Understanding Cellulite

By Elana Pruitt © 2006-2009
PlasticSurgery.com Editor

Understanding Cellulite: A Woman's AbdomenBecause about 90 percent of post-adolescent women show signs of “orange peel skin” – that irregular, lumpy surface most commonly visible on the thighs, buttocks, and legs – men should thank their lucky stars! Or rather, their unique skin anatomy. Posed as an annoying cosmetic condition, cellulite will always drive women crazy. From the slim to the full-figured, it latches on to all body shapes and sizes. While it may be temporarily improved with various treatments, creams, or dietary considerations, the root of the “cottage cheese” look seems to be inherently female and a popular frustration.

Getting to the Root of the Cellulite Problem

It seems common for most women to confuse the concept of cellulite with that of normal fat, assuming cellulite is a direct response to overeating or lack of exercise. If it were only that simple! According to Los Angeles dermatologist Howard Murad, M.D. author of “The Cellulite Solution“, they have completely different roles within the skin’s layers.

“Fatty tissue primarily functions as a protective cushion for your organs and as an energy reserve”, writes Dr. Murad. “When you reduce your normal intake of food, your body automatically burns its own reservoir of stored fat. On a low-calorie diet, fat comes off in many areas, but the cellulite bulges remain.”

Before you dedicate too much of your energy at the gym towards strictly alleviating signs of cellulite, take a quick breather. “When you lose weight, no matter what diet-exercise program you use, the percentage of body fat decreases, but there is no measurable loss of cellulite”, he says. “This is because the body cannot utilize fat trapped in the dermal layer, the fat that actually contributes to cellulite, as fuel.”

And while a poor diet and lack of exercise alone is not a direct link in causing cellulite, upping your nutritional intake and losing excess body fat will at least help to improve its appearance. “Without a healthy lifestyle, the overall appearance of existing cellulite can worsen over time due to weight gain, poor nutrition, and inadequate water intake”, the American Skincare and Cellulite Expert Association (ASCEA) reports.

Yet, diet and exercise can sometimes increase the appearance of cellulite, says Dr. Kochi Tang, founder of medical salon High Maintenance in Las Vegas, Nevada. Losing the base layer of fat can actually push cellulite higher, sitting it at the skin’s top level. “This is why it can look even ‘spongier’”,’ she says.

Initializing in the first level of skin tissue, commonly known as the hypodermis or subcutaneous fat layer, the “dimpled skin” effect occurs when fat cells swell and rise to the surface, after developing in the dermal layer of the skin. But why do fat cells become toxic and swell? According to plastic surgeon Dennis J. Hurwitz, M.D., F.A.C.S., of Pittsburgh, Pennsylvania, a combination of issues like genetic disposition, hormones, and weight loss patterns are considered major contributing factors toward its growth.

Simply getting older is also an inevitable source of cellulite among women. According to the ASCEA, “Aging results in a loss of thickness and tone of the connective tissue within the dermis and the superficial fat layer. The outcome is a more visible and flabby cellulite.” Hormonal changes like puberty, pregnancy, menopause, premenstrual syndrome, and the initial months on birth control pills especially prompt its development, according to the ASCEA.

According to Dr. Murad, “The reason men never get cellulite is likely that they have much less estrogen in their bodies than women do.” Another major factor as to why women own this condition, instead of men, is due to the vertical chambers where an abundance of fat can be stored in the subcutaneous layer. “The chambers in men are arranged as small diagonal units, which not only store smaller quantities of fat but are also unlikely to result in cellulite formation”, he writes.

And as for genetics, Dr. Murad justly states in his book, “If your mother had cellulite, you are more likely to have it too.”

Top Medical Cellulite Treatments

Due to the genetic disposition of cellulite, the uneven texture found on most women’s buttocks and thighs can be improved, but not prevented, admits Dr. Tang. Two top medical treatments designed to temporarily, yet effectively, reduce the appearance of cellulite include Endermologie® and Mesotherapy.

Endermologie® is a French technique developed in the 80s as a way to treat scars, eventually catching on as an effective way to improve skin texture. It is a subdermal approach to treating cellulite through a motorized roller and regulated suction on specific areas of the body. This non-invasive method is known to temporarily increase blood and lymphatic flow, the stretching of connective tissue, skin exfoliation, stimulation of collagen production, and facilitate fat metabolism, according to the ASCEA.

