SKIN EFFECT AND

BIO-ELECTRICAL IMPEDANCE ANALYSIS

There has been a great deal of debate as to whether electrical frequencies can penetrate the skin via
electrodes. The argument has been that the electrical frequencies will only travel along the outside of
the body, never penetrating through the skin entering the body. Many un-knowledgeable people do
not understand that scientific studies called “Bio-electrical impedancemetry or Bio-electrical
lmpedance Analysis” have been done which prove that the skin effect does not really exist. The real
question should be, what is the Cell Effect? The theory of the skin effect only exists in the minds of
those who have not read these scientific reports. This report, taken off the internet, is just one of doz-
ens of reports done on bio-electrical impedance analysis. If one but takes the time to look on the inter-
net they will find many such reports that give this same information.

This report along with all of the bio-electrical impedance analysis reports shows that frequencies do in
fact pass through the skin into the tissue of the body, using electrodes, as long as the proper methods
are used. There are limits to frequency penetration depending on whether a low frequency (5,000
hertz) is used or a high frequency (1,000,000 hertz or 1MHz) is used. These limits only apply to cell
penetration. These reports show that low frequencies only go through the connective tissue where
high frequencies can penetrate the cells of the body.

Because most of these types of reports are very technical we will give a simple explanation at the end
of each section, in blue print, if one is needed. The following report was once on the internet.

Bio-Electrical Impedance Analysis Report

Bio-electrical impedancemetry or Bio-electrical lmpedance Analysis (B.I.A.) initiated in France by A.L.
THOMASSET in 1962 today forms part of the arsenal of the means of exploration of biological tissues.
Already widely diffused in the USA and the Anglo-Saxon countries, this method has a promising fu-
ture. After a brief historical recapitulation, this work will present the basis on which the method was
founded, followed by some examples illustrating its numerous applications in the medical field, as well
as the perspectives opened up in biological research in general. In a word, bio-electrical IM-
PEDANCEMETRY is a simple technique allowing easy measurement of body water and its extra and
intra-cellular distribution in the organism.

Water is the main component of the human body where it represents 58 to 62%, of the body weight. In
many pathological cases this quantity varies. However, until now, because of the absence of simple
means, it was not measured. Today, this measurement is at the disposal of all physicians thanks to
Bio–Electrical Impedance Analysis: B.I.A.
1
The first concerned are nephrologists for the monitoring of hemodialysis, and nutritionists. But many
other physicians are concerned by this work, as for example those in medical and surgical intensive
care, those in units for the severely burned, cardiologists and those involved in metabolic disorders.
Moving away from such specialties, other physicians and researchers in sports medicine, occupational
medicine, thermal medicine, and of course in physiology and biology will find in this work many argu-
ments allowing them to develop their activities.

Historical Background

It was by studying the electrical activity of the brain by EEG that A.L. Thomasset in Lyon from 1955 to
1960 observed that the differences of potential could be similar to the law of Ohm and comply to the
formula: U = R. I. This idea led the author to look for the value of R, the electrical resistance of the
brain tissue, then step by step to measure that of the whole body. For this, the body being both an
ionic and non-homogeneous conductor, it was necessary to use an alternating current and not a direct
current. Because of this, the resistance studied took the name of impedance, a value expressed by
the symbol Z. The equality U = R. I is therefore written U = Z. I i.e. Z = U/I, U being the difference of
potential, I the intensity of the measurement current. Then, if we use for the measurement a current of
constant intensity I the potential in volts that is collected between two electrodes is equivalent to Z
multiplied by this constant U = Z. Cte and is representative of the impedance of the conductor. None-
theless, this measurement should be performed in certain precise conditions that we shall examine
later.

Now as from the beginning of the study most of these conditions were fulfilled, as the measurements
were systematically recorded in the morning, between 8 and 9am, in a medical department where
men and women were hospitalized for various reasons, it allows us to confirm that the measurements
were reproducible.

