No cellulite treatments work permanently, but we keep trying them anyway
By R. Morgan Griffin
Reviewed By Brunilda Nazario, MD
The world's relentless war on cellulite has a new front. This year, an Italian clothing company released the first line of anticellulite pants. As you casually sashay about town, the friction between your body and the jeans reportedly releases an anticellulite cream -- all for $139. Does it work? The world's dermatologists are unconvinced.
Jeans saturated with skin cream are only one of many remarkable cellulite treatments. We've all seen other miracle cures: creams, herbs, massage machines, and lasers. But let's cut to the chase: Is there any treatment out there that will get rid of cellulite?
"There's really nothing that works well," says Lisa Donofrio, MD, associate clinical professor of Dermatology at Yale University.
But this stark fact -- there is no cure for cellulite -- doesn't stop us from hoping and shelling out a lot of money. Even the most savvy and cynical among us tend to get wide-eyed and trusting when we read the claims on a tube of a miracle cream.
While there aren't any permanent cures, there are some cellulite treatments out there that might -- might -- help some people get temporary improvement. So to guide you in the right direction, here's a survey of what's out there: from the harmless (and maybe just a little bit effective) to the unproven and potentially dangerous.
What Is Cellulite?
From a medical standpoint, the fat in cellulite is just fat, the same as any other fat on your body. The term cellulite has only been used in the U.S. for about 30 years -- it was popularized in 1973 by a book-writing spa owner. The term refers to the dimpled appearance of the skin seen in areas of the hips, thighs, and buttocks. It is more commonly seen in women because of the way a women's body distributes fat. Experts estimate that about 85% of women develop cellulite.
"You often see it at times of hormonal surge, like pregnancy or puberty," says Elizabeth Tanzi, MD, co-director of laser surgery at the Washington Institute of Dermatologic Laser Surgery in Washington.
Tanzi says that men may be less likely to have cellulite because they have thicker skin, which is much better at hiding the fat beneath.
While many look at cellulite as a disease -- a harmful build-up of toxins that must be healed -- it's no such thing. It's a perfectly normal and natural way of carrying fat.
Even though cellulite isn't an illness and doesn't need a cure, there are plenty of cellulite treatments nonetheless. Here's the rundown:
Exercise and Diet
Getting regular exercise, eating a healthy diet lower in calories, and maintaining a normal weight may work as a cellulite treatment for some people. No special diet is necessary: just a commonsense one that's high in fruits and vegetables and low in fat.
But exercise and diet won't necessarily solve the problem. Losing weight will reduce the proportion of fat in your body, and hence a proportion of the fat that's trapped in cellulite.
However, the appearance of cellulite is really genetically predetermined. "I always recommend exercise and a good diet as a way to deal with cellulite," says Tanzi. "But it's true that in some women, exercise and diet don't do a thing."
There are countless creams available as cellulite treatments. Many are over the counter and a few are by prescription. Most have some eye-catching ingredient -- prehistoric mud, the pollen of the most rare Alpine weed, and so on.
Do any of them work? According to some doctors, these cellulite treatments may work in some people. However, even proponents caution that the effects are modest and not permanent.
"I don't recommend creams, but if patients want to try one, I generally don't have a problem with it," Tanzi tells WebMD. She suggests looking for creams that contain caffeine or theophylline. There are some studies that show these ingredients might have an effect on cellulite, causing fat cells to dissolve. Other studies disagree.
Even if these ingredients might cause fat to dissolve theoretically, slathering it on the surface of your skin isn't going to do much, Donofrio says. Your skin is designed to keep things out, after all. Expecting a topical cream to "soak into" the fat is kind of like placing a sandwich on your belly and expecting it "soak into" your stomach. The cream will never get near the fat deposits.
"I think that the effects of any cream are doubtful," says Donofrio. "But I do have some patients that swear by them." If you want to try them, she strongly advises that you go with an $8 bottle you can pick up from a drugstore. "The ingredients are really no different from the fancy ones that cost $100 a bottle," she says.
One of the best-known cellulite treatments is Endermologie, a "deep-massage" approach to reducing cellulite developed in France. It uses a device that suctions the skin with a vacuum and kneads it with a set of rollers.
"Some studies have shown the deep-tissue massage can break up some of the fibrous bands, help circulation, and improve the appearance of the skin," says Tanzi. She says that while it works for some women, the effects don't last. You'll need regular maintenance treatments to keep up appearances.
