We’re talking about cellulite, of course. Also called edematous fibrosclerotic panniculopathy (say that ten times fast), this dimpled, rippled, or uneven skin topography develops when lobules of normal fat swell and protrude through fibrous bundles of connective tissue located within and beneath the skin. Cellulite is entirely normal and affects virtually all women - and plenty of men and children, too. Gender, genetics, hormones, the makeup and quantity of our body’s natural fat stores, the looseness of our skin, and inflammation are all thought to play a role in cellulite formation.
So what do we do about it? Many physicians would answer this: Absolutely nothing! This benign skin feature doesn’t represent a problem or abnormality, and doesn’t have to be viewed as one. Even so, if you feel cosmetically motivated to minimize cellulite, there are some treatments that might temporarily help - at least a little.
Products: Creams containing caffeine may mildly improve the appearance of cellulite temporarily by dehydrating skin cells for a few hours. For long term improvement, applying retinoids may offer a very subtle, very gradual benefit over months by slowly strengthening the skin. By evening out the skin’s tone and helping to mask shadows, self-tanner might help to minimize the appearance of cellulite a bit, too.
Surgical Methods: Subcision is a procedure in which a needle or other sharp tool is used to break up fibrotic bands of tissue within the skin, potentially improving the appearance of cellulite. In a study of 25 women who underwent an FDA-approved subcision procedure called Cellfina, 95.6% reported that they were satisfied three months afterward, according to an Oct. 2018 study from the Aesthetic Surgery Journal. Bruising, swelling, pain, and infection are potential risks, though no serious adverse events were reported in the study. Results may last as long as three years.
Energy Treatments: Different types of energy can be directed into the skin to help reduce cellulite, including acoustic (sound) wave therapy; laser energy (Cellulaze) to thicken skin and break down the fibrous bands that allow cellulite to form; radiofrequency (such as ThermiSmooth or Profound) to heat and break down cellulite; or a combination of infrared light, radiofrequency energy, and vacuum suctioning (VelaShape). Each of these treatments may offer at least a temporary benefit, according to scientific studies. But like with any medical procedure, there are risks, and it’s important to seek the care of a board-certified physician knowledgeable about the technologies.
Other Therapies: In carboxytherapy, carbon dioxide gas is directed beneath the skin to help reduce cellulite by a few proposed mechanisms, including by stimulating blood vessels and key components of skin remodeling. Endermologie is a spa treatment involving massage and vacuum suction over cellulite-prone areas; studies are mixed on whether it might help. There isn’t sufficient evidence to support the use of supplements, ionithermie treatments (which deliver a mild electric current to the skin) or mesotherapy (injections of herbs, enzymes, hormones, or other ingredients). And while cryolipolysis (CoolSculpting) and liposuction can reduce fat, they aren’t expected to improve cellulite; liposuction may actually worsen it, in some cases.
Exercise: Anyone can develop cellulite - even those with a normal or low body weight. But people who exercise regularly to maintain muscle strength and tone and reduce body fat may notice improvement in unwanted dimpling. And the endorphin high might just help us focus on all that our bodies can do, rather than on the fact that we may have developed a little cellulite along the way.
BY LAUREL NAVERSEN GERAGHTY, MD