active or past infections or who had heart failure, the elevated concentrations of CRP measured via the patch correlated well with the protein's levels in serum. Wearable biosensors for the real-time sensitive analysis of inflammatory proteins in sweat may facilitate the management of chronic diseases.

Flexible thermoelectric generator and energy management electronics powered by body heat

Uninterrupted, efficient power supplies have posed a significant hurdle to the ubiquitous adoption of wearable devices, despite their potential for revolutionizing human‒machine interactions. This challenge is further compounded by the requirement of these devices to supply dependable energy for data-intensive sensing and transmission. Traditional thermoelectric solutions fail to deliver satisfactory performance under conditions of extremely low voltages. Here, we present a novel solution of a wearable thermoelectric generator integrated with an energy management system, which is capable of powering sensors and Bluetooth by harnessing body heat. Distinct from previous works, our innovation lies in its ability to consistently operate even with a minimal temperature difference (i.e., 4 K) between the human skin and the ambient environment, ensuring reliable data transmission within a time as short as 1.6 s. Furthermore, our system can recharge utilizing body heat under ultralow voltage conditions (30 mV). Our developed system provides a novel pathway for the continuous, reliable monitoring of self-contained wearable devices without depending on batteries.

Wearable Microfluidics for Continuous Assay

The development of wearable devices provides approaches for the realization of self-health care. Easily carried wearable devices allow individual health monitoring at any place whenever necessary. There are various interesting monitoring targets, including body motion, organ pressure, and biomarkers. An efficient use of space in one small device is a promising resolution to increase the functions of wearable devices. Through integration of a microfluidic system into wearable devices, embedding complicated structures in one design becomes possible and can enable multifunction analyses within a limited device volume. This article reviews the reported microfluidic wearable devices, introduces applications to different biofluids, discusses characteristics of the design strategies and sensing principles, and highlights the attractive configurations of each device. This review seeks to provide a detailed summary of recent advanced microfluidic wearable devices. The overview of advanced key components is the basis for the development of future microfluidic wearable devices.

Skin-interfaced microfluidic systems with spatially engineered 3D fluidics for sweat capture and analysis

Skin-interfaced wearable systems with integrated microfluidic structures and sensing capabilities offer powerful platforms for monitoring the signals arising from natural physiological processes. This paper introduces a set of strategies, processing approaches, and microfluidic designs that harness recent advances in additive manufacturing [three-dimensional (3D) printing] to establish a unique class of epidermal microfluidic ("epifluidic") devices. A 3D printed epifluidic platform, called a "sweatainer," demonstrates the potential of a true 3D design space for microfluidics through the fabrication of fluidic components with previously inaccessible complex architectures. These concepts support integration of colorimetric assays to facilitate in situ biomarker analysis operating in a mode analogous to traditional epifluidic systems. The sweatainer system enables a new mode of sweat collection, termed multidraw, which facilitates the collection of multiple, independent sweat samples for either on-body or external analysis. Field studies of the sweatainer system demonstrate the practical potential of these concepts.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Smartphone-based platforms implementing microfluidic detection with image-based artificial intelligence

The frequent outbreak of global infectious diseases has prompted the development of rapid and effective diagnostic tools for the early screening of potential patients in point-of-care testing scenarios. With advances in mobile computing power and microfluidic technology, the smartphone-based mobile health platform has drawn significant attention from researchers developing point-of-care testing devices that integrate microfluidic optical detection with artificial intelligence analysis. In this article, we summarize recent progress in these mobile health platforms, including the aspects of microfluidic chips, imaging modalities, supporting components, and the development of software algorithms. We document the application of mobile health platforms in terms of the detection objects, including molecules, viruses, cells, and parasites. Finally, we discuss the prospects for future development of mobile health platforms.

