Many people try, with variable success, to improve the appearance of their skin through weight loss, exercise, massage and creams marketed as a solution to cellulite. Medically proven treatment options are available as well, though results aren’t immediate or long-lasting.

Cellulite looks like dimpled or bumpy skin. It’s sometimes described as having a cottage cheese or orange peel texture.

You can see mild cellulite only if you pinch your skin in an area where you have cellulite, such as your thighs. Cellulite that is more severe makes the skin appear rumpled and bumpy with areas of peaks and valleys.

Cellulite is most common around the thighs and buttocks, but it can also be found on the breasts, lower abdomen and upper arms.

What Causes Cellulite?

Cellulite is caused by a build-up of fat underneath the skin. Some women are more predisposed to it than others. The amount of cellulite you have and how noticeable it is can be based on your genes, body fat percentage, and age. The thickness of your skin also affects the appearance of cellulite. People of all body types and weights can get cellulite.

In addition, hormonal factors play a large role in the development of cellulite, and genetics determine skin structure, skin texture and body type. Other factors, such as weight and muscle tone affect whether you have cellulite, though even very fit people can have it.

Cellulite is much more common in women than in men. In fact, most women develop some cellulite after puberty. This is because women’s fat is typically distributed in the thighs, hips and buttocks — common areas for cellulite. Cellulite is also more common with aging when the skin loses elasticity.

Weight gain can make cellulite more noticeable, but some lean people have cellulite, as well. It tends to run in families, so genetics might play the biggest role in whether you develop cellulite. An inactive lifestyle also can increase your chances of having cellulite, as can pregnancy.

You can have it whether you’re heavy or thin. Muscle tone can affect it, and very fit people sometimes have it. Hormonal factors and genetics both play a role. It might also be related to the thickness of your skin. Women are more likely to get it than men. It tends to form more as you get older.

The distribution of fat in women is more visible than in men. The collagen fibres between the skin and muscle separate the underlying fat into multiple pockets. Cellulite can become more visible as you age and your skin becomes thinner and loses elasticity. This exposes the rippled connective tissues underneath.

Lifestyle factors may play a role. For example, cellulite may be related to:

• Unhealthy diet
• Fad dieting
• Slow metabolism
• Lack of physical activity
• Dehydration
• hormones
• poor diet
• an unhealthy lifestyle
• accumulated toxins
• genetics
• weight gain
• inactivity
• pregnancy

Grades of cellulite

A cellulite severity scale, using three grades:

Grade 1, or mild: There is an “orange-peel” appearance, with between 1 and 4 superficial depressions, and a slightly “draped” or sagging appearance to the skin.

Grade 2, or moderate: There are between five and nine medium-depth depressions, a “cottage cheese” appearance, and the skin appears moderately draped.

Grade 3, or severe: There is a “mattress” appearance, with 10 or more deep depressions, and the skin is severely draped.

Hormonal factors and age

Hormones likely play an important role in cellulite development. Estrogen, insulin, noradrenaline, thyroid hormones, and prolactin are part of the cellulite production process.

One theory is that as estrogen in women decreases in the approach to menopause and blood flow to the connective tissue under the skin also decreases.

Lower circulation means less oxygen in the area, resulting in lower collagen production. Fat cells also enlarge Trusted Source as estrogen levels fall.

These factors combine to makes the fat deposits more visible. As the fat under the skin protrudes through weakening connective tissue, the familiar dimpling effect results.

Age also causes the skin to becomes less elastic, thinner, and more likely to sag. This increases the chance of cellulite developing.

Genetic factors

Certain genes are required for cellulite development. Genetic factors can be linked to a person’s speed of metabolism, distribution of fat under the skin, ethnicity, and circulatory levels. These can affect the chance of cellulite developing:

Dietary and lifestyle factors

Cellulite is not caused by “toxins,” although a healthy lifestyle may help reduce the risk.

Exercise and diet may help reduce the appearance of cellulite.

People who eat too much fat, carbohydrates, and salt and too little fibre are likely to have greater amounts of cellulite.

It may also be more prevalent in smokers, those who do not exercise, and those who sit or stand in one position for long periods of time.

Wearing underwear with tight elastic across the buttocks can limit blood flow, and this may contribute to the formation of cellulite.

Cellulite is more prevalent in people who have excess fat, but slim and fit people can have it too. It is more likely to happen after the age of 25 years, but it can affect younger people as well, including teenagers.

Treatment and removal

Several therapies have been suggested for removing cellulite, but none have yet been confirmed by scientific research.

Acoustic wave therapy uses a hand-held device to transmit sound waves. It may work, but it can take several sessions.

Laser treatment may improve the appearance of cellulite for a year or more. It involves inserting a very small laser probe under the skin. The laser is then fired, breaking up the tissue. This can also thicken the skin by increasing collagen production. The thickened skin may reduce the appearance of the cellulite below.

Subcision involves a dermatologist putting a needle under the skin to break up the connective tissue bands. Results can last 2 years or more.

Vacuum-assisted precise tissue release cuts the bands using a device containing small blades. As it cuts the connective bands, the tissue underneath moves up to fill the space under the skin, removing the appearance of cellulite. This may last for 3 years, but data on its success is limited.

Carboxytherapy involves inserting carbon dioxide gas under the skin. Side effects include bruising and discomfort after the procedure, but some cellulite might disappear.

Endermologie involves a deep massage with a vacuum-like device that lifts the skin. The United States (U.S.) Food and Drug Administration (FDA) have approved it as safe, but there is little evidence that it works.

Several sessions of acoustic wave therapy can help to treat cellulite.

Ionithermie cellulite reduction treatment involves covering the affected area with a special mud or clay, then wrapping it in plastic before applying an electric current. It is not proven to be effective.

Radiotherapy aims to reduce cellulite by heating it, but any results are short-term.

Laser-assisted liposuction removes small amounts of fat, but this may make dimpling worse. Research has not yet shown that it works to reduce cellulite.

Ultrasonic liposculpting targets and destroys fat, but again, research is lacking to show that it works.

Medications and creams

Some medications and creams have been proposed because they act on fatty tissues.

Caffeine dehydrates cells, making them less visible. This needs to be applied daily. Various caffeine creams for cellulite are available to purchase online.

Retinol may reduce the appearance of cellulite by thickening the skin. At least 6 months’ use is needed to see results. It is important to try a patch test first, because some people have experienced adverse effects, such as a racing heart. Retinol treatments are available to buy online.

Alternative solutions

Alternative or supplemental therapies include caffeine, grape seed extract, or Ginkgo Biloba. These agents have been applied topically, orally, and by injection, but none of them has proven effective.

Some people wear compression garments to reduce the appearance of cellulite. These garments try to compress arteries and increase blood and lymph flow to reduce visible cellulite. Compression stockings and other garments may be purchased online.

Liposuction and dieting do not remove cellulite because it does not affect the structure of the connective tissue.

However, reducing fat intake will mean having less fat to push through the tissues. Eating a healthy, balanced diet and exercising may, therefore, reduce the appearance of cellulite.