Bye Bye Cellulite!

What is Cellulite?

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Cellulite is a term used to describe the dimpled appearance of skin caused by fat deposits that are just below the surface of the skin. It generally appears within the skin around the abdomen, lower limbs, and pelvic region, and typically it occurs in women after puberty. Cellulite is also known as adiposis edematosa, dermopanniculosis deformans, status protrusus cutis, and gynoid lipodystrophy in the medical field and as orange peel syndrome, cottage cheese skin, hail damage, and the mattress phenomenon in colloquial language.

Skin CelluliteThe pictures above show how the outer layers (hypodermis or subcutaneous fat layer) of the skin are unique from other layers because of the fat “lobes” that are organized into chambers surrounded by strands of connective tissue. The example on the left shows how when there is cellulite present, the fat lobes push the outer layer of the skin and the connective tissues pull on the skin to create distortion and an unevenness in the skin.

Cellulite: Facts

  • Over 85 percent of women have some level of it.
  • It is much more common in women than men.
  • Genetics are a major determining factor in the appearance of cellulite.
  • Diet and exercise can help to some extent to minimize the appearance of cellulite.
  • There are non invasive treatments that can help to reduce the appearance of cellulite.


Cellulite: Levels of

Level 1 – The skin surface exhibits dimpling after pinching. There are no clinical symptoms, but a microscopic examination of cells will show underlying anatomical changes.

Level 2 – There are visible bumps when standing. The skin shows pastiness, has decreased elasticity and increased anatomical changes can be observed under microscopic examinations.

Level 3 – There are more pronounced ripples and bumps are visible when standing or sitting. There is a visible roughness to the skin (like an orange peel) along with all level 2 signs.


Cellulite: Understanding It

Before seeking treatment for cellulite, it helps to understand what it is and why it occurs, experts say. “It’s largely genetic,” says Carolyn Jacob, MD, a dermatologist and associate clinical instructor of dermatology at Northwestern Memorial Hospital, Chicago. “Ninety percent of women have it.”

Cellulite is fat, but with a different appearance than other fat. It looks like dimpled skin, sort of cottage-cheesy, and most often shows up on the thighs, hips, and buttocks. If it’s mild, it can only been seen when the skin is pinched. But in more severe cases, the bumpiness and peaks and valleys show when the skin isn’t pinched.

Cellulite is much more common in women than in men, experts say. Why? Fat in women often accumulates in the thighs, hips, and buttocks. Underneath the skin, the fat contains fibrous bands.

In men, these bands are typically in even rows, says Robert Weiss, MD, president of the American Society of Dermatologic Surgery and a dermatologist in Hunt Valley, Md. But in women, even in women at a healthy weight, the bands aren’t in regular, even rows but are in more of a zigzag pattern, he says, probably due partly to hormonal influences. That allows the fat to push through the connective tissue that typically keeps it distributed evenly, resulting in the bumps, peaks, and valleys that appear as cellulite.

Genetics play a role in whether you will get noticeable cellulite, and so does the amount of fat in your body. Excess weight can make the cellulite more noticeable.


Cellulite: Causes

The causes of cellulite are not well understood, but there are several suggested causes that are generally agreed upon and have been put forth as explanations. Among these are:

Genetic factors

Several genetic factors have been shown to affect the development of cellulite. Genes may predispose an individual to particular characteristics associated with cellulite, such as gender, race, slow metabolism, distribution of fat just underneath the skin, and circulatory insufficiency.

Hormonal factors

Hormones play a role in the formation of cellulite. Estrogen may be the most important hormone to initiate and aggravate cellulite. However, there has been no reliable clinical evidence to support such a claim. Other hormones including insulin, the catecholamines adrenaline and noradrenaline, thyroid hormones, and prolactin are all believed to participate in the development of cellulite.


Dieting has shown to have minimal effects on improving or worsening the appearance of cellulite, though people who eat too much fat, carbohydrates or salt and too little fiber are likely to have greater amounts of cellulite.


Cellulite may be more prevalent in smokers, those who do not exercise, and those who sit or stand in one position for long periods of time. Also, a high stress lifestyle can cause an increase in the level of catecholamines, which are associated with the appearance of cellulite.


Underwear with tight elastic across the buttocks (limiting blood flow) may contribute to the formation of cellulite.