Microfluidic solutions for biofluids handling in on-skin wearable systems

On-skin wearable systems for biofluid sampling and biomarker sensing can revolutionize the current practices in healthcare monitoring and personalized medicine. However, there is still a long path toward complete market adoption and acceptance of this fascinating technology. Accordingly, microfluidic science and technology can provide excellent solutions for bridging the gap between basic research and clinical research. The research gap has led to the emerging field of epidermal microfluidics. Moreover, recent advances in the fabrication of highly flexible and stretchable microfluidic systems have revived the concept of micro elastofluidics, which can provide viable solutions for on-skin wearable biofluid handling. In this context, this review highlights the current state-of-the-art platforms in this field and discusses the potential technologies that can be used for on-skin wearable devices. Toward this aim, we first compare various microfluidic platforms that could be used for on-skin wearable devices. These platforms include semiconductor-based, polymer-based, liquid metal-based, paper-based, and textile-based microfluidics. Next, we discuss how these platforms can enhance the stretchability of on-skin wearable biosensors at the device level. Next, potential microfluidic solutions for collecting, transporting, and controlling the biofluids are discussed. The application of finger-powered micropumps as a viable solution for precise and on-demand biofluid pumping is highlighted. Finally, we present the future directions of this field by emphasizing the applications of droplet-based microfluidics, stretchable continuous-flow micro elastofluidics, stretchable superhydrophobic surfaces, liquid beads as a form of digital micro elastofluidics, and topological liquid diodes that received less attention but have enormous potential to be integrated into on-skin wearable devices.

Device integration of electrochemical biosensors

Electrochemical biosensors incorporate a recognition element and an electronic transducer for the highly sensitive detection of analytes in body fluids. Importantly, they can provide rapid readouts and they can be integrated into portable, wearable and implantable devices for point-of-care diagnostics; for example, the personal glucose meter enables at-home assessment of blood glucose levels, greatly improving the management of diabetes. In this Review, we discuss the principles of electrochemical biosensing and the design of electrochemical biosensor devices for health monitoring and disease diagnostics, with a particular focus on device integration into wearable, portable and implantable systems. Finally, we outline the key engineering challenges that need to be addressed to improve sensing accuracy, enable multiplexing and one-step processes, and integrate electrochemical biosensing devices in digital health-care pathways.

Epidermal Wearable Biosensors for Monitoring Biomarkers of Chronic Disease in Sweat

Biological information detection technology is mainly used for the detection of physiological and biochemical parameters closely related to human tissues and organ lesions, such as biomarkers. This technology has important value in the clinical diagnosis and treatment of chronic diseases in their early stages. Wearable biosensors can be integrated with the Internet of Things and Big Data to realize the detection, transmission, storage, and comprehensive analysis of human physiological and biochemical information. This technology has extremely wide applications and considerable market prospects in frontier fields including personal health monitoring, chronic disease diagnosis and management, and home medical care. In this review, we systematically summarized the sweat biomarkers, introduced the sweat extraction and collection methods, and discussed the application and development of epidermal wearable biosensors for monitoring biomarkers in sweat in preclinical research in recent years. In addition, the current challenges and development prospects in this field were discussed.

Microfluidic systems in clinical diagnosis

The use of microfluidic devices is highly attractive in the field of biomedical and clinical assessments, as their portability and fast response time have become crucial in providing opportune therapeutic treatments to patients. The applications of microfluidics in clinical diagnosis and point-of-care devices are continuously growing. The present review article discusses three main fields where miniaturized devices are successfully employed in clinical applications. The quantification of ions, sugars, and small metabolites is examined considering the analysis of bodily fluids samples and the quantification of this type of analytes employing real-time wearable devices. The discussion covers the level of maturity that the devices have reached as well as cost-effectiveness. The analysis of proteins with clinical relevance is presented and organized by the function of the proteins. The last section covers devices that can perform single-cell metabolomic and proteomic assessments. Each section discusses several strategically selected recent reports on microfluidic devices successfully employed for clinical assessments, to provide the reader with a wide overview of the plethora of novel systems and microdevices developed in the last 5 years. In each section, the novel aspects and main contributions of each reviewed report are highlighted. Finally, the conclusions and future outlook section present a summary and speculate on the future direction of the field of miniaturized devices for clinical applications.