This reproducibility was the fundamental and determining quality without which the study could no
longer be pursued. All the authors who had studied the problem before, since d' Arsonval, Cole and
Curtis, Barnett, to mention only a few, placed without success the un-moistened electrodes on the skin
a capricious barrier for the current that needs only to be traversed by using moistened electrodes or
needle-electrodes inserted under the skin to avoid this pitfall.

Given this, the meaning of the body impedance measurements was a simple game thanks to the work
of the school of F.D. Moore at Harward, while H.P. Schwann in Philadelphia, Ch. Eyraud and J. Lenoir
[15] of the C.N.R.S. in Lyon validated the study scientifically.

2
In defense of physicians, it should be admitted that, until now, they had no simple means at their dis-
posal to perform such a measurement. Today, this means is now available to them through electrical
impedance measured by a method that we developed as from 1962 and experimented in various
fields of physiology and medical practice.

We trust that the readers will find in this presentation the basic elements of the method as well as
some examples of applications liable to throw light on their own observations.

Explanation: Alternating current (AC) is used for biological tissue. Earlier experimenters were unable
to read body impedance because they did not moisten the skin or insert needles. Today many body
impedance devices, which do not use needles, are used to determine if there are any blockages in the
electrical flow in the body. Many of these instruments, such as the Bio-Meridian an FDA approved de-
vice, use a metal probe to access meridians of the body. The skin must be moistened at each merid-
ian point in order to check the impedance. Defibrillators used to electrically shock the heart use a con-
ductive jell in order to prevent burning of the skin, allowing the electrical current to enter the body.
Moisture is the key to getting frequencies into the body.

Electrical impedance

The word impedance comes from the Latin impedire meaning to prevent, to stop from going on. In
terms of electricity, impedance signifies the resistance of a conductor when an electric current passes.

However, conventionally speaking, the term resistance refers to the obstacle to the direct current,
and it is represented by the letter R.

The terms impedance refers to the obstacle to the alternating current and it is represented by the
letter Z.

Impedance Z, as resistance R, is expressed in ohms.

Explanation: Resistance refers to the obstacle of direct current. Impedance refers to the obstacle of
alternating current.

Electrical conductivity

The electric conductivity of a conductor is its capacity to conduct the current. It is called conductance
for a direct current and admittance for an alternating current.

3
Conductance is equal to the inverse 1/R of the resistance.

Admittance is equal to the inverse 1/Z of the impedance.

In both cases, conductivity is expressed in mho (the inverse of the word ohm). In practice, use has
prevailed, and most often the designations resistance or impedance expressed in ohms are employed
to define conductivity.

Resistivity of a conductor

This is the resistance that a sample of this conductor with a length and section equal to one unit op-
poses to an electric current passing through it between two electrodes each with a section equal to
one unit and placed on two opposite faces of the volume thus defined of the sample to be measured.

Figure 3.1: Determination of the resistivity

1 cm

1 cm

1 cm

Example: The resistivity of copper is the resistance of a cube of this metal measuring 1 cm on each
side, through which passes a current between two electrodes measuring 1 cm2 placed on sides A and
B of this cube.

Resistivity is conventionally expressed by the Greek letter p. It is measured by means of a direct cur-
rent if we are dealing with an electric conductor such as iron or copper, and by means of an alternat-
ing current if it is an ionic conductor and furthermore non-homogeneous such as a biological tissue,
but in this case resistivity varies with the frequency of the measurement current, and one should indi-
cate the frequency of the current used in the following manner : p5kHz or p1MHz

Explanation: Resistance depends on both material used (body tissue) and frequency used.
4
Notion of frequency of an electric current

A direct current has a null frequency. It passes through a conductor always in the same direction from
the positive pole to the negative pole.

An alternating current is an oscillating current usually sinusoidal which passes through a conductor
alternately in one direction then in the opposite direction, a certain number of times per second.