Tanzi estimates that individual sessions cost anywhere from $100 to several hundred dollars. They're usually done weekly and take about an hour.
"If you've got a lot of disposable income, I think Endermologie is the best way to go," says Donofrio. "It's going to cost some money, but some people will get pretty nice results. A lot of people will get no results, but at least they're not going to get hurt."
Another cellulite treatment originally developed in France, mesotherapy, involves a series of injections into small pockets of cellulite. They contain a solution -- a cocktail of homeopathic medications and supplements -- that supposedly break down fat and flush it away.
"It's pretty well accepted by women in Europe," says Tanzi. "But it hasn't been studied scientifically here. There's a lot of skepticism."
She also points out that any cellulite treatment that requires injections -- in this case, a lot of injections -- heightens the risk for side effects and problems. It's also very expensive, with individual sessions costing perhaps hundreds of dollars.
"I consider mesotherapy a snake oil," says Donofrio. "If you look at the literature, there just isn't good evidence that it works and it can also cause really serious infections."
The fact is that no combination or herbs or vitamins is known to have any effect on cellulite whatsoever. If you want to try one anyway, check with your doctor first, since some can cause dangerous interactions with other medications. Remember, just because a remedy is "natural" or "traditional" doesn't mean it is safe, let alone a good cellulite treatment.
You might think that if cellulite is just fat, liposuction is just what you need. But that's not the case.
"We get a lot of patients who think that liposuction will help," says Tanzi. "We try to correct them very quickly. Not only does liposuction not help, but it can actually make cellulite look worse."
The problem is that liposuction can really only get at fat that's deep down beneath the skin. Cellulite is generally too close to the surface for liposuction to help. Besides, it's the fibrous bands that really give cellulite its appearance anyway -- getting rid of fat alone wouldn't really do much.
A number of cellulite-treatment devices have been developed that combine deep tissue massage with other features, such as light and radio frequency therapy.
Tanzi is taking part in a clinical trial of one such device called the VelaSmooth, manufactured by Syneron. Although the results won't be known for a few months, Tanzi is optimistic about the treatment.
"In general, I think the future of cellulite treatment is very promising," says Tanzi. "In the future, we're going to have treatments that, if not permanent, will certainly be longer lasting than what we have now."
But Donofrio says that future is a long way off.
"We're not even close," she tells WebMD. Donofrio likens treating cellulite to changing your hair color: You might be able to get a temporary effect, but there's no way to do anything permanent. Achieving that would require genetic changes -- a lot more than dyes or creams can do.
What Can Be Done?
Obviously, there's little evidence that any of these cellulite treatments will do much. Until that miraculous cure appears, if it ever does, we'll all just have to muddle through. If you're dying to try something -- and provided the therapy you want has no risks -- both Tanzi and Donofrio say you can give it a shot. However, keep a level head: at best, the results are going to be modest. Think hard before investing too much money.
If you're considering treatment in a doctor's office, Donofrio recommends shopping around. Don't sign on to a treatment after only talking to one doctor. Donofrio observes that some doctors who have ponied up for an expensive cellulite-treatment machine might be tempted to use it even in cases where it probably won't work. If you do decide to get a series of treatments, make sure you understand how many you'll need and how much you're paying.
Since the war on cellulite is unlikely to be won any time soon, you may need to learn to change your attitude a little too. The next time you're looking over your shoulder, staring unhappily at the reflection of your backside in your bedroom mirror, remember this: Celebrities, the demigods of our society, have cellulite too.
So think of cellulite as the great leveler. Despite her wealth and the army of dermatologists, plastic surgeons, personal trainers, and make-up artists at her beck and call, even J. Lo has cellulite, according to the tabloids. And if professional sex symbols can have cellulite, why can't you?
Published July 12, 2004.
SOURCES: Lisa M. Donofrio, MD, associate Clinical professor, dermatology, Yale University School of Medicine, New Haven, Conn.; also in private practice, The Savin Center, New Haven, Conn.; and Laser & Skin Surgery Center of New York. Elizabeth Tanzi, MD, co-director, Laser Surgery, Washington Institute of Dermatologic Laser Surgery, Washington. Sainio E. European Journal of Dermatology, December 2000; vol 10: pp 596-603. The American Academy for Dermatology web site.
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