A photoacoustic patch for three-dimensional imaging of hemoglobin and core temperature

Electronic patches, based on various mechanisms, allow continuous and noninvasive monitoring of biomolecules on the skin surface. However, to date, such devices are unable to sense biomolecules in deep tissues, which have a stronger and faster correlation with the human physiological status than those on the skin surface. Here, we demonstrate a photoacoustic patch for three-dimensional (3D) mapping of hemoglobin in deep tissues. This photoacoustic patch integrates an array of ultrasonic transducers and vertical-cavity surface-emitting laser (VCSEL) diodes on a common soft substrate. The high-power VCSEL diodes can generate laser pulses that penetrate >2 cm into biological tissues and activate hemoglobin molecules to generate acoustic waves, which can be collected by the transducers for 3D imaging of the hemoglobin with a high spatial resolution. Additionally, the photoacoustic signal amplitude and temperature have a linear relationship, which allows 3D mapping of core temperatures with high accuracy and fast response. With access to biomolecules in deep tissues, this technology adds unprecedented capabilities to wearable electronics and thus holds significant implications for various applications in both basic research and clinical practice.

Autonomous wearable sweat rate monitoring based on digitized microbubble detection

Advancements in wearable bioanalytical microsystems have enabled diurnal and (semi)continuous monitoring of physiologically-relevant indices that are accessible through probing sweat. To deliver an undistorted and physiologically-meaningful interpretation of these readings, tracking the sweat secretion rate is essential, because it allows for calibrating the biomarker readings against variations in sweat secretion and inferring the body's hydration/electrolyte homeostasis status. To realize an autonomous wearable solution with intrinsically high signal-to-noise ratio sweat rate sensing capabilities, here, we devise a digitized microbubble detection mechanism-delivered by a hybrid microfluidic/electronic system with a compact footprint. This mechanism is based on the intermittent generation of microliter-scale bubbles via electrolysis and the instantaneous measurement of their time-of-flight (and thus, velocity) via impedimetric sensing. In this way, we overcome the limitations of previously proposed sweat rate sensing modalities that are inherently susceptible to non-targeted secretion characteristics (pH, conductivity, and temperature), constrained by volume, or lack system integration for autonomous on-body operation. By deploying our solution in human subject trials, we validate the utility of our solution for seamless monitoring of exercise- and iontophoretically-induced sweat secretion profiles.

A Comprehensive Review of the Recent Developments in Wearable Sweat-Sensing Devices

Sweat analysis offers non-invasive real-time on-body measurement for wearable sensors. However, there are still gaps in current developed sweat-sensing devices (SSDs) regarding the concerns of mixing fresh and old sweat and real-time measurement, which are the requirements to ensure accurate the measurement of wearable devices. This review paper discusses these limitations by aiding model designs, features, performance, and the device operation for exploring the SSDs used in different sweat collection tools, focusing on continuous and non-continuous flow sweat analysis. In addition, the paper also comprehensively presents various sweat biomarkers that have been explored by earlier works in order to broaden the use of non-invasive sweat samples in healthcare and related applications. This work also discusses the target analyte's response mechanism for different sweat compositions, categories of sweat collection devices, and recent advances in SSDs regarding optimal design, functionality, and performance.

Ultra-Thin Flexible Encapsulating Materials for Soft Bio-Integrated Electronics

Recently, bioelectronic devices extensively researched and developed through the convergence of flexible biocompatible materials and electronics design that enables  more precise diagnostics and therapeutics in human health care and opens up the potential to expand into various fields, such as clinical medicine and biomedical research. To establish an accurate and stable bidirectional bio-interface, protection against the external environment and high mechanical deformation is essential for wearable bioelectronic devices. In the case of implantable bioelectronics, special encapsulation materials and optimized mechanical designs and configurations that provide electronic stability and functionality are required for accommodating various organ properties, lifespans, and functions in the biofluid environment. Here, this study introduces recent developments of ultra-thin encapsulations with novel materials that can preserve or even improve the electrical performance of wearable and implantable bio-integrated electronics by supporting safety and stability for protection from destruction and contamination as well as optimizing the use of bioelectronic systems in physiological environments. In addition, a summary of the materials, methods, and characteristics of the most widely used encapsulation technologies is introduced, thereby providing a strategic selection of appropriate choices of recently developed flexible bioelectronics.

