Cellulite
Cellulite
Definition
Cellulite is a popular term to describe fat deposits under the skin. It is characterized by a dimpled or orange-peel appearance due to structural changes underneath the skin's top layer. Cellulite is a perfectly normal and harmless condition, however, it is a cosmetic concern of many people.
Description
Cellulite is a normal occurrence resulting from uneven fatty deposits, mostly below the waistline. In women, fat is arranged in large chambers underneath a fairly thin layer of skin. These chambers are separated by columns of collagen fibers. In obese (overweight) persons, too much fat is being stuffed into these chambers, causing the pitting and bulging of the skin. In addition, as women age, the fibers shrink and thicken, pulling the skin downward. This results in a quilt-like appearance on the skin surface, especially in areas such as the buttocks, thighs, or hips. Most women develop cellulite as they age, regardless of their race. According to some studies, as many as 95% of women over age 30 develop some form of cellulite in their body.
Female hormones (estrogen, and to a lesser extent, progesterone) play important roles in the formation of cellulite. Estrogen stimulates the storage of fat, which is needed for menstruation, pregnancy , and lactation. In addition, during the later phases of pregnancy, estrogen also causes the breakdown of collagen fibers to relax the cervix, making it possible for a woman to deliver her baby. This collagen breakdown sets the stage for the formation of cellulite. Progesterone may also contribute to the cellulite problem by weakening veins and causing water retention and weight gain.
Cellulite is mostly a female problem. Due to different body physiques, men tend to have lower percentages of body fat, while women have higher percentages. In addition, men tend to accumulate fat in the abdominal area while women have fat deposits mostly in the buttocks and thighs. Men have thicker skin and the chambers are smaller and more tightly-held together. Therefore, cellulite is not often found in men.
Causes & symptoms
Many scientists believe cellulite, as well as obesity , is mostly predetermined by the genes that the persons carry. However, environmental as well as behavioral factors are also believed to have some effects on the development of cellulite.
The following factors are thought to contribute to the development of cellulite:
- Being overweight. Though cellulite also appears on thin people, excess weight makes cellulite worse.
- Pregnancy. Cellulite problems get worse with each successive pregnancy. During pregnancy, estrogen and progesterone levels are high. As a result, pregnant women have increased fatty deposits, weight gain, water retention, and weakened fiber structure. The most effective ways for women to get rid of body fat and cellulite and get back to pre-pregnancy shape are breast-feeding and exercise .
- Aging . As women age, skin sags and wrinkles. In addition, the body's energy requirement lowers, thus, there is more fat accumulation.
- Poor blood circulation. When there is impaired blood flow to the fat-storage area, collagen fibers are damaged due to lack of oxygen and accumulation of toxic wastes. The fibers shrink and thicken, resulting in the quilted appearance of the fat chambers. In addition, because oxygen is needed to burn fat for energy, fat in these poorly oxygenated areas is the last to be used. This is also why cellulite is so difficult to eliminate. Poor blood circulation is often caused by sedentary lifestyles, smoking , and high caffeine consumption.
- Poor lymph drainage. The lymphatic system acts like a sewage system, filtering out and carrying away cellular wastes and toxins. If it is impaired, toxic products accumulate and inflate these fat cells, causing cellulite.
- Lack of exercise. Cellulite may be caused by impaired blood circulation and poor muscle tone underneath the skin, which are caused by sedentary lifestyles.
- High fat and sugar consumption. This often leads to excess caloric and fat intake, which causes increases in body fat and thus, cellulite.
- Food allergy. Food allergy causes a variety of symptoms including food craving, weight gain, bloating and water retention, all of which worsen cellulite.
- Highly processed foods that contain preservatives, artificial sweeteners and other additives. Heavy consumption of prepackaged foods causes build up of these toxins in the body.
- Yo-yo dieting. Yo-yo dieting causes a woman to lose fat in the upper body while increasing fat deposits in the buttocks, thighs, and hips. Therefore, this practice tends to make cellulite problems worse than before dieting.
- Sun exposure. Prolonged exposure to the sun accelerates the skin-aging process.
Diagnosis
There are high-tech methods developed to determine the presence and extent of cellulite such as ultrasound and electrical impedance, which are expensive and unnecessary. However, a woman can determine for herself if she has cellulite using the skin-pinch and roll technique. First, a woman sets up a reference point for later comparisons. Using her fingers, a woman should gently pinch a large fold of skin in an area not known for having cellulite. Then she should do the same with skin in the buttock, thigh or hip areas. Comparing the first pinch with later experiences, she should see if there are signs of cellulite such as skin thickening, dimpling, broken veins, cold skin, and lumpiness.
Treatment
Exercise
The best solutions to cellulite problems involve reducing subcutaneous fat through diet and exercise. Working out for at least 30 minutes five times a week firms up the skin by increasing muscle tone and keeping connective tissue fibers healthy. Exercise also increases blood circulation to these problem areas.
Diet
Dieting has to be combined with regular exercise to be effective in controlling or reducing cellulite. The following dietary changes are recommended:
- Drinking lots of water. Water cleanses the digestive system and flushes toxins out of the body.
- Eating a low-fat, low-sugar, high-fiber diet with emphasis on fruits, vegetables, and whole grains.
- Refraining from smoking. Smoking causes poor blood circulation and contributes to premature aging of the skin.
- Avoiding highly processed foods, caffeine, and alcohol.
- Avoiding salty foods. Salty foods increase water retention and make cellulite appear worse.
