Cellulite: at a glance

Cellulite is a commonly used term for a medical condition scientifically known as localized adiposity (AL), which is a complex of developmental changes in the growth of adipose tissue. Cellulite usually occurs in locations such as the lower limbs, buttocks, abdomen, hips, knees, ankles and elbows, and causes a dimpled, lumpy, ‘orange-peel’ appearance. While it can affect both sexes, it is much more prevalent in women, affecting up to 90% of the female population regardless of an individual’s age or weight.

Description

Cellulite is the result of an altered metabolism within the subcutaneous tissue. This alteration results in the adipocytes (fatty tissue) getting larger and an increased level of water retention in the intercellular spaces. Cellulite forms in the hypodermis, or adipose tissue, which is the tissue that lies below the dermis and is made up mainly of adipocytes.

Causes

The mechanism behind cellulite is quite complex. Under optimal conditions, the adipocytes in the hypodermis act as an energy reserve for the body. However, in some individuals, the influence of certain hormones can cause the adipose tissue to thicken considerably. This thickening will worsen and the cellulite will be more visible if an individual follows a diet that is too high in calories for their needs.

Symptoms

Cellulite appears as a slightly protruding area of skin, with the characteristic ‘orange-peel’ appearance and texture. The condition can vary considerably in severity from mild, where dimples and ripples are barely visible, to more severe cases where the protruding fat nodules under the skin are larger and hard to the touch.

Diagnosis

Although cellulite is commonly considered a purely aesthetic concern, it can become a real health problem. The thickening of the adipose tissue can impair lymphatic and venous circulation, which can cause edema or the compression of nerves, which can be particularly painful.
A diagnosis of cellulite is made by a specialist who will:

• assess the patient’s medical history (lifestyle habits (e.g. smoking), weight, medications);
• do examinations to check for stasis and/or chronic venous insufficiency of the lower limbs (presence of dyschromia, visible capillaries, edema, micro varices or varices);
• run the echo color doppler (ECD) examination to fully assess venous circulation;
• check ratios of lean mass, fat mass, total water content and basal metabolism;
• use ultrasonography to distinguish the different forms in which adipose tissue may present (increased in thickness, edematous, fibrotic, nodular);
• use thermography, which can detect the first stages of cellulite, when it is not yet even visible or detectable by touch.

Treatment

Treatment for cellulite can vary and may include:

• Weight loss through a healthy, balanced diet and regular physical activity
• Reducing water intake and that of sweetened drinks
• Discontinuing the birth control pill, which can exacerbate cellulite
• Adjusting treatment for other conditions (e.g. thyroids, depression, etc.)
• Targeted massage to promote blood and lymph circulation
• Cellulite can also be removed with liposuction, but if other treatment options are not simultaneously pursued, it will likely come back following surgery.

Prevention

The following should be adopted in order to reduce the chances of developing cellulite:

• eat a balanced diet with plenty of fiber
• avoid wearing clothing that impedes lymphatic circulation, especially of the lower limbs
• engage in regular physical activity
• do not take stimulants, hormones or birth control pills