Facile Preparation of Dual Functional Wearable Devices Based on Hindered Urea Bond-Integrated Reprocessable Polyurea and AgNWs

With the advancement of material science and electronic technology, wearable devices have been integrated into daily lives, no longer just a stirring idea in science fiction. In the future, robust multifunctionalized wearable devices with low cost and long-term service life are urgently required. However, preparing multifunctional wearable devices robust enough to resist harsh conditions using a commercially available raw material through a simple process still remains challenging. In this work, reprocessable polyurea (HUBTPU) with a hard segment of hindered urea bonds (HUBs) and a soft segment of polyether is synthesized via a facile one-pot method. The robust dual functional wearable devices were obtained by simply spray-coating silver nanowires (AgNWs) on HUBTPU elastomer substrates. Due to the dynamic combination and decomposition of the HUBs and hydrogen bonds at 130 °C, the robust elastomer demonstrates favorable adhesion to various substrates. Especially, the partially embedded AgNW structure is also achieved by using ethanol as a spray solvent. The adhesion of HUBTPU substrates and embedded structure leads to stronger interfacial adhesion and stability compared to non-adhesive substrates. The as-obtained HUBTPU electrodes are able to be heated to 115 °C by applying a low voltage and sensing the strain deformation caused by human movement, which means that the electrodes are endowed with both electrical heating capability and strain sensing functionality. Therefore, this strategy reveals a potential way to prepare multifunctional wearable devices using other conductive particles and adhesive functional polymer substrates.

Utilizing Gradient Porous Graphene Substrate as the Solid-Contact Layer To Enhance Wearable Electrochemical Sweat Sensor Sensitivity

Wearable sweat monitoring represents an attractive opportunity for personalized healthcare and for evaluating sports performance. One of the limitations with such monitoring, however, is water layer formation upon cycling of ion-selective sensors, leading to degraded sensitivity and long-term instability. Our report is the first to use chemical vapor deposition-grown, three-dimensional, graphene-based, gradient porous electrodes to minimize such water layer formation. The proposed design reduces the ion diffusion path within the polymeric ion-selective membrane and enhances the electroactive surface for highly sensitive, real-time detection of Na⁺ ions in human sweat with high selectivity. We obtained a 7-fold enhancement in electroactive surface against 2D electrodes (e.g., carbon, gold), yielding a sensitivity of 65.1 ± 0.25 mV decade^-1 (n = 3, RSD = 0.39%), the highest to date for wearable Na⁺ sweat sensors. The on-body sweat sensing performance is comparable to that of ICP-MS, suggesting its feasibility for health evaluation through sweat.

Wearable Sensors for Healthcare: Fabrication to Application

This paper presents a substantial review of the deployment of wearable sensors for healthcare applications. Wearable sensors hold a pivotal position in the microelectronics industry due to their role in monitoring physiological movements and signals. Sensors designed and developed using a wide range of fabrication techniques have been integrated with communication modules for transceiving signals. This paper highlights the entire chronology of wearable sensors in the biomedical sector, starting from their fabrication in a controlled environment to their integration with signal-conditioning circuits for application purposes. It also highlights sensing products that are currently available on the market for a comparative study of their performances. The conjugation of the sensing prototypes with the Internet of Things (IoT) for forming fully functioning sensorized systems is also shown here. Finally, some of the challenges existing within the current wearable systems are shown, along with possible remedies.

Surface Wettability for Skin-Interfaced Sensors and Devices

The practical applications of skin-interfaced sensors and devices in daily life hinge on the rational design of surface wettability to maintain device integrity and achieve improved sensing performance under complex hydrated conditions. Various bio-inspired strategies have been implemented to engineer desired surface wettability for varying hydrated conditions. Although the bodily fluids can negatively affect the device performance, they also provide a rich reservoir of health-relevant information and sustained energy for next-generation stretchable self-powered devices. As a result, the design and manipulation of the surface wettability are critical to effectively control the liquid behavior on the device surface for enhanced performance. The sensors and devices with engineered surface wettability can collect and analyze health biomarkers while being minimally affected by bodily fluids or ambient humid environments. The energy harvesters also benefit from surface wettability design to achieve enhanced performance for powering on-body electronics. In this review, we first summarize the commonly used approaches to tune the surface wettability for target applications toward stretchable self-powered devices. By considering the existing challenges, we also discuss the opportunities as a small fraction of potential future developments, which can lead to a new class of skin-interfaced devices for use in digital health and personalized medicine.

