Ten20 vs. NuPrep: What Is the Difference and When Should You Use Each?
Ten20 Conductive Paste and NuPrep Skin Prep Gel are frequently used together in EEG, evoked-potential, sleep-laboratory, and other neurodiagnostic workflows. Although both products support electrode performance, they do entirely different jobs.
NuPrep prepares the skin before electrode placement. Ten20 stays with the electrode during the examination.
NuPrep is a mildly abrasive preparation gel used to reduce resistance at the skin surface. Ten20 is a thicker, adhesive conductive paste used with non-gelled neurodiagnostic electrodes to help hold them in position and maintain electrical contact.
In many workflows, the correct choice is therefore not Ten20 or NuPrep. It is:
- Prepare the electrode site with NuPrep.
- Remove excess preparation gel.
- Apply Ten20 to the non-gelled electrode.
- Place and secure the electrode.
Ten20 instructions specifically direct users to prepare the site with an abrasive product such as NuPrep before filling and placing a cup electrode.
Ten20 vs. NuPrep at a glance
| Feature | NuPrep Skin Prep Gel | Ten20 Conductive Paste |
|---|---|---|
| Product type | Mild abrasive skin-preparation gel | Adhesive conductive electrode paste |
| Primary job | Prepare intact skin and help lower impedance | Hold non-gelled electrodes and conduct the recorded signal |
| When used | Before electrode placement | With the electrode during the examination |
| Removed before placement? | Excess is removed; all residue is removed for cardiac electrodes | No, it remains beneath and around the electrode during testing |
| Adhesive function | No | Yes |
| Conductive function | Improves the skin interface by lowering resistance | Provides conductive contact between skin and electrode |
| Common procedures | EEG, evoked potentials, ECG stress testing, cardiac rehabilitation, cardiac catheter monitoring | EEG, evoked potentials, PSG, MSLT, and related neuromonitoring |
| Typical electrode type | Non-disposable neurodiagnostic electrodes or cardiac monitoring electrodes after prep | Non-gelled neurodiagnostic cup electrodes |
| Texture | Light abrasive gel | Thick, non-drying paste |
| Cleanup | Remove excess and clean according to protocol | Washes away with warm water |
| Use with current-inducing electrodes | No | No |
| Applied to broken skin | No | No |
| Manufactured with natural rubber latex | No | No |
| Plain-language role | “Prepare the site." | “Hold and conduct” |
NuPrep’s instructions list EEG, evoked potentials, ECG stress testing, cardiac rehabilitation, and cardiac catheter monitoring as examples. Ten20’s labeled applications include EEG, evoked potentials, polysomnography, and multiple sleep latency testing, all using non-gelled neurodiagnostic electrodes.
What is NuPrep Skin Prep Gel?
NuPrep Skin Prep Gel is a mild abrasive gel applied to the skin before an electrode is attached. Its purpose is to reduce the resistance created by the outer skin layer, oils, dry cells, and other surface conditions that can interfere with electrode contact.
NuPrep is a product for situations in which lower skin impedance would improve test results.
What does NuPrep do?
NuPrep helps:
- Prepare the electrode site
- Reduce skin-to-electrode impedance
- Improve contact consistency
- Support clearer physiological recordings
- Reduce signal problems related to poor surface preparation
- Prepare sites before EEG, ECG, or other compatible monitoring electrodes
High electrode-to-skin impedance can make physiological recordings more vulnerable to power-line interference, movement artifacts, and signal attenuation. Proper preparation is therefore an important part of obtaining stable EEG, ECG, and evoked-potential recordings.
What NuPrep does not do
NuPrep is not:
- An electrode adhesive
- A replacement for Ten20
- A paste that holds cup electrodes in place
- A reusable-electrode gel for TENS or NMES
- A defibrillation gel
- An ultrasound coupling gel
- Intended for broken or compromised skin
NuPrep should not be left in a thick layer beneath a disposable cardiac electrode. For cardiac applications, Remove all NuPrep from the prepared site with dry gauze before applying the electrode.
What is Ten20 Conductive Paste?
Ten20 Conductive Paste is a thick adhesive paste designed for use with non-gelled neurodiagnostic electrodes.
It performs two jobs at the same time:
- It helps hold the electrode in position.
- It maintains a conductive interface for recording the physiological signal.
Ten20 is especially useful with bell-shaped cup electrodes for EEG, evoked-potential, PSG, MSLT, and related neurodiagnostic examinations. It as non-drying and washable with warm water.