This number of times depends on the generator that produces it. It may vary from a few units (as is
the case for domestic current of 50 Hz (hertz), or cycles per second, in France), to several million cy-
cles per second. This number is called current frequency and is expressed in cycles per second or in
hertz (Hz).

A current is said to be of low frequency (LF) when this frequency is below 50,000 hertz, of (MF) me-
dium frequency between 50,000 and 500,000 hertz, and high frequency (HF) above 500,000 hertz.

When studying body impedance the current used in (LF) low frequency is 5,000 hertz or 5 KHz
(kilohertz), and in (HF) high frequency 1,000,000 hertz or 1 MHz (1 Megahertz).

Why use an alternating current to measure the impedance of a

biological tissue?

Essentially for two reasons:

Because a biological tissue is an ionic conductor: it is known that electrical conduction in a material
occurs through charge carriers, which may be electrons, such as is the case for metals; or free ions in
suspension in solutions, as is the case for biological tissues.

If a direct current is passed through an ionized solution, the well-known phenomenon of polarization
occurs, i.e. very rapidly at the level of each electrode a double layer of ions is deposited which acts as
an insulator and prevents the current from passing. Therefore, a direct current cannot be used to
measure the resistance of such a conductor.

Because it is a heterogeneous conductor: i.e. it is composed of both resistive elements and [noref]
capacitive elements diversely associated. Whereas the resistive elements allow the alternating cur-
rent to pass whatever its frequency, the capacitive elements allow the alternating current to pass only
if it has a high frequency.

5
Such that the opposition encountered by electricity to circulate in a biological conductor must neces-
sarily be studied by means of an alternating current. Thus it is indeed an impedance.

Explanation: Direct current known as DC current travels in only one direction. DC cannot be used to
measure the resistance of the human body. DC current causes ions to build up eventually causing po-
larization. This can cause heating in tissue if one is not careful. Alternating current is safer to use in
biological tissue and will allow the passage of high frequencies through the body including the bone.

Capacitive element

This is an element able to store electrostatic charges. A condenser with its two armatures (fig3.2)
separated by an insulator (di-electric) is a capacitive element.

Figure 3.2: Condenser

Armatures

Di-electric

In biological tissues the cellular content represents one of these armatures, the interstitial fluid repre-
sents the other. They are separated by the cell membrane which plays the role of insulator or di-
electric. In common language in electricity to designate a condenser the term capacity is often used,
the object being designated following its function. This is an improper use of language, in fact, the ca-
pacity Cp represents the ability of a conductor to receive a charge Q.

Explanation: The body can receive an electrical charge.

Capacity and impedance of a condenser

This capacity is evaluated in farads and depends on the form, the dimensions of the di-electric as well
as the nature of the di-electric.

A condenser (capacitive element) interrupts the circulation of the direct current, for as soon as its ar-
matures are charged, one positively, the other negatively, the current no longer passes.

On the other hand, an alternating current appears to cross the obstacle represented by the di-electric
6
of the condenser. In reality, the condenser acts on the current by retarding it by a half-period (90% or
k/2) (fig 3.3).

Figure 3.3: Behavior of a condenser in alternative current.

0 k/2 k 3k/2

The condenser impedance (1/C2kf) is all the higher as the frequency is lower and reciprocally it tends
towards zero when the current frequency tends to infinity. It may be considered that the condenser
conducts in a normal fashion the alternating current, which is true in practice if not in theory.

These notions concerning the properties of condensers show why a low frequency current does not
cross the membranes, whereas they are crossed all the more easily as the current frequency is high.
A condenser can accumulate a certain electric charge Q whose value is given by the formula:
Q = Cp x U, where U is the difference of potential between the armatures, Such that : Cp = Q/U.