Transducer Technologies for Biosensors and Their Wearable Applications

The development of new biosensor technologies and their active use as wearable devices have offered mobility and flexibility to conventional western medicine and personal fitness tracking. In the development of biosensors, transducers stand out as the main elements converting the signals sourced from a biological event into a detectable output. Combined with the suitable bio-receptors and the miniaturization of readout electronics, the functionality and design of the transducers play a key role in the construction of wearable devices for personal health control. Ever-growing research and industrial interest in new transducer technologies for point-of-care (POC) and wearable bio-detection have gained tremendous acceleration by the pandemic-induced digital health transformation. In this article, we provide a comprehensive review of transducers for biosensors and their wearable applications that empower users for the active tracking of biomarkers and personal health parameters.

An ultra-compact and wireless tag for battery-free sweat glucose monitoring

Glucose monitoring before, during, and after exercise is essential for people with diabetes as exercise increases the risk of activity-induced hyper- and hypo-glycemic events. The situation is even more challenging for athletes with diabetes as they have impaired metabolic control compared to sedentary individuals. In this regard, a compact and noninvasive wearable glucose monitoring device that can be easily worn is critical to enabling glucose monitoring. This report presents an ultra-compact glucose tag with a footprint and weight of 1.2 cm² and 0.13 g, respectively, for sweat analysis. The device comprises a near field communication (NFC) chip, antenna, electrochemical sensor, and microfluidic channels implemented in different material layers. The device has a flexible and conformal structure and can be easily attached to different body parts. The battery-less operation of the device was enabled by NFC-based wireless power transmission and the compact antenna. Femtosecond laser ablation was employed to fabricate a highly compact and flexible NFC antenna. The proposed device demonstrated excellent operating characteristics with a limit of detection (LOD), limit of quantification (LOQ), and sensitivity of 24 μM, 74 μM, and 1.27 μA cm^-2 mM^-1, respectively. The response of the proposed sensor in sweat glucose detection and quantification was validated by nuclear magnetic resonance spectroscopy (NMR). Also, the device's capability in attachment to the body, sweat collection, and glucose measurement was demonstrated through in vitro and in vivo experiments, and satisfactory results were obtained.

Low-Cost Wearable Fluidic Sweat Collection Patch for Continuous Analyte Monitoring and Offline Analysis

Sweat sensors allow for new unobtrusive ways to continuously monitor an athlete's performance and health status. Significant advances have been made in the optimization of sensitivity, selectivity, and durability of electrochemical sweat sensors. However, comparing the in situ performance of these sensors in detail remains challenging because standardized sweat measurement methods to validate sweat sensors in a physiological setting do not yet exist. Current collection methods, such as the absorbent patch technique, are prone to contamination and are labor-intensive, which limits the number of samples that can be collected over time for offline reference measurements. We present an easy-to-fabricate sweat collection system that allows for continuous electrochemical monitoring, as well as chronological sampling of sweat for offline analysis. The patch consists of an analysis chamber hosting a conductivity sensor and a sequence of 5 to 10 reservoirs that contain level indicators that monitor the filling speed. After testing the performance of the patch in the laboratory, elaborate physiological validation experiments (3 patch locations, 6 participants) were executed. The continuous sweat conductivity measurements were compared with laboratory [Na⁺] and [Cl^-] measurements of the samples, and a strong linear relationship (R² = 0.97) was found. Furthermore, sweat rate derived from ventilated capsule measurement at the three locations was compared with patch filling speed and continuous conductivity readings. As expected from the literature, sweat conductivity was linearly related to sweat rate as well. In short, a successfully validated sweat collection patch is presented that enables sensor developers to systematically validate novel sweat sensors in a physiological setting.

