The Skinny on Cellulite

What Exactly Is Cellulite and What Causes It?

Woman massaging her legs
What is cellulite, what causes it, and how can you get rid of it?. Datacraft Co Ltd/Getty Images

With all of the articles in women's magazines, you'd think we would have a good understanding of what exactly cellulite is, but that's simply not the case.

Some people will tell you that cellulite is just fat, plain and simple. Others will say that cellulite is composed of trapped toxins and excess water underneath the skin. The truth is that cellulite is a condition that affects the appearance of the skin in areas with underlying fat deposits (most noticeably on the buttocks and thighs), giving the skin a dimpled, lumpy appearance.

Fat, in and of itself, is not responsible for the lumpy, bumpy look of cellulite. In the right circumstances, fat can be a beautiful thing. In fact, facial fat is what’s responsible for the smooth and beautiful plump round cheeks you see on the young. Plastic surgeons even charge patients a lot of money to inject patients' own fat into areas of the patients' faces and bodies. In fact, fat injections are sometimes used as a treatment to improve the appearance of cellulite.

Before you get excited about these potential treatments, however, read on. Many of the so-called treatments to date won't reduce the cellulite on your thighs but will reduce the thickness of your wallet.

Cellulite vs "Normal Fat"

So what is it that makes cellulite different from “normal” fat? It is the structure of the overlying skin and of the underlying connective tissue that determines whether a given area has a smooth or rippled appearance.

Who Gets Cellulite?

Have you ever wondered why men are so much less likely to have cellulite, even when obese? Or why obese children usually do not have cellulite? Or why you see even very slim women with cellulite?

While the appearance of cellulite tends to worsen in proportion to the amount of fat present in the affected area, cellulite can affect even the thinnest women.

The reason for this is that while fat deposits do exacerbate the condition, fat itself is not the primary cause.

Why Do I Have Cellulite?

Underneath the skin lies a layer of fibrous connective tissue that is responsible for adhering the skin to the muscle beneath it. In most men, this connective tissue is arranged in a cross-hatched or diagonal manner, in a smooth and continuous pattern.

The connective tissue of women is another story, running vertically (perpendicular to the skin). Because of this, these fibrous bands (called septae) tether the skin to the underlying tissue at certain points, essentially creating discrete “fat chambers” to push up on the skin while the bands pull the skin downward.

This difference in connective tissue arrangement (coupled with the fact that men usually have thicker skin than women) explains why far fewer men have cellulite than women.

Bad News First

When we are young, our connective tissue is supple and elastic, stretching and giving with the skin so that everything remains smooth. Then puberty hits, and hormones wreak havoc on the connective tissue, making it stiffer and less elastic. At the same time, our fat cells tend to expand in certain areas, pushing out on the skin.

As the bands of connective tissue contract and stiffen with age, they pull down on the skin even more. At the same time, increasing fat stores push outward in the surrounding areas. Put these two occurrences together, and the result is an unappealing landscape of dimples and bulges.

As we get older, the outer layer of skin weakens, thins, and loses elasticity. Gravity takes its toll, and the skin begins to sag. Since the connective septae remain intact and often contracts and stiffens further as time marches on, the appearance of cellulite continues to worsen with age.

Another probable aggravating factor in the development of cellulite is yo-yo dieting.

Repeated cycles of weight gain and weight loss further compromise skin elasticity, making cellulite more pronounced.

The Good News

You can improve (not eliminate) the appearance of cellulite by living a healthy lifestyle. That means staying hydrated, not smoking, and yes, following a sensible diet and exercise program.

A combination of proper diet and exercise will decrease the layer of fat underneath the skin, making cellulite less noticeable. A proper diet can also be helpful in keeping the skin and connective tissue stronger, healthier, and more supple. In addition, staying properly hydrated and eating well will help prevent water retention (which exacerbates cellulite).

Exercise helps with cellulite in a multitude of ways. Not only does it help keep body fat levels lower, it also improves circulation and muscle tone in cellulite-prone areas. Improved circulation will keep both the skin and connective tissue healthier, as well as helping with the elimination of waste and excess fluid retention.

If you're worried that quitting smoking will cause you to gain weight, and hence, increase cellulite, think again. Smoking is poison to connective tissue, causing the normal aging process of stiffening and contracting of connective tissue to go into hyperdrive  If you're still having a hard time kicking the habit, remember that smoking not only affects connective tissue (which leads to cellulite) but smoking damages your skin (think wrinkling) in at least nine different ways.

Treatments for Cellulite?

If you're tired of your cellulite, you're probably wondering what you can do to get rid of it beyond eating healthy, exercising, and quitting if you smoke. Most supposed treatments for cellulite will do little more than reduce your bank account. That said, there are some cellulite treatments and procedures that are effective for some people. Even with these treatments, however, it's important to be realistic. If you are considering having a surgical procedure, here are some points to think about before cellulite surgery.

The Ugly Truth

You may stick to world’s best diet and exercise program, and still have cellulite. The presence, severity, and location of cellulite are in large part determined by hormones and heredity.

While there are a few cellulite treatments that can somewhat improve the appearance of cellulite, there is no “cure” for cellulite. In fact, most of the cellulite “solutions” offered by those who would separate you from your hard-earned cash are little more than expensive placebos.

Sources:

Christman, M., Belkin, D., Geronemus, R., and J. Brauer. An Anatomical Approach to Evaluating and Treating Cellulite. Journal of Drugs in Dermatology. 2017. 16(1):58-61.​

Green, J., Cohen, J., Kaufman, J., Metelitsa, A., and M. Kaminer. Therapeutic Approaches to Cellulite. Seminars in Cutaneous Medicine and Surgery. 2015. 34(3):140-3.

Luebberding, S., Krueger, N., and N. Sadick. Cellulite: An Evidence-Based Review. American Journal of Clinical Dermatology. 2015. 16(4):243-56.

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