Between 80 and 90 percent of women will develop cellulite after the age of 18. Few men will develop cellulite. Hardly fair, the causes of cellulite are thought to be due to a combination of factors including hormonal, aging, genetics and possibly a female difference in fat layer architecture. Cellulite may not be curable but you can improve unsightly puckering by understanding cellulite and how to take control.

What exactly is cellulite?

Cellulite is the unsightly dimpling and puckering of the skin most often involving the thighs and buttocks. While most women carry their weight gain in these areas, you don't have to be overweight to have cellulite. As we age, collagen and elastin bundles break down, weakening the dermis. We are all familiar with what the end result is upon our face... wrinkles. But on the legs and buttocks, in response to this loss of dermal elasticity, the fat can become displaced upwards into the lower dermis. Fibrous bands that are supposed to tether the skin down start to trap this displaced fat creating the lumpy bumpy appearance of cellulite. Think of a quilted mattress (the fat) with the buttons as the tether points (the fibrous bands) and you quicky get the idea.

So how do you get rid of that cottage cheese sitting on your thighs? Seems like there are cellulite "cures" advertised in every magazine you pick up or every infomercial you watch. So far, the FDA has only approved a nonsurgical form of deep massage called endermologie for temporary improvement in the appearance of cellulite. Endermologie came to us from France where it has been used for at least 10 years.

In February of 1999, Vanderbilt University published a widely publicized medical journal article that showed that this procedure did indeed help improve the structure of the skin and disperse the trapped fat. An endermologie machine rolls and sucks the skin in a vacuum-like manner. A form of deep massage, it aims to loosen or break down some of these fibrous bands and disperse the lumps of fat into a smooth layer. Endermologie is performed as a weekly series of treatments. Typically anywhere from 12 or more treatments are performed to achieve whatever the maximum effects will be and then you undergo periodic maintenance therapy.

While no treatment is a guarantee, endermologie combined with a good diet, adequate daily water intake and exercise can help many women improve the look of their cellulite. Unfortunately a single "emergency" treatment for a special occasion is unlikely to do much for your cellulite. Cost for a series of endermologie treatments tends to run over $1000.

With a recent study from Vanderbilt in 2001 published in the Journal of Plastic and Reconstructive Surgery showing that deep mechanical massage can indeed help improve the appearance of cellulite (although highly dependent upon the skill of the masseuse), there has been great interest in home massage. A variety of massage tools with rubber tips, wooden balls and even motorized massage heads are sold with claims of helping improve the appearance of cellulite. These devices tend to be inexpensive, often less than $10.00 for the simple wooden tools. From a practical standpoint I think you may increase your chances by having someone else administer the home massage as they can apply a more direct pressure upon the skin. I take a realistic view of these. While I don't think they'll harm you, provided you're not massaging to the point of bruising, I think they will provide limited improvement. Still, a modicum of improvement if it happens is better than none at all.

Spas have taken deep massage one step further and offer a Japanese version of cellulite treatment known as body brushing. In this technique, a plant based bristle brush (often coconut husk or other fiber) is roughly moved across the skin's surface trying to exfoliate away the outer most portions of the epidermis. The theory: increase blood flow and lymphatic drainage thus removing toxins from the skin and improving cellulite. The reality: makes absolutely no physiological sense. While you may experience a nice glowing appearance to the skin similar to what you'd see after a microdermabrasion treatment, neither increased blood flow nor lymphatic drainage have any bearing at all upon the cause or cure of cellulite. Enjoy the treatment for what it is but don't plan to get rid of those lumpy legs. Personally if you are thinking of this as an option you would be better off using DermaNew Total Body Experience Kit with the massage head and alternate the use with the exfoliator. That way at least you would get smooth glowing skin and enjoy the massage aspect as well.

A litany of cellulite creams are out there. Many of the "older" versions of these products contained the active ingredient theophylline best known for its use as an asthma medication. The topical application of theophylline does not cure cellulite but rather temporarily plumps up the skin for a few hours creating a smoother texture.

One of the reasons that so many of us are suddenly confronted by cellulite in our 40's is that as we age, the levels of enzymes we need to breakdown stored fat as well as prevent fat deposition go down. Combined with a loss of dermal collagen, the appearance of cellulite is worsened.

If we could strengthen the dermis which thins with age and contributes to the formation of cellulite we could theorhetically prevent or improve cellulite. Furthermore, if we could speed up eliminating some of that misplaced fat, then our dimples could be more effectively smoothed away.

If you have a strong predisposition for developing cellulite you should consider the following factors that tend to have a significant impact:

• Junk food, alcohol, fried food & sugar overwhelm the body
• Poor blood circulation due to lack of exercise
• Changes in estrogen levels which dictate how much fat your body stores or releases

The underlying physiology of the body can contribute the following factors:

• Capillary walls become excessively permeable causing localized accumulation of fluid
• Inadequate lymphatic drainage slows the removal of excess fluid
• The changes in blood flow, lymphatic drainage, fat, and connective tissue result in cellulite - a bumpy or dimpled appearance of the skin

DS Laboratories Oligo.DX Cellulite Reducing Gel attacks cellulite in the following ways, even in women who do not respond to diet and exercise:

1. Dilates the capillary vessels facilitating the removal of metabolized fats and the draining of liquids and toxins trapped in the tissues.
2. Accelerates the digestion of fats stimulating the action of the skin's enzymes.
3. Accelerates the biochemical processes needed for cell drainage and regeneration.

L'Occitane Almond Delightful Shape includes a patented complex composed of almond proteins, silicium and essential oils of immortelle, peppermint and palmarosa that promotes, stimulates skin microcirculation, and thus helps drain away excess water and toxins.

The complex is complemented by quinoa extract, which helps prevent the formation of new fat, and lemon essential oil, which, combined with caffeine, enhances the complexs contouring action.

Other studies have shown that the use of topical L-Ascorbic acid helps promote the formation of collagen bundles by stimulating fibroblast activity within the dermis. Cellex-C has been documented to have this ability. Cellex-C Body Smoothing Lotion should not be thought of as "the cure", but in combination with deep massage or endermologie, your diet and exercise you may at least help make the skin look smoother and supple in the same manner that Cellex-C helps with puffiness and fine lines on the face and neck.

Korres Black Tea & Verbena Skin Smoothing Cream-Gel With Caffeine contains an active combination of plant extracts and lipolytic factors transferred via special carriers (second generation liposomes) into the deeper layers of the skin and demonstrates a combined triple action during all the stages of cellulitis and local obesity formation: it obstructs lipogenesis, accelerates the process of lipolysis and promotes the elimination of fatty acids. It also enhances elasticity, an even complexion and the smooth appearance of the skin.

Pills have absolutely no effect upon cellulite. Cellasene has not been proven in medical literature to improve the appearance of cellulite or take off inches.

In some way it is comforting to know that almost all women get some degree of cellulite. It seems to be one of those sisterhood things. It is equally comforting to know that there are some steps we can take to help improve its appearance.

Thank you for taking the time to read through this important information. I hope you have found this article informative.

Audrey Kunin, M.D.

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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