A touch-based multimodal and cryptographic bio-human-machine interface

The awareness of the individuals’ biological status is critical for creating interactive environments. Accordingly, we devised a multimodal cryptographic bio-human–machine interface (CB-HMI), which seamlessly translates touch-based entries into encrypted biochemical, biophysical, and biometric indices (i.e., circulating biomarkers levels, heart rate, oxygen saturation level, and fingerprint pattern). As its central component, the CB-HMI features thin hydrogel-coated chemical sensors and a signal interpretation framework to access/interpret biochemical indices, bypassing the challenge of circulating analyte accessibility and the confounding effect of pressing force variability. Upgrading the surrounding objects with CB-HMI, we demonstrated new interactive solutions for driving safety and medication use, where the integrated CB-HMI uniquely enabled one-touch bioauthentication (based on the user’s biological state/identity), prior to rendering the intended services.

The awareness of individuals’ biological status is critical for creating interactive and adaptive environments that can actively assist the users to achieve optimal outcomes. Accordingly, specialized human–machine interfaces—equipped with bioperception and interpretation capabilities—are required. To this end, we devised a multimodal cryptographic bio-human–machine interface (CB-HMI), which seamlessly translates the user’s touch-based entries into encrypted biochemical, biophysical, and biometric indices. As its central component, the CB-HMI features thin hydrogel-coated chemical sensors and inference algorithms to noninvasively and inconspicuously acquire biochemical indices such as circulating molecules that partition onto the skin (here, ethanol and acetaminophen). Additionally, the CB-HMI hosts physical sensors and associated algorithms to simultaneously acquire the user’s heart rate, blood oxygen level, and fingerprint minutiae pattern. Supported by human subject studies, we demonstrated the CB-HMI’s capability in terms of acquiring physiologically relevant readouts of target bioindices, as well as user-identifying and biometrically encrypting/decrypting these indices in situ (leveraging the fingerprint feature). By upgrading the common surrounding objects with the CB-HMI, we created interactive solutions for driving safety and medication use. Specifically, we demonstrated a vehicle-activation system and a medication-dispensing system, where the integrated CB-HMI uniquely enabled user bioauthentication (on the basis of the user’s biological state and identity) prior to rendering the intended services. Harnessing the levels of bioperception achieved by the CB-HMI and other intelligent HMIs, we can equip our surroundings with a comprehensive and deep awareness of individuals’ psychophysiological state and needs.

Lab on a body for biomedical electrochemical sensing applications: The next generation of microfluidic devices

This chapter highlights applications of microfluidic devices toward on-body biosensors. The emerging application of microfluidics to on-body bioanalysis is a new strategy to establish systems for the continuous, real-time, and on-site determination of informative markers present in biofluids, such as sweat, interstitial fluid, blood, saliva, and tear. Electrochemical sensors are attractive to integrate with such microfluidics due to the possibility to be miniaturized. Moreover, on-body microfluidics coupled with bioelectronics enable smart integration with modern information and communication technology. This chapter discusses requirements and several challenges when developing on-body microfluidics such as difficulties in manipulating small sample volumes while maintaining mechanical flexibility, power-consumption efficiency, and simplicity of total automated systems. We describe key components, e.g., microchannels, microvalves, and electrochemical detectors, used in microfluidics. We also introduce representatives of advanced lab-on-a-body microfluidics combined with electrochemical sensors for biomedical applications. The chapter ends with a discussion of the potential trends of research in this field and opportunities. On-body microfluidics as modern total analysis devices will continue to bring several fascinating opportunities to the field of biomedical and translational research applications.

