Introduction and Symptoms

Cellulite is a condition in which skin appears as dimpled or cottage cheese due to underlying fat deposits. It is most commonly noticeable on thigh and buttocks and usually occurs after puberty.  It is more prevalent in females than in males. It is rare in males except seen in males with androgen-deficient states or in patients receiving estrogen therapy.

Risk factors or causes

Cellulite is often classified as cellulite with no clinical symptoms but laboratory examination detects underlying position (Grade1). Second grade shows pastiness and decreased elasticity. Further grade (grade 3) includes visible roughness of the skin (orange peel appearance) along with grade 2 signs. Multiple causes has been attributed for cellulite like hormonal factors, genetic, diet, lifestyle and clothing.

Treatments

Numerous therapies have been advertised or claimed to treat cellulite,  but unfortunately, despite having many claimed therapies, none is evidenced as a definitive treatment.  Treatment can be either non-pharmacological or pharmacological. Non pharmacological treatment involves massage suction techniques, liposuction, sub incision or phosphatidylcholine injections. Pharmacological treatment involves topical application of xanthines, retinoids, lactic acid, and herbals. Laser treatment seems   to have a promising future as a treatment modality.

Massage suction therapies works on basis that cellulite is caused by microcirculation. These techniques employ mechanical means to mobilize the subcutaneous fat. Sub incision is also used to correct the anatomical structure of subcutaneous fat by severing fat septae.  After anesthetizing the concern area, a 16 or 18-gauge needle is inserted into the subcutaneous fat. Phosphatidylcholine injections are used in treat ment of localized fat deposits like lipoma or lipodystrophy in HIV. Topical medications like aminophylline cream are also reported to be used.  It is hypothesized that aminophylline migrates to the subcutaneous fat and causes local lipolysis of adipocytes and hence reducing the size of hypertrophic fat cells and adipocyte clumping.

Self care

Apart all the treatment options available one can always keep the cellulite away by exercising, weight control and healthy lifestyle. Cellulite-aggravating factors like stress, sedentary lifestyle and hormonal contraceptives should be avoided. Improvement of circulation is a strategy to reduce the cellulite. Massage with essential oils like even primrose oil or fish oil can be an effective treatment measure for the disease. Other treatment measures include fat absorption reducers and thermogenic food. Fat absorption foods like chitosan(a shellfish) and some oligopeptides are known to reduce fat absorption. Thermogenic foods like yerba mate and dandelion contain methylxanthine, which is evidenced as thermogenic food. Diet measures include reducing dietary fat and increasing intake of fibre diet.  For any successful weight loss and cellulite reduction program, exercise regimen should accompany with proper diet measures. Exercise should be of endurance/aerobic nature like jogging, brisk walking, bicycling etc. Aerobic exercise causes body fat to be burned while anaerobic exercise is effective at muscle building.

Drugs used in treating

Phosphatidylcholine injections are used for the treatment of localized lipid deposition, be it is a lipoma or cellulite.  A school of thought states that it acts as detergent and dissolves fat. Anti-cellulite creams contain methylxanthine or retinol. Methylxanthine, as described above, reduce lipogenesis and increase lipolysis  through phosphodiesterase inhibitory action.