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EEMCO Electrical Hydration
EEMCO Electrical Hydration
Background/airns: The improvement of stratum corneum hy- ables are also analyzed as well as study designs for predictive
dration is one of the most important claims in the cosmetic in- or use tests.
dustry. Conclusions: Practical suggestions for standardization of meas-
Methods: Objective assessment of moisturization can be done urements are given.
with devices based on electrical methods provided these instru-
ments are used in an appropriate manner. Key words: hydration - stratum corneum - conductance - ca-
Results: This paper deals with the biophysical basis behind pacitance - skin bioengineering - impedance
these techniques and describes the most important variables,
pitfalls and drawbacks related to measurements and current in- 0 Munksgaard, 1997
strumentation. Individual-related and environment-related vari- Accepted for publication 23 August 1996
126
Electrical methods for assessment of SC hydration
therm. It has been customary in the literature to define moisturization, although the exact relationship is ex-
three types of water according to their strength of tremely complex and variable.
binding to the keratin: ”tightly bound water” for
water contents from 0 to around 7%, “bound water”
between about 7% and 35”0, and “free water ” above 2. Some basic considerations
35%).This division can be considered simplistic on the a) Dependence on properties of the skin s u f a c e
basis of more detailed theory (8), but is generally Because the electrodes in contact with the skin are
helpful. The consequence of variation in water bind- generally rigid, their areas of contact with the skin
ing strength is that there is no direct proportionality may be dependent upon the pressure applied. Sub-
between total water content and electrical conduc- stances present between the electrodes and the skin
tance. Substances or treatments that interact with the (hairs, oils, waxes) may affect the results and must be
keratin-water network may, therefore, modify con- taken into account. Conductance measurements may
ductance without, in fact, changing the water content also be influenced by changes in surface microto-
of the sample. pography (11).
Because of the complex physics involved in this
situation, it is incorrect to refer to the electrical “ca-
pacitance” of the skin without specifying the stimulat- b) lntegratioii over depth
ing frequency and other experimental conditions used The distribution of the electric field through the dif-
to make the estimate. What this literature generally ferent skin layers cannot be calculated adequately be-
calls ”capacitance” is not actually electrical capaci- cause of the complexity of the geometry and the com-
tance in the usual scientific and engineering sense, be- position of the materials involved. For example, the
cause it is frequency dependent, unlike true electrical field distribution partly depends on the complex per-
capacitance. mittivity of the tissue, which is itself very dependent
Commercially available electrical methods for as- on the distribution of polar materials (water, ions, di-
sessing skin moisture are based on measuring impe- poles, etc.) with depth through the various skin
dance or its reciprocal, conductance, as a function of layers. It is possible to some extent to overcome this
one or more different stimulating frequencies. Both theoretical difficulty by direct experimentation using
impedance and conductance are frequency-dependent skin stripping. All non-invasive instruments give re-
vector quantities, and the derivation from them of sults that are to some extent an integration over
standard physical parameters such as resistance, reac- depth, with the precise dependence on depth varying
tance and capacitance is not always simple. Standard from instrument to instrument and also from skin site
textbooks of physics should be consulted. In the case to skin site. This source of variance can only be par-
of heterogeneous and time-varying biological ma- tially overcome by calibration procedures involving
terials such as skin, the situation is significantly more measurement of depth dependence in skin layer
complicated, and a specialised review may be necess- models. It should therefore be noted that it is possible
ary (10). It should be noted in particular that when for commercial instruments to give the same reading
the equivalent electrical capacitance of skin is calcu- from different water amounts if these amounts are
lated, it is still a frequency-dependent property, unlike distributed according to different water depth pro-
the electrical capacitance of nonbiological dielectrics files.
described in the literature of engineering and physics.
For this reason the electrical ”capacitance” of skin will c) Water content and skiti temperatiire
be referred to here using inverted commas (thus: “ca- It is possible for skin that is moist and cool to give
pacitance”). It is not a true material property, but is exactly the same electrical response at a single fre-
highly dependent on the method of measurement quency as dry and warm skin. To separate and specify
used, and any estimates of this quantity should there- potentially confounding influences such as water con-
fore also record the stimulating frequency or frequen- tent, temperature change and sweat gland activity, it
cies at which they were obtained. is necessary to use some form of electrical spectro-
A simple view is that the impedance (or conduc- scopic technique, that is, stimulation at three or more
tance) measures the opposition to (or ease of) the flow different frequencies, or a time-domain approach fol-
of electric current through the skin, and depends lowed by Fourier transformation (5, 6). Therefore, it is
upon resistance and reactance. Capacitance is calcu- recommended to control skin and room temperature
lated from reactance. Skin conductance and ”capaci- to reduce the requirement for multi-frequency meas-
tance” are related, and generally both increase with urements.
