The name “cellulite” stemmed from the French medical literature over 150 years ago. The original name, cellulite, implies that it is a disease. But years of study now contradict this theory. As a matter of fact, a number of the scientific literature refers to this changed skin condition as so-called cellulite. To better understand what cellulite is, let’s get on on this explanation with a review of skin anatomy.
Layers of the Skin
Epidermis, "epi" coming from the Greek meaning "over" or "upon", is the outermost layer of the skin. It is composed of stratified squamous epithelium with an underlying basal lamina and forms the waterproof, defensive wrap over the body's surface
There are no blood vessels in the epidermis and cells in the deepest layers are nourished by diffusion from blood capillaries extending to the upper layers of the dermis. The major type of cells which make up the epidermis are Merkel cells, keratinocytes, with melanocytes and Langerhans cells also present.
The epidermis can be further subdivided into the corneum, lucidum (a layer only found at the palms of hands and bottoms of feet), granulosum, spinosum, basale. Cells are produced through mitosis at the basale layer. The daughter cells move up the strata changing shape and composition as they die due to separation from their blood supply. The cytoplasm is released and the protein keratin is added. They eventually reach the corneum and slough off (desquamation or shedding of skin). This development takes about 27 days and is called keratinization. This keratinized layer of skin is responsible for keeping water in the body and keeping other detrimental chemicals and pathogens out, making skin a natural barrier to infection.
The dermis is the layer of skin below the epidermis that is composed of connective tissue and cushions the body from stress and strain. The dermis is closely attached to the epidermis by a basement membrane. It also contains a lot of Mechanoreceptors or nerve endings that offer the sense of touch and heat. It contains the hair follicles, sweat glands, sebaceous glands, apocrine glands, lymphatic vessels and blood vessels. The blood vessels in the dermis provide nourishment and waste removal to its own cells as well as the Stratum basale of the epidermis.
The subcutaneous tissue is not part of the skin and lies below the dermis. Its function is to connect the skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. It consists of loose connective tissue and elastin. The main cell types are fibroblasts, macrophages and adipocytes (the subcutaneous fat contains 50% of body fat). Fat serves as padding and insulation for the body.
This is where our discussion will ardently focus in describing cellulite. This uppermost layer of subcutaneous fat has been described as standing fat-cell chambers separated by connective tissue. From these fat-cell chambers, small projections of fat cells extend beyond the dermis. This unevenness and irregularity of the subcutaneous fat gives skin the bumpy or potholed appearance we call cellulite.
It is well recognized that women generally have a higher percentage of body fat than men. For example, a healthy range of body fat for women is 20-25%, and a healthy range of body fat for men is 10-15%. The thighs and buttocks of women are apt to store more of this body fat.
This type of fat deposition is typically termed gynoid, or pear shape. Body fat is stored mainly due to the actions of an enzyme known as lipoprotein lipase (LPL). LPL is found on the blood vessel walls throughout the body. It functions like a ‘regulatory’ enzyme, which controls the distribution of fat in various depots in the body. It has been shown that women have a higher LPL concentration and activity in the hip and thigh region.
Knowing this, why are women more prone to cellulite then men? Cellulite occurs more often in women because men have thicker epidermis and dermis tissue layers in the thighs and buttocks. More distinctively dissimilar, the first layer of fat, which is slightly thinner in men, is pulled together into polygonal units separated by crisscrossing connective tissue.
Most women have connective tissue patterned like columns. It's easier for fat cells to bulge out of columns than small openings. In addition, men generally have a thicker dermis, which serves as a more effective natural girdle. Also in women at 30 years of age, the dermis reaches its full thickness and due to the aging process of the collagen and elastic fibers, which is bound together by the connective tissue starts to get looser and permits more protrusion of adipose cells into the dermis area, resulting in the display of cellulite. In addition, an increased deposition of subcutaneous body fat may often reflect a lifestyle of less exercise and changes in dietary consumption.
Types of Cellulite:The first type of cellulite is from any pinch or compression of tissue in the thighs or buttocks. This is the mattress look seen in thighs when legs are crossed while seated. This is very gender-typical to nearly all women of a variety of ages, and is suggested to be the compression of the fat-cell chambers underlying the skin.
The second type of cellulite is the mattress or orange peel appearance that a woman may have in her typical standing posture or when lying down, which is referred to as cellulite.
Cellulite may be classified into four grades or stages according to clinical and microscopic examination of organs and tissue changes.
- Grade I – Symptomatic with no apparent changes but on microscopic evaluation, there may be increased thickness of the areolar layer and increased capillary permeability.
- Grade II – After skin compression or muscular contraction the skin is pale, with decreased temperature and decreased elasticity.
- Grade III – A padded skin and/or orange peel appearance is manifested even at rest. Palpable sensation of thin granulations in the deep dermal levels, pain to palpation, decreased elasticity, lack of color in the skin and decreased temperature.
- Grade IV – There are the same characteristics as in grade III with more palpable, visible and painful nodules, adherence to the deep dermal levels and an apparent wavy look of the skin surface. Microscopic examination reveals the lobular structure of the fatty tissue has vanished and some nodules are encapsulated by dense connective tissue. Diffuse liposclerosis followed by important microcirculatory alterations and epidermal atrophy.
Cellulite may also be classified by skin consistency.
- Hard – Hard cellulite is seen in young women who exercise regularly. When pinching, the orange peel aspect is apparent. This is most frequently seen in teenagers.
- Flaccid – Flaccid cellulite is found in inactive women. It is associated with muscle hypotonia (decreased muscle tone) and flaccidity (flabby softness). It is largely seen in women over 40 and also occurs in women who have rapid weight loss. The padded surface is evident and the skin shakes with movement and changes according to position. There may be circulatory disturbances.
