Cellulite: Mini-dimpled skin

The lumpy or mini-dimpled appearance of the skin especially among 80 to 90 percent of women in their thirties and older which replaces the smooth, firm, gorgeous-looking complexion in the thighs, buttocks and abdomen of younger ladies, is called cellulite. This disfiguring change in the skin tone and look, which affects more women than men, have prompted millions to seek various “treatment” options in the market to melt away the sub-dermal fats causing cellulite. We shall discuss which one works and which of the advertised remedies are a waste of money and could possibly even cause more disfiguring complications.

What causes Cellulite?

We normally have at least a layer of fats under the skin. When we overeat, especially fatty foods, and gain weight from our diet and lack of daily exercise, we also gain more fats under our skin. The fats are arranged side by side, with firm collagen fiber under them, attached to the muscles below them. With more fats growing larger, these fat globules bulge upwards, pushing the skin outward, causing lumps, and the spaces between these fatty deposits are the mini-dimples that are characteristic of cellulite. The areas mostly involved are the thighs and their backside, abdomen, breasts, and upper arms, especially among those who are overweight. Cellulite is not a disease but a cosmetic, aesthetic, condition.

Who are more likely to develop cellulite?

Those whose parents, especially mothers, who have cellulite are more prone to develop cellulite, so genetics plays a role. However, with healthy lifestyle (dieting, daily exercise, and weight control) these children may not necessarily develop cellulite. Other factors are hormonal alterations during pregnancy and aging. The risks that can aggravate or even precipitate the formation of cellulite are inactivity (lack of exercise), high carbohydrate-high fat-high salt diet, weight gain, yo-yo dieting, and even dehydration.

Do herbal creams work?

Topical herbal creams (sweet clover, evening primrose oil, gingko biloba, etc), which are advertised to be effective against cellulite through improvement in circulation, have no scientific basis and have been found to be ineffective. A study of more than 30 so-called “anti-cellulite” creams were found to contain 260 chemical components, all of which were not effective, and 25 percent of them have caused allergies of varying degrees.

How about massage-suction?

The FDA has approved at least one lipo-massage machine that provides a kneading skin massage and suction to reduce cellulite temporarily. The 35-minute therapy done twice a week for 14 weeks, which is not cheap, is followed by the recurrence of cellulite when treatment is stopped.

Does tanning make cellulite disappear?

No, tanning does not make cellulite go away. While it might hide cellulite and make it less obvious, cellulite becomes visible again, and may even appear worse, once the tan fades. The reason is clear, frequent exposure to the UV rays damages the skin, thins it and makes it less resilient. One does not have to spend money to get the unhealthy effects of UV rays. Sun exposure will do that, for free.

Is topical retinol cream effective?

While retinol cream has been effective in improving the appearance of facial complexion, only one study (using 0.3 percent of retinol cream for 6 months) showed improvement of the cellulite, many other clinical studies did not. There is no proof that amoniphylline products are effective against cellulite.

Does mesotherpy work?

Mesotherapy (injection nof fat-dissolving agents under the skin) is most controversial a mong the treatments proposed for cellulite.The drug used is phosphatidylcholine (lecithin extract plus sodium deoxycholate, a detergent), which could cause rash, swelling, infection, painful skin bumps, scarring and skin deformity, according to a warning from the FDA.

Do radiofrequency or laser help?

RF devices produce heat aimed at damaging the fats and connective tissues under the skin, to achieve improvement in skin turgor and tightening and to smoothen out the lumpiness in cellulite. On the other hand, laser is used to encourage collagen formation to thicken the skin and reduce the unsightly effect of cellulite. It may also be combined with the other two of the modalities listed above. Just like RF therapy, laser use shows some benefits, but nothing permanent. While there appears to suggest that RF and laser afford some benefits, at least temporarily, we need larger and more long-term clinical investigation to validate its effectiveness.

Is liposuction the answer?

Definitely no. Liposuction would worsen the dimpling and lumpiness of the skin. Laser-assisted liposuction has been tried but the reports are mixed and it is too early to tell if it would be superior to standard liposuction. Besides, laser could lead to burns and scarring of the tissues.

Are body-wraps effective?

Wrapping the body with warm, aromatic, bandages may tighten the skin to some degree by the dehydration it causes, but the effect is transient and there is no scientific study to prove any lasting benefit from body wraps. The FDA warns against this form of therapy.

Does surgery help?

Subcision is the procedure tried for cellulite. This invasive surgery uses a needle to snip the connective tissues under the skin that connect the fatty globules to the muscles below to eliminate the dimpling effect. The 90-minute procedure costs about $4,000 and causes some edema and bruising. Long term studies are needed to confirm the benefits from subcision.

What is the final word?

Medical science does not have the final word as yet on an effective treatment for cellulite. There are dozens of claims on a “cure for cellulite,” and more unfounded and baseless therapies will hit the market. And as long as there are gullible and ignorant or misinformed clients willing to patronize them, “donating” their hard earned money to these vendors, the scams will continue.

While living a healthy lifestyle will not magically make cellulite disappear, eating the proper diet (fish, vegetables, some fruits, nuts and whole grains), combined with daily exercise and weight control, have been found to improve the tightness of the skin and smoothen the complexion of the areas involved. Since a healthy lifestyle could maximize well-being and longevity, a must for all of us, improvement in the appearance of cellulite and even a flatter tummy are welcome bonuses.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]