By Cynthia Salter-Lewis, MD

ReNew Med-Spa, Manalapan

Cellulite reduction and body contouring treatments are the most sought after therapies today.  However, part of the difficulty in treating cellulite is our incomplete understanding of it.  Even to this day there is no consensus as to the etiology of cellulite. Cellulite occurs in nearly 90% of all women. There are numerous treatment options available including topical, weight loss, endermologie, laser, and the latest therapy that has been introduced to the United States - Acoustic Wave Therapy (AWT). Many of these more advanced treatments have been shown to diminish the appearance of cellulite.

Why Does Cellulite Affect Women And Not Men?

It may be that men organize their fat differently than women. There are several proposed reasons for cellulite development.  In men, the connective tissue bands that organize and support fat lobules run parallel to the skin. This means that men have minimal pulling down of the skin by fat deposits, and therefore smoother skin. The fat in women is organized into vertically oriented, rectangular lobules that run perpendicular to the skin. As we age these vertical bands of connective tissue become tighter, yanking down on the skin creating a valley. Simultaneously, fat is being jammed up against the skin's surface creating a hill. As your skin thins with age secondary to a weaker dermis, these protrusions become more noticeable. Although the development of cellulite is largely based on heredity and genetics there may be other key contributing factors. Poor blood circulation and poor lymphatic flow due to lack of exercise, stress, inadequate water intake and other factors exacerbate the hardening of these vertical bands of connective tissue.

What Are My Options?

An effective treatment for cellulite must address all of the above factors to give lasting results.  The treatment options available include traditional therapies for cellulite like various creams, heated wraps, endermologie, and weight loss which have been practiced for several years. More recent advances in cellulite treatment include laser as well as acoustic wave therapy. The latter has been recently introduced in the United States with very impressive results.

How Does Weight Affect Cellulite?

Most people believe that cellulite is caused or increased by weight gain and obesity.  Obesity does not cause cellulite.  Almost all females, lean or obese, have cellulite.  In fact obese males have no problem with cellulite.  What happens is that cellulite becomes more obvious with increases in weight and looks more diminished in appearance with weight loss.  Therefore, diet and exercise should be part of the treatment plan in order to reduce the clinical appearance of cellulite.

Are Cellulite Creams Any Good?

There are over 200 ingredients used in at least 30 different cellulite creams available today.  It is important to note that many of the ingredients in these creams are not known and may present a risk for adverse effects like allergies.  Although cellulite creams have not demonstrated any long lasting effect there are some ingredients that deserve mention. 

Aminophyline (a drug used for asthma) has been recently used as a topical form for the  treatment of cellulite.  Other related topical treatments include those formulated with caffeine and theophylline.  After using these creams you can expect to see a subjective mild improvement in cellulite that last for only a few hours.

Based on the hypothesis that cellulite appears as a consequence of a weakened dermis in concert with fat cells protruding through, retinol theoretically has a role in the treatment of cellulite.  Retinol increases the deposition of collagen in the dermis.  A thicker dermis may restrict movement of the protruding fat cells below.  In theory it seems that topical creams containing retinol would have a great effect on the treatment of cellulite.  However, most studies show little to no long lasting improvement.

There are herbal products on the market containing ginkgo, seaweed, algae, and grape seed oil to name a few. To this date, studies fail to prove a significant reduction in the appearance of cellulite.   

Are There Other Treatments Available?

Endermologie has been available in the United States since 1996. Twelve to sixteen treatment sessions are suggested with maintenance treatments every month.  Despite its popularity for cellulite treatment, its lasting effectiveness is controversial.

Lasers have been used as one of the newer additions to cellulite therapy.  The Velasmooth and Tri-Active are the most common lasers used.  For the Velasmooth the treatments are twice weekly for a total of 16 treatments.  Patient studies report a mild to moderate improvement in cellulite reduction.  The results do diminish over time but seem to last for approximately 6 months.  Monthly maintenance treatments are necessary in order to maintain results. 

The Tri-Active System is used for the treatment of cellulite as well.  Three treatments per week for two weeks and then biweekly treatments for five weeks are required.  A total of 16 treatments are suggested.  Monthly maintenance treatments are necessary. 

Acoustic wave therapy most recently came on the scene for cellulite reduction.  It uses a device that delivers pressure waves to disrupt the fibrous tissue responsible for the skin dimpling of cellulite.  Research has suggested that acoustic wave therapy increases the thickness of the dermis and thereby decrease the protrusion of fat into the reticular dermis.   The treatments required are two treatments weekly for three weeks.  Maintenance is required but only once every three months. Studies suggest that acoustic wave therapy is a promising new treatment for moderate improvement in the appearance of cellulite.

There is no permanent cure for cellulite. Hopefully one day we will find that magic bullet that will rid us of cellulite forever. Until then there are many promising treatments available today that have been proven to significantly improve the appearance of cellulite.  Medical breakthroughs like Acoustic Wave Therapy and laser treatments are providing women with good results. These therapies are not cures and do require occasional maintenance sessions. The bottom line is that creams and potions don't work - at best they may hydrate the skin and give a very transient improvement. These creams can be very expensive, so before you invest your money and hopes in a bottle or jar it may be wiser to seek out the advice of a health care professional that specializes in the use of more advanced devices to treat cellulite.

ReNew Med-Spa

510 Route 9 North, Manalapan, NJ

732-972-3233