Cellulite: Dimpled skin

For women, cellulite is unwanted company; it comes uninvited and refuses to budge

The three words, which even the shapeliest woman dreads hearing are “you have cellulite”. Most women are unclear on what it actually means, often confusing it with loose skin related to obesity, which is a different issue. All overweight people do not necessarily develop cellulite, nor are thin and physically fit people immune to it.

Cellulite is an alteration in the topography of the skin that occurs almost exclusively in women, affecting the pelvic region, upper arms, thighs and abdomen.

The affected area looks lumpy and padded like a badly stuffed mattress and the skin develops a puckered, dimpled ‘orange peel’ appearance. The culprit is not just fat, but poor blood and lymph circulation in the area that causes tiny leakages of these fluids into existing fat pockets.

Fluid and fat collects into a lump, which further gets enclosed in fibrous tissue. Because of this ‘sealing-in’ effect of the fibrous walls, it is difficult to dissolve or drain this lumpiness or simply lose it with diet and exercise. Even a lean, exercised limb may have cellulite in patches of poor circulation like the back of the thigh due to long hours of sitting in one position. Thus, it’s a frustrating problem for women who work out, yet cannot flaunt their legs or midriffs.

What causes cellulite?

The most important factor in developing cellulite is the hormone oestrogen. That is why it occurs predominantly in women, starts after puberty, worsens in pregnancy and with oestrogen therapy, like hormone-based contraceptive usage.

It also tends to run in families and has some racial predisposition, occurring more frequently in white women than their Asian or African counterparts. Latin women tend to develop it on their hips, whereas Anglo-Saxon women tend to develop it on the abdomen.

Lack of exercise leading to lesser muscle mass and poor blood flow in the veins can also be blamed for cellulite. Tight clothing worsens the problem by restricting blood circulation. Obesity, of course, compounds the situation by increasing fatty tissue.

Can cellulite be treated?

Treating cellulite is a challenge for even the most experienced dermatologist. Some treatments work for some women, while they don’t for others—results are unpredictable. Lifestyle changes MUST be enforced—including regular cardiovascular workouts to lose fat, build muscle mass and improve circulation. Smoking and oestrogen-based oral contraceptives should be discouraged strongly.

Regular massaging can help in the early stages by draining lymph from the area. The massage must be firm, though, and performed in a specific direction to drain fluid from limbs towards the heart. Some oils claim to have anti-cellulite properties.

There is no scientific evidence to back their claims. Anecdotal incidents where they’ve worked could be due to the massage rather than the oil itself.

Evening primrose oil supplements work in some cases because it contains a plant derivative that affects oestrogen levels. It must be taken orally in the form of capsules; applying it doesn’t help.

Super pulsed radiofrequency therapy has been used to create deep heating in the affected areas and rupturing the fat lobules. The effects are variable and range from excellent in some to barely perceptible in others.

Mesotherapy works much better for cellulite. Tiny doses of a fat dissolving medication [lipolytic cocktail] are put in using a Mesogun or special Meso-syringes in the affected areas. The treatment is repeated every few weeks and 4 – 8 therapies are needed to smoothen the area. The treatment dissolves fat that has divided into compartments and pushes it into the blood circulation to be metabolised by
the body.

Ultrasonic cavitation is another method that uses sound rays [to be precise, waves of a frequency lesser than audible sound] to break the fat lobules, akin to using ultrasound to rupture a kidney stone.

Laser lipolysis achieves the same effect using laser energy that penetrates skin and reaches the fat layer without damaging the surface. However, both these treatments result in temporary bruising due to their destructive nature.

Even after getting rid of cellulite, lifestyle changes like regular exercise and weight control are a must for long-term resolution because cellulite is notorious for reappearing.

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Parul Kolhe
Parul Kolhe, MBBS, DDV, is a cosmetologist, hair specialist and dermatosurgeon. She runs her own cosmetology clinic, 'Tvacha' at Bhandup, Mumbai. She has won national acclaim for her work on chemical peels for acne, pigmentation and skin rejuvenation as well as skin grafting for vitiligo. She is an avid trekker and writes poetry in her spare time.

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