What does Ten20 do?
Ten20 helps:
- Fill non-gelled electrode cups
- Secure the electrode against the prepared site
- Maintain electrical contact
- Reduce electrode movement
- Support longer neurodiagnostic examinations
- Limit interruptions caused by electrodes lifting or detaching
What Ten20 does not do
Ten20 is not
- A skin-preparation abrasive
- A substitute for NuPrep
- A general-purpose ECG monitoring paste
- Intended to be placed under pre-gelled disposable ECG electrodes
- A TENS or NMES contact medium
- A defibrillation gel
- Intended for open wounds or compromised skin
The Ten20 instructions limit its labeled use to neuromonitoring procedures with non-gelled neurodiagnostic electrodes.
The simplest way to remember the difference
| Clinical question | Product |
|---|---|
| Do I need to prepare the skin and reduce impedance? | NuPrep |
| Do I need to fill and hold an EEG cup electrode? | Ten20 |
| Do I need both lower impedance and secure cup-electrode placement? | NuPrep first, then Ten20 |
| Do I have a pre-gelled disposable ECG electrode? | NuPrep may be used for site preparation when protocol permits; Ten20 is generally not used |
| Do I need conductive gel for reusable rubber or metal electrodes? | Consider a compatible electrode gel rather than either product |
| Do I need TENS or NMES electrodes? | Use compatible pre-gelled stimulation electrodes |
| Do I need ultrasound coupling? | Use ultrasound gel |
| Do I need defibrillation gel? | Use a product specifically indicated for defibrillation |
When should NuPrep be used?
EEG and evoked-potential preparation
NuPrep may be applied to the marked scalp or skin site before placing non-disposable neurodiagnostic electrodes. Proper preparation helps lower impedance before the electrode and conductive paste are applied.
ECG stress testing
Movement and perspiration can make electrode contact more difficult during exercise testing. NuPrep may be used according to facility protocol to prepare the skin before applying compatible ECG electrodes.
We offer monitoring products for various clinical needs, including Kendall Medi-Trace 530 electrodes for stress testing, Holter monitoring, active patients, and diaphoretic conditions.
Cardiac rehabilitation and monitoring
The manufacturer lists cardiac rehabilitation monitoring and cardiac catheter monitoring among NuPrep’s example applications. Remove all NuPrep residue with dry gauze before applying cardiac electrodes.
For related monitoring supplies, browse our ECG and EKG monitoring electrode collection.
When impedance is higher than expected
NuPrep may be useful when poor surface contact is associated with:
- Dry or flaky skin
- Surface oil
- Inconsistent electrode contact
- Motion-related artifact
- Elevated impedance readings
- Difficulty obtaining a stable tracing
Do not continue rubbing simply because an impedance target has not been reached. Confirm electrode condition, lead connections, placement, equipment settings, and facility protocol before repeating skin preparation.
When should Ten20 be used?
Routine EEG
Ten20 can fill and secure non-gelled cup electrodes after the scalp sites have been marked and prepared.
Evoked-potential testing
Stable electrode position is important when small physiological responses are being recorded and averaged. Ten20 helps hold the recording electrodes in position during the examination.
Polysomnography
Sleep studies can last for many hours and involve substantial patient movement. Ten20’s adhesive, non-drying consistency makes it useful for cup electrodes used during PSG.
Multiple sleep latency testing
MSLT protocols involve repeated sleep opportunities and extended electrode wear. Ten20 is among the manufacturer’s specifically listed applications.
Other non-gelled neurodiagnostic electrodes
Ten20 may fit other neuromonitoring applications when the electrode and equipment instructions permit an adhesive conductive paste.
It should not automatically be used under every recording electrode. Pre-gelled disposable pads, snap ECG electrodes, tab electrodes, dry electrodes, and proprietary sensors may require entirely different preparation and contact media.
How to use NuPrep and Ten20 together
The following is a general workflow based on the manufacturer instructions. Always follow the current product labeling, facility protocol, equipment instructions, and patient-specific requirements.
Step 1: Identify and mark the electrode site
Locate the required position using the applicable EEG, evoked-potential, PSG, or neurodiagnostic placement system.
Step 2: Inspect the skin
Do not apply either product over the following:
- Open wounds
- Abrasions
- Active dermatitis
- Infected skin
- Unexplained rash
- Other compromised tissue
Step 3: Apply a small amount of NuPrep
Place a small amount on a clean cotton swab or gauze pad rather than dispensing directly onto the patient.