127
Berardesca et al.
Skicon 200
Estimates of Hydration This device employs measurements of conductance at
A number of prototypes for measuring electrical high frequency (3.5 MHz). The probe consists of two
properties of skin have been manufactured in differ- concentric electrodes, of 2 and 4 mm diameter, separ-
ent reserach laboratories. Some commercial devices ated by a suitable dielectric. The estimate is displayed
are also available. They work at differences frequen- after 3 s. The Skicon measures a more superficial
cies, using various sizes of probes that are applied range of depths than the Corneometer (2,14,16), and
with distinct pressure on the skin. The influence of may therefore seem more variable, even though it has
these variables has been not thoroughly studied in the been reported to be more sensitive in measuring
literature. All of them give hydration values (ex- highly hydrated skin and water sorption-desorption
pressed in arbitrary units) that are not linearly corre- processes (16). The readings are increased significant-
lated with the hydration state of the skin, and read- ly in the presence of glycerol and conductive materials
ings are affected by the presence of salts and ions on other than water, so very great care must be taken in
the skin (12). interpreting the meaning of the results.
Other instruments, such as the SCIM (surface char-
acterizing impedance monitor) can be used to assess
moisture according to the multifrequency model. The
Corneometer 820-825 SCIM instrument measures electrical impedance, both
This is described as being a "capacitance" measuring magnitude and phase angle, at 31 different frequen-
device operating at low frequency (40-75 Hz), which cies. The probe has concentric electrodes and this is
is sensitive to the relative dielectric constant (or per- used to select the range of depths over which the re-
mittivity) of material placed in contact with the elec- sults are integrated (21, 22). Further data are needed
trode surface. Because increasing the water content of to evaluate and compare the usefulness of this instru-
the stratum corneum will in general increase its rela- ment in assessing skin moisturizers. The multifrequ-
tive permittivity (although by a very complex and ency approach has also been used to characterise skin
variabie relationship), the device can therefore esti- disease (8, 10, 21-23).
mate in about 20 ms the stratum corneum water con-
tent in arbitrary (relative) units (12). The probe exerts
a constant pressure on the skin surface of 3.5 N, and
General Considerations Before Starting
covers an area of 49 mm2. It estimates water content
a Study
in the epidermis to an approximate depth ranging be- Some practical advice, independent of the instrument
tween 60 and 100 pm (5,13). The Corneometer has used, should be followed to perform accurate and re-
been widely used to estimate the dryness of skin (2, producible measurements. The probe should be
14-17). Results are strongly influenced by the qualities placed normal to the skin surface with slight pressure,
of the skin surface, including surface roughness (11). just sufficient to start the measurement process. Each
The new version (825) allows continuous measure- of the devices described above has a spring in the
ments. probe to assure a reproducible pressure. A different
position of the probe, or too many hairs, can cause
unreliable readings (24). When necessary, shaving or
Nova DPM 900 cutting the hairs is recommended before starting the
This instrument uses measurements of phase angle study (16). Several measurements of the same site can
(10). Phase angle is one of the two (polar) coordinates cause occlusion, which results in an increase in the
of impedance at each particular frequency of stimula- values displayed. Therefore, it is recommended to
tion. The device is described as using frequencies up wait for at least 5 s before repeating a measurement
to 1MHz (18),and can have different diameter or cus- on the same site. It is advisable to measure at least
tomized probes. Measurements may be sampled three times, once at each of three different but nearby
"continuously", after a 5 s interval, or singly and im- sites, in order to have more reproducible data.
mediately (19). It measures the upper stratum corne- Measuring failures may occur if the skin or probe sur-
um layers, like the Skicon 200. Readings are usually face is wet, for instance by sweating, or if the surface
higher than with the Corneometer, but in good corre- is contaminated by dirt particles, oil or grease.
lation (19). The Nova DPM has also been reported to Cleaning of the probe is recommended between meas-
be less variable than the Corneometer, but less suit- urements.
able for testing dry skin (19). It is also important to consider environmental in-
128
Electrical methods for assessment of SC hydration
fluences. To obtain reproducible readings, it is desir- and Skicon are more useful in assessing relatively
able to perform measurements under appropriate am- high water content levels and desorption kinetics,
bient conditions (25), keeping the ambient tempera- whereas the Corneometer is more sensitive when as-
ture low enough to minimise sweat production (e.g., sessing relatively dry skin (20).
