Can You Beat Cellulite?
3 experts take a look at the latest treatments
By Colette Bouchez
Reviewed By Cynthia Dennison Haines, MD
Perhaps nothing is cuter than a pair of dimples accentuating your smile. But it's not so cute when dimples turn up on your thighs, buttocks, tummy, and upper arms.
The problem is cellulite, fatty deposits of dimpled skin that can appear on even the most fabulously thin body.
"That's because cellulite is not a fat problem, it's a skin problem. It has nothing to do with what you weigh, or how much weight you lose," says Hollywood dermatologist Howard Murad, MD, author of The Cellulite Solution.
The fat that causes cellulite is not the same as the fat that takes us from a size 10 to a 14, experts say. That fat lies far below the skin, closer to our bones, and it is what the body burns as fuel for energy.
Cellulite, on the other hand, is made up of fat cells that reside within the skin. They can't be burned as fuel, says Murad, so dieting, exercise, even liposuction won't help.
Cellulite is a decidedly womanly problem, primarily targeting females over 35. Although doctors aren't sure why, many say hormones and anatomy are key.
"The best evidence for increased incidence in women is that it's related to hormonal changes, but also the anatomy of what's called 'septa' -- fibrous bands of tissue that surround fat cells in the skin to help keep them in place," says Bruce Katz, MD, medical director of Juva Skin and Laser Center in New York, and clinical professor of dermatology at the Mt. Sinai School of Medicine.
In men, Katz says, the septa run in a diagonal pattern, while in women, their pattern is vertical.
When we are young, this doesn't matter, since both designs work equally well in keeping cellulite anchored within the deeper layers of skin. As we age, however, the normally elastic septa can become hard and rigid. When they do, they bear down on the buoyant cellulite cells, which begin pushing up through the spaces of the hardened septa pattern.
"When the septa run vertically, it results in a 'mattress tufting' effect,'" Katz tells WebMD. "The fat cells push up in between and create those dimples we know as cellulite."
Got Cellulite? Blame Mom!
Along with the pattern of the septa, it matters how many of these fibrous bands you have. Since septa are genetic, cellulite is, too -- passed down from mother to daughter like an ugly pair of heirloom earrings nobody really wants.
"Cellulite is hereditary, so much so that the indications of who will get it, and to what degree, are present almost from birth," says dermatologist Amy Newburger, MD, director of Dermatology Consultants of Westchester in Scarsdale, N.Y. In fact, Newburger tells WebMD, skin biopsies taken from infants are highly predictive of whether cellulite will develop later in life, based on the number of septa bands found in the skin.
To further complicate matters, doctors say, the circulatory system that feeds our skin cells and lymph vessels can become damaged over time, allowing cellulite to become more apparent.
The Cellulite Solutions: What May Help
For generations, doctors have said cellulite was here to stay -- a lumpy, bumpy rite of passage to womanhood that we just had to learn to live with.
But in the last 20 years several treatment options have emerged. While the science is still shaky, with few studies to attest to the effects, some experts report significant results -- at least anecdotally.
To help you get a handle on what's available, our three experts discussed the possibilities.
Option 1: Creams and Lotions
Arguably the easiest and least-costly approach is lotions and creams that purport to stimulate cell circulation, melt fat, and move fluid and toxins out. Many doctors are not convinced they help. But Newburger says there are creams and lotions that have some effect -- those whose key ingredient is methylxanthines (one form of which is caffeine).
"Caffeine creams work great to pull fluids out of the spaces between cells and induce lipolysis -- fat burning in the layer just below the skin's surface," says Newburger.
In a study published in the journal Dermatologic Surgery in 1999, researchers found that methylxanthine creams reduced fat cells in skin, with visible results in about eight weeks. The higher the concentration of methylxanthine, the better the cream worked.
Newburger says a good delivery system to drive the creams into the cells, like liposome technology, is also important.
Among the hottest-selling caffeine cellulite creams are Neutrogena's Anti-Cellulite Treatment (about $18.49 for 5 ounces) and CelluSculpt Anti-Cellulite Slimming Treatment by Avon (about $16 for 6.7 ounces).
Option 2: The Cellulite Diet