Step 4: Prepare the site gently
For non-disposable electrodes, Weaver recommends lightly rubbing with approximately four or five small circular movements. Less pressure should be used for neonates, geriatric patients, fragile skin, or other high-risk patients.
Step 5: Remove excess NuPrep
Remove visible excess before electrode placement.
For cardiac electrodes, remove all NuPrep from the site with clean, dry gauze before applying the electrode.
Step 6: Place Ten20 on a clean working surface
Dispense the required amount onto clean tape, gauze, or another appropriate preparation surface. Avoid repeatedly contaminating the original container.
Step 7: Fill the electrode cup
For a bell-shaped cup electrode, fill the cup until it is slightly overfilled.
Step 8: Apply the electrode
Position the cup on the prepared site and press with moderate pressure.
Step 9: Add support if required
Tape or gauze may be used according to the electrode instructions and clinical protocol.
Step 10: Verify impedance and signal quality
Check electrode impedance and the incoming tracing before beginning the formal recording.
Step 11: Remove and clean after the examination
Remove the electrode carefully and wash away Ten20 with warm water. Inspect the skin for redness or irritation.
The Ten20 IFU describes this prep-first, paste-second process for cup electrodes.
NuPrep application: EEG vs. ECG
The application procedure differs slightly according to the electrode type.
| Step | EEG or non-disposable electrode site | Cardiac electrode site |
|---|---|---|
| Applicator | Cotton swab | Gauze pad |
| Motion | Four or five small, light circular motions | Four or five light circular motions |
| Pressure | Gentle: reduce further for fragile skin | Gentle: do not over-abrade |
| Excess preparation gel | Remove excess | Remove all NuPrep with dry gauze |
| Next step | Apply the appropriate electrode medium and electrodes. | Apply compatible cardiac electrode |
| Ten20 is needed. | Frequently, for non-gelled cup electrodes | Generally no for pre-gelled disposable cardiac electrodes |
These distinctions come directly from the current NuPrep instructions.
Why should you avoid over-abrasion?
The goal of skin preparation is to improve electrode contact—not to make the skin visibly raw.
Too much pressure or repeated abrasion can cause the following:
- Redness
- Soreness
- Skin irritation
- Increased sensitivity during a long examination
- Damage to fragile skin
- Potential permanent scarring in severe cases
Weaver specifically warns that over-abrasion can cause topical injury and permanent scarring.
Use even less pressure when preparing:
- Neonatal skin
- Geriatric skin
- Thin or fragile skin
- Previously irritated sites
- Patients with known sensitivity to cosmetics or lotions
If rash, itching, swelling, redness, or another abnormal reaction develops, wash the product away and follow the facility’s clinical procedure.
Ten20 and NuPrep compared with other conductive products
Ten20 and NuPrep are only two categories within electromedical contact media.
| Product | Primary function | Adhesive? | Mildly abrasive? | Typical applications |
|---|---|---|---|---|
| NuPrep Skin Prep Gel | Prepare skin and help lower impedance | No | Yes | EEG prep, evoked potentials, ECG stress testing, monitoring preparation |
| Ten20 Conductive Paste | Hold non-gelled electrodes and conduct signals | Yes | No | EEG, EP, PSG, MSLT |
| SignaGel Electrode Gel | General conductive contact medium | No | No | ECG, EMG, biofeedback, defibrillation when equipment calls for gel |
| Spectra 360 Electrode Gel | Salt- and chloride-free conductive gel | No | No | Long-duration monitoring and reusable electrodes; not defibrillation |
| Tensive Conductive Adhesive Gel | Conductive contact with temporary adhesive properties | Yes | No | Selected EMG, EEG, and compatible electrode applications |
| Pre-gelled ECG electrode | Records ECG signal through built-in hydrogel | Self-adhering | No | Bedside, telemetry, stress, Holter, or diagnostic ECG |
| Pre-gelled TENS/NMES electrode | Delivers stimulation current | Self-adhering | No | TENS, NMES, EMS, and compatible electrotherapy |
The correct medium must be selected according to the electrode, equipment, and procedure instructions. “Conductive” does not mean that every gel or paste can safely substitute for another.
Browse our complete conductive gel, lotions, and contact media collection.
Can NuPrep or Ten20 be used with TENS and NMES?
No. The current instructions for both products state that they should not be used with current-inducing electrodes.
