It is estimated that 80-90% of women have cellulite – whether you can see it or not.  In fact, only when cellulite is severe (grades III and IV on a I-IV scale)  does the skin have the unsightly orange-peeled appearance that makes cellulite so undesirable.  Most upsetting  is the fact that there is really no cure for cellulite.  Many products and treatments are available but even the best can provide only mild to moderate improvement.

So what causes cellulite?

A variety of genetic and lifestyle factors contribute to the presence and severity of cellulite.

Hormones:   Hormones such as estrogen, thyroid hormones, noradrenaline, and prolactin contribute to cellulite formation.  Thus, conditions that increase the levels of these hormones in the body (e.g. hyperthyroidism, certain medications like birth control pills, etc.) may increase the severity of your cellulite [2].

Diet:  Excessive intake of carbohydrates, fat or salt combined with not enough fiber may contribute to cellulite [2].

Poor circulation:  Health conditions such as varicose veins decrease blood flow to the legs and can contribute to cellulite formation.  Lifestyle choices can also lead to poor circulation and therefore cellulite, such as smoking, lack of exercise, wearing tight clothing, and having a job that requires you to sit or stand for long periods of time [2].

What are the current treatments for cellulite?

Topical Creams:  Anti-cellulite creams aim to improve circulation, break down fat, improve the structure of the dermis and subcutaneous tissue, remove free radicals, or a combination of the above [3].  Despite the general dissatisfaction with anti-cellulite creams, some women claim to see a mild to moderate improvement with some creams.

According to , the best anti-cellulite cream of 2012 is Cellutherm [4].  Cellutherm contains hyaluronic acid, which is used frequently in fillers and anti-wrinkle creams to add volume under the skin.  Hyaluronic acid has been found to absorb through the epidermis to the deeper layers of skin after topical application [5], suggesting that it may be possible for hyaluronic acid to reach the area afflicted with cellulite.  However, the effectiveness and safety of hyaluronic acid as a cellulite treatment is debatable.  For example, increased concentrations of hyaluronic acid have been seen with certain cancers.  Although this does not prove a causative relationship, it certainly demands further study before the safety of hyaluronic acid use can be determined.

Cellutherm (as well as many other creams) also contains sorbitan laurate, lauryl proline, and quinoa extract.  The manufacturers of cellutherm claim that these ingredients can be applied topically to reduce cellulite by decreasing  fat and fat production and by preventing shrunken fat cells from re-expanding [4].  The company refers to clinical studies supporting these claims but does not cite any publications or include links to any articles on their website.  When I searched PubMed for an article to support cellutherm, I was unable to find any published works.

I did manage to find one article regarding the effects of quinoa extract on collagen in calf skin [6].  It was found that 3 phytochemicals present in quinoa extract  inhibit collagenase (an enzyme that dissolves collagen) activity [6].  If the findings of Dr. Alexander Dagum are correct (who, in 2006, completed a study in which he injected 10 women with collagenase in the upper thigh area and reportedly found a significant reduction in cellulite [7]), then evidence does not support the claims that quinoa extract reduces cellulite.  In fact, it may do the opposite.

Caffeine is another common ingredient found in anti-cellulite creams.  It works by increasing blood flow to the area and does seem to produce a mild albeit temporary clearance of cellulite.  You don’t need to buy an expensive cream to see if it works – instead you can try a homemade scrub with coffee grounds:  .

Radiofrequency and Mechanical Massage:   Devices that utilize radiofrequency and/or mechanical massage (e.g. Velashape, Thermage) improve the appearance of cellulite by breaking up fatty deposits,  increasing circulation to the area and increasing lymphatic drainage.  I briefly experimented with these devices and definitely noticed an improvement in several clients.   However, many of my clients felt that the results were too subtle to make the treatments worth the cost.

Mesotherapy:   Mesotherapy involves injecting a mixture a few millimeters under the skin to improve circulation and lymphatic drainage. I have no experience with it myself, however a quick internet search shows that it has mixed reviews related to both effectiveness and comfort (check out ).

Is there hope for the future?

Collagenase:  Dr. Alexander Dagum’s 2006 study regarding collagenase as a treatment for cellulite has resulted in a new drug, Xiaflex, that is currently in the first of three phases in the FDA approval process [8].  Although extremely exciting, Xiaflex is still far from a sure thing.  It has only been tested on a small population (n=10 for the first study, n=63 for the current study) and still needs  to pass the rigorous approval process of the FDA [8]. For before and after photos from the 2006 study, check out this link: 

References

[1] Wanner M, Avram M. An evidence-based assessment of treatments for cellulite. J Drugs Dermatol 2008 April; 7 (4): 341–5.

[2]  Accessed on August 6, 2012

[3] Hexsel D, Soirefmann M. Cosmeceuticals for cellulite. Seminars In Cutaneous Medicine And Surgery September 2011;30(3):167-170.

[4]  Accessed on August 6, 2012

[5] Brown TJ, Alcorn D, Fraser JR.  Absorption of hyaluronan applied to the surface of intact skin. J Invest Dermatol. 1999 Nov;113(5):740-6.

[6]  Nsimba RY; Kikuzaki H; Konishi Y.  Journal Of Biochemical And Molecular Toxicology 2008 Jul-Aug. Vol.22,Iss.4;p.240-50

[7]    Accessed on August 8, 2012

[8]   Accessed on August 8, 2012