Can cellulite be treated?

Therapeutic methods that are physical or mechanical include pneumatic massages, massages that stimulate lymphatic flow, heat therapy, ultrasound, radio frequency therapy, magnetic therapy, radial wave therapy, Endermologie, and electrical stimulation. These methods can reduce the appearance of cellulite in most women, but they require continuing treatments.

A second class of cellulite removal strategies consists of drugs that are supposed to act on fatty tissues. There is a wide variation of pharmacological agents used, such as methylxanthines (caffeine and theobromine), beta-agonists and adrenaline, alpha-antagonists, amino acids, ginkgo biloba, rutin, and Indian chestnut among others. Applying these agents topically, orally, or by injection have been proven to be effective.

Some people with cellulite wear special clothing called compression garments to reduce the appearance of cellulite. These garments try to compress arteries and increase blood and lymph flow to reduce visual cellulite.

Cellulite reduction techniques such as liposuction and dieting actually do not remove cellulite, but rather help to reduce deeper layers of fat and can help to reduce the appearance of cellulite. However, eating a healthful, balanced diet and exercising may be the best way to reduce the fat content in cells and reduce the appearance of cellulite.


Can cellulite be prevented?

Eating healthy, low fat foods such as fruits, vegetables, and fiber can help one to avoid cellulite. Similarly exercising regularly, maintaining a healthy weight, and reducing stress are recommended to help minimize the appearance of cellulite. In addition lymphatic massage that helps stimulate circulation in the affected areas can help to minimize the appearance of cellulite.


Why do even thin women have Cellulite?

  • Cellulite has many causes, specifically genetics.
  • Cellulite is not directly related to obesity or being overweight.
  • Very thin and fit women can and do have cellulite.
  • Cellulite is not a diet, or exercise/lifestyle issue.


Why does Cellulite form?

  • It forms as a result of complex physiological changes to the subcutaneous fat layer.
  • It can form no matter how regularly a person exercises.
  • Cellulite can form no matter how healthy of a diet one has.
  • However, if you do not have a healthy lifestyle the overall appearance of existing cellulite can worsen over time with weight gain, poor nutrition and inadequate water intake.


How does weight gain contribute to excess cellulite?

  • Any layer of excess reserve fat takes on its own shape as it lies on top of muscle.
  • It can push up against the subcutaneous layer, which can heighten the appearance of cellulite.
  • Those who lose weight may realize a reduction in the appearance of their cellulite as the pounds come off, but it is still there.


What are some of the other causes of cellulite?

  • Fat cells that swell due to fat storage.
  • Toxic accumulation in the tissues.
  • Fluid retention and poor hydration habits.
  • Hormones.
  • Poor lymphatic drainage.
  • Thickening of fibers surrounding the fat cells which impedes blood and lymphatic flows.


What the Doctors have to say:

Background and Objectives:

A system that combines bipolar radio frequency (RF) and intense infrared light (IR) together with mechanical massage and suction has recently been reported as being efficient for cellulite treatment. The present split study was designed to evaluate the efficacy of such a system through various treatments of cellulite located on the buttocks.


Ten patients were enrolled for 12 sessions of 30 minutes each performed over one buttock, the other buttock serving as an untreated control. Sessions were conducted twice a week for a period of 12 weeks. Clinical photography and profilometry were carried out to assess textural changes before (baseline) and 2 months after the final treatment. Histopathology was performed at baseline, 2 hours after the first session, and just before the 12th session and 2 months thereafter.


All patients noted improvement in the treated buttock before the final session, which was maintained at the 2-month assessment. Improved skin appearance was noticed after the first session and was maintained throughout the study. All patients were satisfied with the results and requested further treatment in order to balance the results in both buttocks. Random histological analyses suggested dermal firmness, fiber compaction and tightening of skin layers, including the subcutis, as possible reasons for the effects achieved. The authors recognize that the small number of participants limits the statistical power of the study.


Treatment sessions with the combined RF, IR light and mechanical massage and suction system were complication free, produced improvements in the overall cellulite appearance and skin condition, suggesting that further treatment sessions for maintenance could sustain patient satisfaction index (SI) and lead to lasting results. Based on the good results in the limited trial population, further studies with larger patient populations are warranted.