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by Fayne Frey, Board Certified Dermatologist

The complicated relationship we have with our cellulite

If cellulite bothers you, you are not alone. Many of my patients worry about putting on shorts and swimsuits as summer approaches. They ask me how to get rid of the unattractive orange-peel textured skin on their upper thighs, hips and/or buttocks.  Although completely harmless, many women consider this condition unsightly. Cellulite is extremely common, affecting about 85% of all women after puberty. Still, the relationship we have with our bodies is complex, and we let the presence of cellulite eat away at our self-esteem.

What causes cellulite?

Cellulite is when the skin’s surface puckers when fibrous connective tissues cords tether the skin to the underlying muscle while an abundance of fat pushes up against the skin, creating an uneven surface or dimpling. Some people say it looks like cottage cheese. We don’t know exactly what causes it, but we know hormones play a role, which is why we often see it appear after puberty and during pregnancy. There may also be a genetic component that determines cellulite development. And yes, like many conditions, it is more common with age. Cellulite is particularly common in overweight women, however, even thin women have cellulite. It can show up on anyone regardless of body mass index.

Can I get rid of my cellulite?

That’s the million-dollar question. Everyone wants to know how if they can get rid of the dimpled mess.  The short answer is NO. Treatments are available, but all too often these so called solutions are neither immediate or long lasting. 

Available treatments for cellulite

Over-the-counter creams

A ton of over-the-counter products available in the beauty aisle claim to eliminate this undesirable textured skin. Unfortunately, there is little or no research that shows any of these costly creams permanently reduce cellulite. Also, these products usually contain caffeine or aminophylline and require constant reapplication.

FDA approved treatments

There are several FDA approved options to reduce cellulite. For example:

Spa treatments

Spa treatments that use approved medical devices to give deep tissue massages may temporarily improve the appearance of cellulite. Unfortunately, little evidence supports enduring results.

More invasive treatments

Subcision is a medical procedure where your dermatologist inserts a needle just below the skin to break up the fibrous bands beneath the skin. This treatment can reduce the skin dimpling and last two years or possibly longer. 

Vacuum-assisted precise tissue release cuts through the fibrous bands that cause us to see cellulite with the help of small blades. After your dermatologist cuts the bands, the tissue moves upward to fill out and eliminate the dimpled skin.  A small study showed patients who received this treatment had less cellulite for up to three years.

Carbon dioxide gas application below the skin is another technique used to destroy underlying fat with the hopes of minimizing cellulite. This procedure originated in France in the 1930’s, but is still relatively new to the U.S. It appears to take two – six months to see results. 

Recently, the FDA approved a new injection to aimed at reducing cellulite called QWO™ , an enzyme thought to break up the fibrous bands to improve the appearance of the dimpled skin. This procedure requires multiple treatments for optimal results. We don’t yet know if this technique provides permanent benefits.

Ultrasound and surgical techniques like liposuction are additional treatments offered to minimize cellulite. Unfortunately, the research does not show these procedures by themselves to be effective.

My best advice to minimize cellulite

Treatments to reduce cellulite are expensive and generally not covered by insurance. Some come with unwanted side effects and none of these procedures by themselves appear to provide quick or lasting results. 

Here’s my recommendation:  Eat a nutritious diet, exercise regularly and maintain a healthy weight. There are no guarantees, but it may reduce the appearance of those unwanted skin dimples. 

Perhaps more importantly, love yourself for who you are, despite the “physical flaws” defined by a disingenuous beauty industry. Unrealistic cultural norms are designed to make us feel inadequate to encourage us to spend money to fix ourselves. Try not to worry about what other people think. That’s often easier said than done, but it’s my hope you will stop obsessing over a few dimples and flaunt that bathing suit!