A difference of potential U represents the difference of concentration of the charge carried between
the two poles of a resistance conductor R when this conductor is traversed by a current of intensity I
(Ohm's law U = R x I)

Explanation: The lower the frequency (1 to 50,000 hertz) the more difficult the frequency will have in
penetrating into the body. Moisture is critical for the use of low frequencies. High frequencies
(1,000,000 hertz or 1MHz) will penetrate the body without any resistance. Though moisture is not as
critical for the passage of high frequencies it should still be used with electrodes.

Impedance variation of a biological tissue according to the fre-

quency of the measurement current

When one studies the impedance Z of a biological conductor it may be observed that it varies accord-
ing to the frequency of the measurement current. The higher the frequency the more easily the cur-
rent passes and consequently, the lower the impedance. If these variations are recorded, we obtain
a curve whose general aspect is represented in figure 4.1.
7
 Figure 4.1: Evolution of the modulus of impedance IZI with respect to the frequency F

IZI

1k 5k 10k 100k 1MHz F

It is the aspect that is taken on by the variations of the impedance modulus of a biological tissue as
represented schematically in figure 4.2 where cells can be seen surrounded by their membranes en-
veloped in the extra-cellular fluid as well as the lines indicating the (LF) low frequency (5,000 hertz)
and (HF) high frequency (1,000,000 hertz or 1MHz) current.

Figure 4.2: Analogy between a biological tissue and a filtering network

Membranes Z 5kHz (5,000 hertz)

ECF
Rs=ZECF
HF

BF
Rp=ZICF
ICF
Z 1MHz (1,000,000 hertz)
(a) (b)

It may be observed that there is an analogy between figure 4.2a and figure 4.2b which shows an elec-
tric circuit involving the association of a series resistance (Rs) with a capacitive element (Cp) and an-
other resistance (Rp) in parallel. The impedance curve of this classical circuit is represented in figure
4.3 with respect to the frequency. This circuit is called an electronic filter as, depending on the value of
the capacity C, it does not allow the electric currents to pass except above a given frequency.

8
 Figure 4.3: Evolution of the impedance modulus IZI with respect to
the frequency for the circuit of figure 4.2

IZI
a b

KHz
5k 10k 500k 1MHz
In fact, in the biological tissue the membranes act as a di-electric or an insulator separating two con-
ducting media, the extra-cellular fluid (ECF=Rs) and the intra-cellular fluid (ICF=Rp) which fulfill the
role of armatures of the biological condenser. It may be added that the membranes are not a good in-
sulator, and that the condenser they make up is a leakage condenser.

To circulate between A and B (Fig 4.2) a low frequency current 10 KHz (10,000 hertz) can only take
the path Rs, i.e. must pass between the cells. The difficulty encountered is relatively great and the im-
pedance corresponds to the part a and b of figure 4.3

Between 10 kHz (10,000 hertz) and 500 kHz (500,000 hertz) the current takes more and more the
path (C+Rp) of figure 4.2 corresponding to the part b and c of figures 4.1 and 4,.3. i.e. it penetrates
more and more easily into the cells (Fig.4,4b).

Figure 4.4: Path of the current through a cell

5KHz Z 5kHz (5,000 hertz)

10KHz
Rs=ZECF
500KHz
A B
1MHZ

Membrane Rp=ZICF

Z 1MHz (1,000,000 hertz)

(a) (b)
9
When the frequency is high enough the capacitive effect Cp (Fig. 4.2b) corresponding to the cellular
membranes is cancelled and the current passing between A and B takes the two resistive pathways
Rs and Rp (fig. 4.4b) such that at the moment we are dealing with a system to which we may apply
the formula of Kirchhoff :

1 1 1 1 1
= + = +
Z1MHz Z5kHz Rp ZECF ZICF
This formula will be used later, when estimating the cellular content.

