Cellulite

• Cellulite is deposits of normal fat cells in the connective tissue of the skin of the lower abdomen, hips, buttocks, and upper thighs.
• Cellulite produces no symptoms and is not a sign of disease.
• The medical assessment of cellulite is visual and subjective.
• Cellulite is found in about 80%-90% of normal adult women.
• Cellulite is less frequently noted in men.

Cellulite is the dimpled appearance of skin. It appears most commonly on the lower abdomen, buttocks, and thighs of adult women. Cellulite is actually deposits of normal fat cells in the connective tissue of the skin of the lower abdomen, hips, buttocks, and upper thighs.

Although somewhat controversial, it seems that this dimpled appearance is due to the accumulation of normal fat cells in the vertically oriented connective tissue fascicles just below the deepest layer of the skin. Although cellulite is more common in obese individuals, it is also seen in those of normal weight.

Obese adult females are the most likely to have significant amounts cellulite.

Cellulite does become more apparent in older individuals. This may be due to the normal thinning of the top layer of the skin so the appearance of the subcutaneous fat is more evident.

There are no symptoms associated with cellulite. The major physical finding is the dimpled, puckered skin in the involved areas. This is entirely a cosmetic problem and is not associated with any dysfunction of other tissues.

There are a large number of medical and surgical approaches designed to improve the appearance of cellulite. However, there is no single most effective approach to treatment. One of the problems is that there is no objective way to measure the amount of cellulite. The comparison of before and after treatment photographs does not seem to be a reliable way to evaluate the effectiveness of treatments. All of the treatments listed below are quite expensive, may have undesirable side effects, and have unpredictable beneficial results, which are also unlikely to be permanent.

A list of these treatments follows (in no particular order of preference):

1. Heating the fat to 125.6 F-131 F (52 C-55 C) using a radiofrequency generator (Thermage)
2. Special manual and machine based massaging techniques; some using suction (Endermologie)
3. Topical creams containing a variety of ingredients including but not limited to caffeine, aminophylline, retinol, extracts of gingko and/or spadeleaf, primrose oil, seaweed, grape seed, etc.
4. Devices using acoustic shock waves
5. 1064 nm Nd:YAG laser
6. Surgical subscision
7. Liposuction
8. Ultrasound
9. Infrared exposures
10. Carbon dioxide injection into fat
11. Mesotherapy involves multiple injections of very dilute ingredients into the skin at homeopathic doses which are unlikely to have a pharmacologic effect.
12. Cryolipolysis using low temperatures to destroy fat cells
13. Injection of bile acids
14. Topical phosphatidylcholine
15. Weight loss

Treatments involving massage, weight loss, and compression can be a delightful sensual experience and might result in an improvement in the appearance of cellulite over a period of many months.

It is unlikely that any products available off the shelf at the local pharmacy will have any effect on cellulite.

There are no home remedies for cellulite that are worth trying.

Weight loss along with endurance and strength training are probably the best ways of improving the appearance of cellulite. In addition, these activities are excellent for improving one's general health.

Cellulite should not be considered a disease since it seems to affect almost all adult women. Its appearance is likely to become more noticeable as one ages.

It is not possible to prevent cellulite. One's goal should be to have as healthy and lean a body as possible.