20°-22”C) and, ideally, relative humidity between 40%
and 60%. The weather conditions of recent days can Variables related to the environment
however be just as influential as the ambient con- Temperature and relative humidity are known to in-
ditions to which the skin is exposed during the test fluence stratum corneum water content (30,31). Under
itself. It is also desirable to minimise air movement in some conditions a linear relationship has been found
the vicinity of the test site. Volunteers should be relax- between ”capacitance” and relative humidity (27).
ed and acclimatized to the measuring environment for Therefore, room humidity should be kept constant, or,
at least 20 min. The instrument itself should also be in cases of variation of relative humidity, this vari-
acclimatized for at least this time. The test site should ation should be dealt with by the statistical analysis of
be exposed to ambient air for at least 10 min before variance. Some normalisation procedures have been
taking measurements. The efficiency and limitations proposed (27). Seasonal variations due to alterations
of these various commercial devices for assessing skin in temperature and relative humidity occur (31-33),
moisturization have been reported in the literature (2, and day-to-day and even diurnal variations are also
7, 14, 16, 20). reported (14).
129
Berardesca et al.
considered as a variable (7). If it is necessary, when application studies report improvement of skin con-
testing different products, to make comparisons with dition after 4 weeks of treatment (4345). Long-term
other instruments or laboratories and reduce differ- studies have the possibility that varying environmen-
ences related merely to instrumentation, it is recom- tal influences could affect volunteers during treatment
mended that a reference material should also be (e.g., changes of climate or season during the experi-
tested (e.g., 10% glycerol in water). ment), and this must be taken into account. Therefore,
more subjects may be needed to distinguish statisti-
Single application as predicitve test (Table 1 ) cally between products of similar moisturizing poten-
In single application studies the time course of hy- tial.
dration is monitored for a few hours after the appli-
cation of a product. This makes this design less sensi-
tive to long-term changes in the environment, which
Statistics
may in turn enable better discrimination between The statistical analysis of data obtained from a study
products (34, 35). Measurements are taken for a base- of electrical impedance or conductance in vivo should
line at t=O and then at fixed intervals between 4 and be straightforward, provided the recommendations
6 h after product application. outlined above have been followed. Again, the com-
In this experimental design, the interactions be- ments here are intended merely as an introduction.
tween the product, the stratum corneum and the An experienced statistical practitioner, or at the very
probe should particularly be taken into account, and least a textbook, should always be consulted for as-
the first measurement should be taken at least 30 min sistance in interpreting the results.
after product application. Indeed, application of A power test should be performed before starting a
emulsions results in immediately raised instrument study in order to enroll the adequate number of sub-
readings (presumably due to water present in the for- jects. When distribution of the data is not normal, it
mulation), and this effect tends to decrease after a 10 may be desirable to apply data transformations to
to 15 min “evaporation phase” (36, 37). Application achieve normality or to present the data with median
of occlusive moisturizers, such as pure petrolatum and confidence intervals. For normally distributed
without water, results in a slower increase of water data, analysis of variance (ANOVA) for repeated
content due to the occlusive interaction between the measures can be used to compare different times and
lipids and the stratum corneum (”lipidization phase” (for short-term studies) the kinetics of moisturization.