In practice, we have indeed chosen the frequency 5 kilo-hertz (5,000 hertz or cycles per second) to
represent the low frequencies (LF) and 1MHz (1,000,000 hertz or cycles per second) to represent the
high frequencies (HF)

The frequency 5 KHz (5,000 hertz) was chosen because it represents the mean between 1 KHz
(1,000 hertz) and 10 KHz (10,000 hertz), i.e. that at 1 KHz (1,000 hertz) there still subsists a slight po-
larization of the electrodes (Fig. 4.1) and that at 10 KHz (10,000 hertz) the current begins to enter into
the cells (Fig. 4,4a).

The frequency 1 MHz (1,000,000 hertz) was adopted as at this frequency the capacitive effect of the
membranes is practically null. Further, it is difficult to control the current beyond this frequency without
parasiting the conductors, either the equipment, or the body to be measured, the errors liable to occur
being greater than the precision sought for.

Explanation: The higher the frequency the less the resistance. At about 1MHz (1 million cycles per
second or hertz) there is no more resistance in the biological tissue of the body. Low frequencies be-
low about 10,000 hertz only travel through the connective tissue of the body. At about 10,000 hertz
frequencies begin to penetrate the outside layers of the cell. This scale gradually goes up so that at
about 100,000 hertz penetration into the cell is very noticeable. From 100,000 hertz to 1,000,000 hertz
(1MHz) penetration into the cell is significant until full penetration is achieved at 1MHz. This under-
standing of how frequencies work in the body explains why a carrier frequency of at least 1MHz
should be used.

10
Resistivity of a biological tissue

The resistivity of tissues varies according to the frequency of the measurement current.

In LF (low frequency) the cells that are concerned in a tissue volume unit act as insulators, enclosed
in a liquid conductor of resistivity Pe. (Fig. 4.5a). A current with a weak LF (low frequency) must
necessarily pass between them. The more the cells are packed together the greater the resistance
(here the resistivity PLF since we are measuring a unit of tissue volume), and conversely, the fewer
the cells in this unit of volume, the more easily the current can pass and in this case PLF is close to
Pe: (fig. 4.5b).

Figure 4.5: A low frequency current (5,000 hertz) across a biological tissue

Cells ECF

a b c d

It can therefore be understood that PLF of a tissue is a function of Pe and γ the latter factor being a
factor of form. It is the form that should be taken on by the electric current to pass through the tissue.
(Fig. 4 .5c).

Normally the tissue of each organ has a texture, i.e. a constant factor γ, and if we accept that Pe of
the plasma is constant, the mean body resistivity PLF of all tissues taken together is constant in the
normal state.

It is the same in all subjects in good health, except, as will be seen later, in lean or obese subjects
where non-conductive fatty inclusions are more or less great in relation to the normal state (Fig.4.5d)
and influence the tortuosity of the electric field in HF (high frequency) as in LF (low frequency).

In HF (high frequency), the measurement current at 1MHz (1,000,000 hertz), cancels the capacitive
effect of the cellular membranes such that to pass through a unit of tissue volume the current uses
both ECF and ICF.
11
 Figure 4.6: A high frequency current across a biological tissue

ECF (Pe) ICF (Pi)

a b c d

The resistivity is therefore a function of Pe (ECF) and Pi (ICF) according to a proportion that depends
on the number of cells in the unit of tissue volume measured (Fig 4.6a).

In the case of extra-cellular edema there are fewer cells in the unit of tissue volume measured, and
the influence of Pe predominates over Pi in relation to the normal state (Fig. 4.6b).

More rarely, we may be faced with a cellular edema, in this case the influence of Pi predominates in
relation to the normal state. Such a case is often encountered in renal pathology (Fig. 4.6c).

It can be seen from these examples that PHF depends more on Pe and Pi than on the factor γ. How-
ever, in the case of leanness or obesity this factor γ plays as much a role as in LF (low frequency), di-
minishing or augmenting PHF (Fig. 4.6d).

Explanation: Organ tissues are of different density. The denser the tissue the greater the resistance
to low frequencies. The illustrations in this report show that low frequencies go around the cells and
high frequencies go through the cells. This is because there is no resistance in penetrating the skin or
cells when using high frequencies. This again shows the benefit of using a carrier frequency of at least
1MHz (1,000,000 hertz).