- Edematous – Edematous (swelling caused by an abnormal accumulation of fluid in body tissues) cellulite manifest as increased volume of the whole lower limbs and the area holds the imprint from fingertip pressure when the finger is removed. The skin is bright and thin. There may be a sense of weightiness and sore legs are frequent complaints. This is the most severe form of cellulite.
- Mixed – Mixed cellulite occurs most often. Here, more than one form of cellulite is evident on different parts of the body on the same person.
The Pinch test:
The easiest way to locate cellulite is the pinch test. Pinch the skin between your index finger and your thumb on your outer thigh, and look for dimpling. Other sections to do pinch test include the buttocks and abdomen.
• Stage 0
No dimpling when the subject is standing and lying. The pinch test reveals “folds and furrows”, but there is no mattress-like appearance.
• Stage 1
No dimpling while the subject is standing or lying, but the pinch test reveals the mattress-like appearance.
• Stage 2
Dimpling appears spontaneously when standing and not lying down.
• Stage 3
Dimpling is spontaneously positive standing and lying down.
Exercise and Diet
Eating a diet that is healthy and low in calories may work for some people. Another idea is to encourage collagen production to build the middle layer of connective tissue -- and improve the circulation. Losing weight will decrease the proportion of fat in the body, hence reducing the proportion of fat trapped in cellulite. A healthy diet will also help reduce fluid retention, and that immediately improves the appearance of cellulite. However, cellulite is actually genetically predetermined so for some women, exercise won’t do much to solve the problem.
Liposuction – it is a misconception that cellulite is just fat so liposuction is the answer. The trouble with liposuction is that it can really only get at fat that is deep down underneath the skin. But usually, cellulite is too close to the surface for liposuction to be of assistance. And another thing, it is the fibrous bands that really give cellulite its orange peel look anyway -- getting rid of fat alone wouldn't in fact do that much. Liposuction may be fine for the younger people, however, in older persons, there have been cases where cellulite retuned or gotten worse.
According to some physicians, these cellulite treatment creams work for several people. There are some studies that show these ingredients might have an effect on cellulite, causing fat cells to dissolve.
There is a good scientific rationale for caffeine supporting in cellulite control. Cellulite is the body's natural way of storing fat in women. The reason that even thin women who exercise frequently still have patches of cellulite is that, as a form of fat, cellulite has a poor blood supply. This makes it much difficult to shift. The reason that caffeine is helpful for cellulite is because it augments blood flow. Caffeine is associated to aminophylline, which is a prescription medication used to open the airways and enhance blood flow. Application of caffeine-based products to cellulite-affected areas can therefore improve the vascularization of these areas, allowing easier cellulite breakdown and removal. Caffeine creams work to pull fluids out of the spaces between cells and induce lipolysis -- fat burning in the layer just below the skin's surface.
This is one of the best-known cellulite treatments. The concept behind a cellulite massage (Emjoi Cellulite - Anti Cellulite Massager) is that by rubbing the cellulite affected areas of the body in a certain way, the circulation is enhanced and the cellulite gets softened and released over time out of the body. Many of the health spas have included the cellulite massage in their services. This therapy is expensive but is a relaxing tool for those who can afford it. Certain types of rollers are also used in this massage. The roller is rolled over the cellulite that results in a deep penetrating massage. This is a slow healing process and it takes some time before results could be achieved. Regular maintenance is needed to retain the smooth appearance. Massages are usually done for an hour once a week.
The idea is using light energy to melt cellulite while mechanically massaging the skin to increase circulation and encourage drainage of lymph vessels. Laser toning (Rio Cellulite Laser with Caffeine-Enriched Serum) is a device that is originally used to remove wrinkles. Apart from this, it has been used quite frequently as a cellulite laser treatment in cases where the cellulite has similar ripples to that of wrinkles. So this apparatus is used as a remedy to cellulite that has analogous nature as that of wrinkles. In cellulite laser treatment, both radio waves and laser light are directed underneath the surface of the skin. The procedure invokes a wound response that encourages collagen production and skin tightening.
Shapewear / compression Leggings
Some leggings are made from specially treated fabric, containing bioactive crystals which warm up as they come into contact with the skin. The crystals once warmed, generate a type of energy which improves blood flow and cell metabolism. This in turn reduces swelling and helps to melt away the fat and other toxins under the skin which can then be excreted by the body. This overall action reduces the effects of cellulite and improves skin condition. Scala leggings results in clinical trials at a Brazilian University, showed 80% of the 50 women tested noticed a marked reduction in their cellulite and also a reduction in their body measurements after 30 days of daily use. Scala also does a range of shapwear product that tone up you body and skin, such as Long Body Shapewear, High Waisted Knee Length Bermuda, High Waisted Panty.
Other leggings like Proskins use Compression Technology that controls the level of pressure that promotes blood circulation and lymphatic drainage, flushing fluid and toxins which would cause cellulite out of the body. This garment can help fight cellulite and reduce inches. The leggings are perfect for wear at the gym, daily use and travel - perfect for everyone.
Can cellulite be totally eliminated?
While no single treatment is a guarantee, several breakthrough treatments are now available that can definitely improve the look of cellulite. Although there has yet to be a permanent solution to cellulite, science is well on its way. The myth that treatments do not help cellulite is entirely false. There are several authenticated medical cellulite treatments that work to smooth out cellulite and convenient home equipments that work. Even if cellulite is not fully and totally curable, it can be very successfully reduced by numerous treatment methods – notably endermologie or cellulite massage treatments (the first non-invasive treatment approved by the FDA specifically for this purpose, its popularity continues to grow, and the treatment is now widely available) and laser treatments that have long been proven to give actual and lasting results.