While women who opt for Endermologie ® commonly go in for six sessions about once every three or four weeks, Dr. Hurwitz says, “About 30 percent of women swear by it, while another one-third say it [the cellulite on their body] looked better, but not good enough.”

Also originally pioneered in France, Mesotherapy entails injecting small amounts of medication and vitamins into the middle layer of the skin, or the mesoderm, to fight cellulite. As Endermologie® topically treats cellulite, this technique penetrates deeper. Its unique quality has been recognized throughout Europe and South America, recently hitting the United States, in doing more than actively treating cellulite. Mesotherapy can also be used to treat specific ailments, such as infection, anxiety, or muscle spasms. Each solution injected into a patient’s skin is specifically formulated to fight the individual problem.

Understanding Cellulite: A Woman's ThighWhile some doctors utilize this technique, others keep caution. “I’m still watchful and waiting, observing the technology”, Dr. Hurwitz mentions, as to why his practice does not offer this cellulite treatment. He acknowledges that Mesotherapy has been around for almost 20 years, although he’s still not sure if it’s “all that good.”

According to Dr. Tang, in order to find out “how fibrotic and deep the cellulite is”, a cosmetic surgeon or dermatologist will need to assess the person’s skin first. He or she will then help determine which treatment would benefit the patient’s condition.

Whether selecting the individual techniques of Endermologie® and Mesotherapy, opting for the combination of both, or even learning about laser therapy, fat grafting or injections, and radio frequency to reduce cellulite, it is important to have realistic goals and expectations. Some doctors may perform liposuction in conjunction with other treatments to help remove excess fat in target areas, but “not likely to be effective” when used on its own, says Dr. Hurwitz.

The Natural Approach to Cellulite Treatment

Attempt to naturally resist cellulite from the inside out. According to Dr. Murad, “As we age, our bodies are subject to countless environmental insults, such as stress, pollution, sunlight, the foods we eat, and many more.” While medical treatments are designed to reduce its appearance, keeping your body and well-being in good health is key to controlling its development before it gets out of hand.

Keep drinking the recommended eight glasses of water a day, because most doctors would agree with its benefit in ridding toxins from your body and keeping your system clean. “If connective tissue stays well hydrated and full of essential nutrients, it is strong, elastic, and youthful”, explains Dr. Murad. “If it does not get these nutrients, it succumbs to environmental damage. The connective tissue weakens and loses its ability to hold onto water. Eventually it breaks down, causing conditions such as cellulite, stretch marks, and wrinkles.”

To build smooth skin in cellulite-prone areas, try to steer clear from that second cup of coffee each morning. What may keep you in good spirits may not be so good for your skin. According to Dr. Tang, orally ingesting caffeine will only make your kidneys work harder. Yet, using an “anti-cellulite” cream with caffeine as a topical ingredient has its benefits. Generally considered a type of diuretic that can help to increase blood flow, this stimulant is one of the most common ingredients in cellulite-fighting creams. Yet, unfortunately, the improved appearance of cellulite dissipates when one stops using the creams.

And what about products that claim to rid your lumps and bumps? Some creams, whether strictly available through your physician or over-the-counter, may provide temporary relief. According to Dr. Murad, topical and internal anti-inflammatories like arnica, aloe vera, allantoin, chamomile, and zinc, in addition to antioxidants vitamin C, E, A, and polyphenols, are “free-radical fighters.”

According to the ASCEA, a massage “increases circulation and lymphatic drainage, reduces muscular spasms and breaks down adhesions.” Treating yourself to one, or scheduling regular appointment times, can only contribute to keeping your skin healthy. Recommended by the ASCEA, other natural attempts to improve the appearance of cellulite are to:

  • Exercise regularly
  • Minimize consumption of saturated fat and carbohydrates
  • Seventy-five percent of the food you eat should consist of fruit, vegetables, and whole grains. The remaining 25 percent may consist of meat, fish, eggs, nuts, and whatever one likes best.

Being female and getting cellulite may always go hand-in-hand. So try to adopt healthy habits, while keeping in mind your medical options to actively treat this unwanted condition.

“Even though plastic surgeons haven’t discovered a magic bullet’ for treating cellulite, the modern liposculpture techniques can significantly diminish the appearance of cellulite, especially in the areas of localized deposits of fat.”
Boris M. Ackerman, M.D.