12
Description

The skin was the obstacle to be surmounted before approaching the body composition by im-
pedancemetry. Although directly accessible to the physician the skin is a relatively little known organ.
Schematically, it is made up of three parts: the epidermis, the dermis and the hypodermis.

Figure 4.7: Schematic organization of the skjn

Insulating epidermis
Basal cells

Dermis

Hypodermis

Muscle

The epidermis consists of several superimposed layers: basal cells of the deep layers, with a nu-
cleus, migrate upwards to form a second rather thick granular layer, well delimited, above which there
is a third layer which is the corneum, made up of non-nucleated cells, overlaping each other, fused
together in depth and open to the external environment, in the same way as microscopic scales.
These three layers are pierced by more or less numerous canals whose role is to evacuate perspira-
tion and hairs whose raisonn d'etre is poorly understood.

The dermis underlying the epidermis is the nourishing part of the skin. It contains the blood capillaries
bathed in a network of collagen fibers. This layer lies on the hypodermis.

The hypodermis is composed of fatty lobules between which vessels nourishing the dermis work their
way. Its thickness is variable, greater in women than in men. It is the hypodermis that makes up the
coating an important part of the Fatty Mass, and it is the double thickness of the hypodermis that is
measured by the method of skin folds.

Whereas the anatomical structure of the skin is well known, its physiology still hides uncertainties, but
it may be said without contest that the epidermis alone ensure 90% of the functions of the skin. Be-
sides the role of barrier separating the external from the internal environment and serving as a con-
tainer for the fluids, the epidermis prevents the penetration into the organism of noxious products and
bacteria, at the same time ensuring the evaporation of water and contributing to the body heat regula-
tion.
13
Skin impedance

There is little data available on this subject. It is only known that the skin is an insulator for weak cur-
rents of low frequency (5,000 hertz), and that it can be easily passed through by the same currents but
at high frequency (1,000,000 hertz or 1MHz).

Figure 4.8: Equivalent electric diagram for the skin

EC
1 2
A B
C D

IC
M

This property is due to the corneal layer of the epidermis, it varies according to the anatomical regions
and according to the time of day for the same region. The epidermis acts as a leakage dielectric. With
the electrodes placed on its surface on the one hand and the sub-epidermal conducting layers on the
other hand it forms two variable condensers, as shown in fig. 4.8 which illustrates that a weak LF
(5,000 hertz) current cannot circulate between A and B, as on this trajectory there are two obstacles 1
and 2 representing the epidermis.

On the other hand, if the same low frequency (5,000 hertz) current enters by means of moistened
electrodes or needles placed under the skin in C and D, it can then follow the pathway E-C, but it can-
not take the pathway I-C interrupted by the condenser M created by the cellular membranes. To ex-
plore the pathway E-C and I-C, the measurement current should necessarily have a high frequency
(1,000,000 hertz or 1MHz).

Explanation and summary: The skin is a good insulator. It is difficult for low frequencies to pass
through it. The skin does have moisture in it. Some people have very moist skin and others have very
dry skin. It takes higher voltage to penetrate dry skin than wet skin. Moisture is the determining factor
for penetration through the skin into the body at low frequencies (5,000 hertz). Once the frequency en-
ters the body the determining factor of penetration into the cell is the frequency used. This report
shows that low frequencies go around the cells through the connective tissue while high frequencies
penetrate both the cells, connective tissue and bones. Bio-electrical Impedancemetry or Bio-electrical
lmpedance Analysis tests have shown that there is no skin effect when the proper methods are used.
They also show that a carrier frequency of at least 1MHz (1,000,000 hertz) is necessary to penetrate
the cells of the body when using low frequencies. Audio frequencies are generally considered to be
below 20,000 hertz. These frequencies need a carrier frequency to enter into the cell.
14