(36, 38, 39). Indeed, the effect of nonabsorbed cream Alternatively, non-parametric tests, such as that of
components on ”capacitance” values can be demon- Friedman, may be used. For normal data, product
strated (38-41), particularly when these components comparisons at the same time interval can be made
are removed from the the skin surface (”wiping ef- by an unpaired Student’s t test for two samples, or
fect”). Application of various humectants increases ANOVA for three or more samples. Multiple sub-
“capacitance” levels, but removal after 1 or 2 h in- group comparisons may be necessary to detect further
duces an immediate decrease in instrument readings, differences between products.
indicating that ”capacitance” values do not only re- In long-term studies, initial values can be compared
flect the ”capacitance” of the skin itself but also that to final values by a paired Student’s t test for normal
of the product (42). Indeed, occlusive products allow data, or a Wilcoxon signed rank test for non-
a build-up of water under the film but decrease the parametric data.
magnitude of the responses, whereas humectants at- Many statistical packages running on personal com-
tract water and increase “capacitance” levels. The puters provide these capabilities.
wiping effect should be taken into consideration be-
cause it alters the interpretation of the study. The
single application test could be predictive.
Conclusions
Water plays an important role in the physical prop-
Repeated application (Table 1 ) erties of the stratum corneum, and reliable quantifi-
This is a more realistic test. Repeated application cation of water in the corneum and its interaction with
studies are used to evaluate the improvement of skin topically applied products is essential for understand-
condition after repeated long-term use (generally a ing skin physiology and developing efficient skin care
few weeks) of the products to be tested. At least 8-12 formulations. Conductance can readily differ by four
h should elapse between the last application of the orders of magnitude between dry and hydrated
product and the final measurements. Several repeated samples (42), and thus offers an approach to assessing
130
Electrical methods for assessment of SC hydration
stratum corneum water, even though the exact re- 2. Blichmann C, Serup 1. Assessment of skin moisture. Acta
Derm Venereol 198&68: 284-290.
lationship between instrument readings and actual
3 Serup J, Blichmann C. Epidermal hydration of psoriasis
stratum corneum water content is complex and vari- plaques and the relation to scaling. Acta Derm Venereol
able, preventing accurate calibration and opening the 1987 6 7 357-359.
possibility of misinterpretation. 4. Salter DC. Instrumental methods for assessing skin moistur-
ization. Cosm Toil 1987 102: 103-109.
These and many similar considerations mean that 5. Salter DC. Monitoring human skin hydration in vivo using
electrical approaches to assessing skin hydration can electrical impedance - a model of skin as a solid ionic con-
give only relative indications, not absolute measures, ductor. Proceedings IX International Conference on Electri-
and even then only if great care is taken in the design, cal Bio-Impedance and European Community Concerted
Action on Impedance Tomography. Heidelberg, 26-30 Sep-
conduct and interpretation of the test. False positive tember 1995: 17-20.
and false negative results may arise if these ap- 6. Salter DC. Further hardware and measurement approaches
proaches are used simplistically, but much valuable for studying water in the stratum comeum. In: Elsner P, Be-
information is available if they are designed and used rardesca E, Maibach H, eds. Bioengineering of the skin:
water and the stratum corneum Boca Raton: CRC Press,
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For these reasons we recommend that electrical ap- 7. Rogiers V, Derde MP, Verleye G, Roseeuw D. Standardized
proaches be used with the care that is appropriate to conditions needed for skin surface hydration measurements.
Cosm Toil 1990: 105: 73-82.
the quality of information required from them; in par-
8. Salter DC. Studies in the measurement, form and interpreta-
ticular, in standard studies, it is acceptable to use only tion of some electrical properties of normal and pathological
a single stimulating frequency, as do most commer- human skin in vivo. Doctor of Philosophy thesis, University
cially available instruments, provided that it is poss- of Oxford, March 1981 (in 3 volumes containing 694 pages).
9. Lev6que JL, Garson JC, Boudouries. L'eau dans les keratin-
ible to ensure an effective standardization of skin tem- es: etide par mesures de la conductibilitb Clectrique. C RA-
perature changes, sweat gland activity, skin sites, cad. Sci 1979: 228: 1679-1682.
water depth profile changes, etc. A statistically-justi- 10. Salter DC: Quantifying skin disease and healing in vivo
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Non-invasive physiological measurements, Vol. 1. London:
the potential confounding variables should be iden- Academic Press, 1979: Ch. 2, 21-64.
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suitable control is essential because absolute cali- and capacitance measurements and skin surface contour
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sophistication, and therefore a multi-technique ap- the homy layer: comparison between capacitance and con-
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Boode HE, eds. Prediction of percutaneous penetration:
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Nova DPM 9003. In: Elsner P, Berardesca E, Maibach H, eds.
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132