- Maintaining a normal, healthy body weight. Obesity increases fatty deposits and makes cellulite much worse.
Body massage
Massage with or without anti-cellulite cream may have some limited benefits by improving blood circulation and lymphatic drainage . Regular massage also helps maintain smoother skin.
Herbal supplements
There are many herbal products on the market for the treatment of cellulite. Products such as Cellasene do not offer any therapeutic benefits. Cellasene is a popular herbal mixture of fucus vesiculous, grape seed extract, sweet clover, ginkgo biloba , borage, lecithin , and fish oil . Its manufacturer claims that the herbal combination works by increasing the rate the body burns fat cells for energy. Many medical experts remain doubtful of its claim of effectiveness. A recent study shows that it may be just another fad product that has no therapeutic value.
There are several products, though, such as Centella asiatica (gotu kola ) and Aesculus hippocastanum (horse
chestnut ) that may help improve the appearance of cellulite. These herbs improve the underlying integrity of the skin by making the connective tissue fibers stronger and more elastic.
Allopathic treatment
Liposuction is the most widely used treatment for cellulite. Fat cells are removed by suctioning through a cut or excision in the buttocks or thigh. Then some of these fat cells are redeposited into areas of dimpling to smooth out the contour. While liposuction significantly reduces total amount of fat in the body immediately, it may not significantly improve skin appearance. In other words, liposuction may or may not remove the dimpling or unevenness under the skin. Nor does it make leathery, wrinkling skin look taut and young. Even when it is effective, liposuction is only a temporary quick-fix solution. As long as there is excessive caloric and fat intake, the excess energy will be stored as fat and cellulite will certainly reappear, albeit probably in other parts of the body.
Liposuction is a surgical procedure. Therefore, it does carry some potentially severe consequences and complications. Pain and edema (fluid accumulation) occur in most patients. It may take up to six months for the edema to completely go away. Skin dimpling may look even worse immediately after surgery, however, the unevenness will smooth out over time. Surgical complications such as infections , uncontrollable bleeding, fatal blood clots , and inadequate or excessive fat removal (leaving behind flabby skin folds) may also occur.
Expected results
Liposuction is not a generally recommended treatment for cellulite because it is an invasive, potentially life-threatening procedure. It can sometimes produce satisfying results but it is not a cure for cellulite. Repeat liposuction is often required because as long as there is excess caloric or fat intake, there will be fatty deposits in the body. Unless there are significant changes in lifestyle and diet, cellulite will reappear.
A 2002 study showed that a combination of ultra-sound-assisted liposuction followed by mechanical massage (endermologie) proved more effective than either technique used alone in reducing cellulite. Women with the best results also added exercise into their post-operative routine.
Fat-dissolving lotions and creams are not proven effective in treating cellulite. Herbal cellulite-dissolving products do not result in loss of body fat, as they often claim. At most, products such as Cellasene may be able to make the dimpling from cellulite become less noticeable. Further, when several ingredients are combined in these creams, it is difficult for investigators to determine which ingredient might be responsible for any reduction in the appearance of cellulite.
The most effective treatment for cellulite remains diet and exercise. Adhering to a low-fat, high-fiber diet and regular exercise will make the body as fit and trim as it can be. These are long-term solutions that also provide many additional health benefits including prevention of heart disease and cancer and slowing the aging process.
Prevention
Cellulite is a normal occurrence in the human body and predetermined by genetics. Some women will naturally have more cellulite than others. However, diet and exercise can keep the body fit and trim.
Resources
BOOKS
The Burton Goldberg Group. "Cellulite." Alternative Medicine: The Definitive Guide. Tiburon, CA: Future Medicine Publishing, Inc., 1999.
Dancey, Elizabeth. The Cellulite Solution. USA: St. Martin's Press, 1996.
Murray, Michael T., and Joseph E. Pizzorno. "Cellulite." Encyclopedia of Natural Medicine, revised 2nd ed. Rocklin, CA: Prima Publishing, 1998.
PERIODICALS
Bernstein, Gerald. "Liposuction: Liposuction of the Thigh." Dermatologic Clinics 17 no.4 (October 1999): 849-863.
Bolivar de Souza, Pinto E., P.J.I. Erazo, F.S.A. Prado Filho, et al. "Superficial Liposuction." Aesthetic Plastic Surgery 20 (1996): 111-122. In Year Book of Dermatologic Surgery, 1997.
"Dermatologists Shed Light on Treatments for Cellulite." Obesity, Fitness & Wellness Week (September 21, 2002): 8.
Lis-Balchin M. "Parallel Placebo-Controlled Clinical Study of a Mixture of Herbs Sold as a Remedy for Cellulite." Phytother Res 13 no.7 (Nov 1999): 627-629.
Scheck, Anne. "Dual Lipoplasty, Endermologie Approach Offers Successful Cellulite Reduction." Cosmetic Surgery Times (July 2002): 22.
ORGANIZATIONS
The American Society of Plastic and Reconstructive Surgeons (ASPRS). 444 East Algonquin Road, Arlington Heights, IL 60005. (800) 228-9900. http://www.plasticsurgery.org
OTHER
Srinivasan, Kalpana. "FTC Eyes Cellulite Supplement: Can Manufacturer Substantiate Claims?" Dr. Koop.com http://abcnews.go.com/sections/living/DailyNews/cellulitepill990527.html.
Mai Tran
Teresa G. Odle