TENS, NMES, EMS, FES, and interferential devices intentionally send electrical current into the body. They require electrodes and contact media specifically designed for stimulation.
Can NuPrep be used before disposable ECG electrodes?
It may be appropriate when the ECG electrode instructions and facility protocol permit abrasive skin preparation.
For cardiac electrodes:
- Use only a small amount.
- Rub lightly.
- Do not over-abrade.
- Remove all NuPrep with clean, dry gauze.
- Apply the pre-gelled ECG electrode to the prepared, dry site.
Do not place a disposable adhesive electrode over a visible layer of NuPrep. Residue could interfere with the electrode’s integrated hydrogel and adhesive.
We offer ECG pads for different monitoring demands, including:
- Kendall Medi-Trace 200 Series for compact routine monitoring
- Kendall Medi-Trace 450 Series for general housewide monitoring
- Kendall Medi-Trace 530 Series for stress, Holter, active, and diaphoretic monitoring
- Kendall Diagnostic Tab Electrodes for compatible resting ECG systems
MRI considerations
NuPrep contains insoluble material that may create shadowing or interfere with an MRI examination. The manufacturer directs users to remove all neurodiagnostic materials from the electrode sites before MRI.
Before a patient enters the MRI environment:
- Remove all electrodes not approved for MRI.
- Remove Ten20 and NuPrep residue.
- Inspect hair-covered and difficult-to-see sites.
- Follow the MRI department’s screening and cleaning protocol.
- Never assume that an electrode, paste, clip, or lead wire is MRI-compatible.
Storage, shelf life and cleanup
| Topic | NuPrep | Ten20 |
|---|---|---|
| Storage | Keep closed; no special storage conditions stated | Keep tightly closed at room temperature |
| Published shelf life | Properly stored containers remain usable through the marked three-year shelf life | Three-year shelf life when properly stored |
| Cleanup from skin | Remove residue according to procedure; warm water may be used | Washes away with warm water |
| Container hygiene | Dispense onto clean gauze or another working surface | Remove paste with a clean applicator or dispense onto a clean surface |
| Cold exposure | Protect from inappropriate storage conditions | Avoid prolonged cold or freezing |
| Expiration information | Printed or stamped on each container | Printed or stamped on each container |
Properly stored opened products remain usable through their marked three-year shelf life. Inspect the expiration date, container condition, and product consistency before use.
For more detail, read our Storage and Cleanup Guide for NuPrep and Ten20.
Troubleshooting poor signal quality
| Problem | Possible cause | Recommended check |
|---|---|---|
| High electrode impedance | Inadequate preparation | Reassess skin preparation, avoiding overabrading. |
| High impedance persists | Dry or damaged electrode | Replace or refill the electrode as appropriate |
| One channel is noisy | Loose or displaced electrode | Check electrode position and Ten20 contact |
| Several channels are noisy | Reference, ground, equipment, or environmental issue | Inspect shared connections and recording setup |
| An artifact appears with movement | The electrode or wire is shifting | Secure the electrode and support the lead |
| The cup electrode repeatedly lifts | Too little paste or inadequate support | Reapply according to the Ten20 instructions |
| Disposable ECG electrode lifts | Moisture, oil, hair, or lead tension | Prepare a fresh site and use a new electrode |
| Skin becomes red | Excessive abrasion, pressure, or sensitivity | Stop, clean the area, and assess the skin |
| Paste spreads between sites | Too much Ten20 | Remove excess and prevent paste from bridging electrodes |
| Impedance changes during a long study | Electrode movement or drying/contact change | Inspect electrode position and signal quality |
| MRI artifact is possible | Prep material remains | Please ensure that all electrodes and preparation residue are removed before the MRI. |
Ten20 should not be spread from one electrode site to another. Bridging adjacent sites with conductive paste can alter the effective recording arrangement and compromise the examination.
Frequently asked questions
Is Ten20 the same as NuPrep?
No. NuPrep prepares the skin and helps lower impedance. Ten20 helps hold a non-gelled electrode in place and provides conductive contact during the examination.
Should NuPrep be used before Ten20?
In many EEG and neurodiagnostic workflows, yes. The Ten20 instructions specifically describe gently preparing the site with an abrasive product such as NuPrep before applying the filled cup electrode.
Can Ten20 lower impedance without NuPrep?
Ten20 provides a conductive interface, but it does not perform the same mild skin-abrasion function as NuPrep. A site with high skin impedance may still require appropriate preparation.
