Is there anything a woman can do to get rid of her cellulite?
Reviewed By Michael Smith
"It started out on my upper thighs ... now it's creeping down to my knees!" says Maria Johnston (not her real name), a spunky, athletic, 43-year-old from Miami, Fla. "How much lower is it going to go? To my ankles?"
Maria is not talking about her hair, or her hemline. She's talking about cellulite, that bumpy, orange-peel-like fat bemoaned by women everywhere.
While it might look like an alien life-form burrowing beneath your skin, cellulite is simply normal fat. It looks bumpy because it's pushing through the connective tissues that usually keep it distributed evenly beneath your skin. The total amount of fat in your body, your age, and your genetic predisposition (blame your parents!) all combine to determine if you'll be saddled with cellulite or not.
While it's impossible to know just how many women are driven batty by cellulite, John Morgan, MD, a dermatologist in Columbia, S.C., estimates that about 85% of women have some cellulite. It is a surprisingly equal opportunity annoyance, appearing on thin and heavy women alike.
Maria has spent more than $5,000 trying to get rid of her cellulite, with varying results. She exercises twice a week with a personal trainer and eats a low-fat diet. Still, she's wary. "I see women who are younger than me, in better shape than me, who work out harder than I do, and they still have cellulite," Maria laments.
She's not wise to quit, though. "Everyone wants an instant fix, a magic pill. There just isn't one," says Morgan. "But diet and exercise remain your best bet. Be patient: It can take at least six months of hard work to see any improvement." Be sure to add resistance training to your routine; stronger muscles underneath your fat deposits can help smooth out the area overall. Still, even with good diet and exercise, some cellulite may remain. "At some point you have to accept that you have done all you can," says Morgan.
Smooth It On, Smooth It Out: Cellulite Creams
Lotions and potions have also yielded little satisfaction for Maria. A few years ago, she spent more than $1,200 on a series of spa treatments that claimed to reduce her cellulite. She saw no improvement. "They had all these big promises about getting rid of cellulite completely, but it didn't work at all!"
Plenty of women are looking for a quick fix in a jar. Over the last few years, a handful of cellulite creams have stormed the market. Pseudo-scientific infomercials flood TV screens nationwide touting a dramatic reduction in the appearance of cellulite by increasing blood flow to the affected areas.
Do they work? Not if you ask Alan Kling, MD, a clinical assistant professor of dermatology at Mount Sinai School of Medicine in New York.
"Cellulite creams are pure hype," says the dermatologic surgeon specializing in liposuction surgery. "People need to remember that the beauty industry can make claims based on anecdotal evidence that have no scientific or medical backing whatsoever."
Some research backs Kling's claim. A double-blind study published in the September 1999 issue of the British Journal of Plastic and Reconstructive Surgery put the creams to the test. After 12 weeks, only 3 of the 17 women in the study reported even the slightest improvement.
Can You Massage Away Cellulite?
Last year Maria went high-tech in her quest: Endermologie. Again, after 12 weeks of twice-weekly treatments, she saw no noticeable difference in before-and-after photographs. "I couldn't see any change. The office staff said I was imagining it -- but I think they were the ones imagining it!"
During Endermologie, available only at dermatologists' or plastic surgeons' offices, a vacuum-like device deeply massages the areas where there is noticeable cellulite. The technique purports to redistribute the fat under the connective tissues, which will then lead to a smoother, more balanced appearance. It has a qualified endorsement from the Food and Drug Administration, which recognizes it as effective in the temporary reduction of cellulite.
The same British study that evaluated cellulite creams also tested the effects of an Endermologie program that included twice-weekly treatments for 12 weeks. While one third of the women in the study felt that their cellulite had improved, before-and-after photographs showed only small objective improvements.
Cellasene: A Miracle Pill?
Many drugstores stock the prepackaged, over-the-counter pill Cellasene. So far, Maria has resisted it. "I don't like the idea of taking pills," she says. "Besides, a friend of mine tried it and it didn't work."
Cellasene, which contains a mixture of herbs such as ginkgo biloba, sweet clover, and grape-seed oil, as well as non-herbal ingredients, claims to improve capillary circulation, inhibit collagen breakdown (which helps keeps skin firm and elastic), and support healthy connective tissue, thereby reducing the appearance of cellulite.
Too good to be true? When British researchers evaluated Cellasene in a November 1999 study in the Journal of Psychotherapy Research, their results were lukewarm. In the study, one group of women took Cellasene and one group took a placebo pill for two months. There was no noticeable improvement in the cellulite in either group. In addition, some doctors caution that the high level of iodine in the pills can lead to thyroid problems.
The Operating Room: Plastic Surgery
A final cellulite treatment option (and one that Maria will not likely resort to) is the most controversial: plastic surgery, in the form of liposuction. While some physicians claim that liposuction can reduce cellulite, it's best suited to remove "deep" fat, not fat that is close to the skin. "If cellulite improves as a result of the liposuction, I tell patients to view it simply as a bonus," says David Amron, MD, a dermatologic surgeon in Beverly Hills, Calif. In fact, trying to remove fat that is quite close to the skin can lead to unsatisfactory results, such as dimples and depressions. In the end, Kling and Amron conclude that liposuction is simply not an effective treatment for cellulite.
Maria's Quest Continues
So Maria soldiers onward, at (almost) any cost. She is currently midway through a 15-week massage and paraffin-wax cellulite treatment regimen. "So far, I haven't seen any results. But I'm going to give it a few more sessions," she says hopefully. She's crossing her fingers that, at $90 per treatment, this will be the technique that finally works.
Originally published April 10, 2000.
Medically updated April 22, 2003.
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