Silicon Micropillar Array-Based Wearable Sweat Glucose Sensor

Wearable technologies have great potential in health monitoring and disease diagnostics. As a consequence, interest in the study of wearable sensors has dramatically increased over recent years. Successful translation of this technology from research prototypes to commercial products requires addressing some of the major challenges faced by wearable sensors such as loss of, and damage in, the biological recognition layer of the skin-interfaced sensors. In this work, we propose a solution to this challenge by integrating micropillar array (MPA) surfaces as part of the sensing layer with the aim to protect and prevent the loss of the enzyme layer from mechanical stress while the sensor is worn. The proposed wearable sensing patch is composed of reference, counter, and working electrodes, all made of MPAs and is designed for measuring glucose in sweat. MPA sensing patch has a wide linear range of 50 μM to 1.4 mM, a sensitivity of 4.7 ± 0.8 μA mM^-1, and a limit of detection of 26 ± 5 μM. The glucose sensing patch was tested using human sweat where glucose-level changes were successfully measured before and after meal consumption. The developed patch provides an alternative solution to the problem of the damage to the sensor microenvironment upon wear. But in addition, it also offers a user-friendly, cost-effective, and reliable sweat analysis platform with significant potential in health monitoring applications.

Wearable aptamer-field-effect transistor sensing system for noninvasive cortisol monitoring

Wearable technologies for personalized monitoring require sensors that track biomarkers often present at low levels. Cortisol—a key stress biomarker—is present in sweat at low nanomolar concentrations. Previous wearable sensing systems are limited to analytes in the micromolar-millimolar ranges. To overcome this and other limitations, we developed a flexible field-effect transistor (FET) biosensor array that exploits a previously unreported cortisol aptamer coupled to nanometer-thin-film In₂O₃ FETs. Cortisol levels were determined via molecular recognition by aptamers where binding was transduced to electrical signals on FETs. The physiological relevance of cortisol as a stress biomarker was demonstrated by tracking salivary cortisol levels in participants in a Trier Social Stress Test and establishing correlations between cortisol in diurnal saliva and sweat samples. These correlations motivated the development and on-body validation of an aptamer-FET array–based smartwatch equipped with a custom, multichannel, self-referencing, and autonomous source measurement unit enabling seamless, real-time cortisol sweat sensing.

Wearable tesla valve-based sweat collection device for sweat colorimetric analysis

Sweat sensor has become one of the most important developing directions of in vitro wearable diagnostic device in recent years. Stable sweat collecting device is the key to realize sweat component analysis. In order to ensure that the collected sweat is not subject to component analysis errors caused by evaporation or environmental pollution, mechanical micro-valves were adopted for microfluidic sweat collection devices to realize sealed storage of sweat. However, this poses a challenge to the stability of machining and reusability of the acquisition device. In this work, the Tesla valve without any mechanical structure were introduced into the design of sweat collection chip. And made full use of its diodicity to improve the collection to a certain extent, prevent backflow at the entrance, and restrain the flow at the exit to contact with the outside world. In addition, through optimizing the shunt angle, branch channel parameters of Tesla valve, boosted its diodicity under low flow rate. Furthermore, a sweat storage chamber with baffle structure that can achieve maximum static storage area was adopted to form a whole sweat collection chip. The design was verified through the flow experiment of methylene blue and methyl red indicators on the chip. Through modification of the filter paper fixed in the collection chamber, the colorimetric analysis of glucose and pH was realized. This device may provide new inspirations for the development of wearable sweat sensor.

Wearable Sweat Loss Measuring Devices: From the Role of Sweat Loss to Advanced Mechanisms and Designs

Wearable sweat sensors have received significant research interest and have become popular as sweat contains considerable health information about physiological and psychological states. However, measured biomarker concentrations vary with sweat rates, which has a significant effect on the accuracy and reliability of sweat biosensors. Wearable sweat loss measuring devices (SLMDs) have recently been proposed to overcome the limitations of biomarker tracking and reduce inter- and intraindividual variability. In addition, they offer substantial potential for monitoring human body homeostasis, because sweat loss plays an indispensable role in thermoregulation and skin hydration. Previous studies have not carried out a comprehensive and systematic review of the principles, importance, and development of wearable SLMDs. This paper reviews wearable SLMDs with a new health perspective from the role of sweat loss to advanced mechanisms and designs. Two types of sweat and their measurement significance for practical applications are highlighted. Then, a comprehensive review of advances in different wearable SLMDs based on hygrometers, absorbent materials, and microfluidics is presented by describing their respective device architectures, present situations, and future directions. Finally, concluding remarks on opportunities for future application fields and challenges for future sweat sensing are presented.