Is NuPrep an electrode gel?
It is a skin-preparation gel rather than a leave-on conductive electrode gel. Its purpose is to condition the skin before an electrode is applied.
Is Ten20 an electrode adhesive?
Yes, but more specifically it is an adhesive conductive paste for non-gelled neurodiagnostic electrodes. It should not be treated as a universal medical adhesive.
Can Ten20 be used for EEG?
Yes. EEG is one of its principal labeled applications.
Can Ten20 be used for sleep studies?
Yes. Weaver lists polysomnography and multiple sleep latency testing among its example uses.
Can Ten20 be used for Holter monitoring?
Holter monitoring is not listed in the current Ten20 indications. Holter systems usually use compatible pre-gelled ECG monitoring electrodes. NuPrep may be used for skin preparation when the electrode and clinical protocol permit it.
Can NuPrep be used for ECG stress tests?
Yes. ECG stress testing is specifically listed in the current NuPrep instructions. All NuPrep should be removed from the site with dry gauze before applying the cardiac electrode.
Can either product be used with TENS electrodes?
No. Both instructions say not to use the products with current-inducing electrodes.
Can NuPrep be applied to broken skin?
No. It is for topical use on intact skin and should not be used on or near open wounds or compromised skin.
Can Ten20 be applied to broken skin?
No. Ten20 is also limited to intact skin.
How hard should NuPrep be rubbed?
Lightly. The current instructions describe four or five small circular motions. Use substantially less pressure on neonatal, geriatric, or fragile skin.
What happens if NuPrep is used too aggressively?
Over-abrasion can irritate or injure the skin. Weaver warns that permanent scarring can occur when abrasion is excessive.
Should NuPrep residue remain under an ECG pad?
No. For cardiac electrodes, remove all NuPrep with clean, dry gauze before applying the electrode.
How much Ten20 should go into a cup electrode?
Fill a bell-shaped cup until it is slightly overfilled, then place it on the prepared site and press with moderate pressure. Avoid using enough paste to bridge neighboring electrode locations.
Does Ten20 dry out during a study?
The manufacturer describes Ten20 as non-drying.
How is Ten20 removed?
It is water-washable and can be removed with warm water. Harsh chemical removers are not normally required.
Are Ten20 and NuPrep made with natural rubber latex?
Weaver states that both products are manufactured without natural rubber latex.
Can NuPrep interfere with MRI?
Residue may create shadowing or interfere with MRI imaging. Remove all electrode-site materials before the MRI examination.
Which product should you buy?
Choose NuPrep when:
- The primary issue is skin preparation.
- Electrode impedance is too high.
- The workflow includes EEG or evoked-potential site preparation.
- The patient is undergoing an ECG stress test.
- Cardiac rehabilitation or catheter-monitoring sites require preparation.
- A pre-gelled monitoring electrode needs a cleaner, lower-resistance skin interface.
- The electrode itself already supplies adhesion and conductive gel.
Choose Ten20 when:
- You are using non-gelled neurodiagnostic cup electrodes.
- The electrode must remain secured during EEG.
- The procedure is an evoked-potential examination.
- The workflow includes PSG or MSLT.
- A thick, adhesive, non-drying conductive paste is needed.
- Warm-water cleanup is preferred.
Choose both when:
- A neurodiagnostic electrode site requires lower impedance.
- A cup electrode must remain secure during a long examination.
- The workflow calls for traditional prep, paste, and cup-electrode placement.
Final takeaway
NuPrep and Ten20 are not interchangeable products.
NuPrep prepares the skin. Ten20 secures the electrode and maintains conductive contact.
For many EEG, evoked-potential, PSG, and MSLT workflows, the most effective sequence is the following:
| Order | Product or step | Purpose |
|---|---|---|
| 1 | Mark and inspect the site | Confirm correct placement and intact skin |
| 2 | NuPrep Skin Prep Gel | Gently prepare the skin and help lower impedance |
| 3 | Remove excess NuPrep | Leave the site properly prepared |
| 4 | Ten20 Conductive Paste | Fill, conduct, and help secure the non-gelled electrode |
| 5 | Verify impedance and tracing | Confirm acceptable contact before recording |
| 6 | Warm-water cleanup | Remove paste and inspect the site afterward |
Browse our full EEG and ECG Diagnostic Supply Guide library for additional information about electrodes, conductive media, skin preparation, storage, and signal quality.
