Overview

Cellulite is a very common and harmless skin condition that causes dimpled and bumpy skin on the thighs, hips, buttocks, and abdomen. This condition is more common in women.

Many people try, with varying success, to improve the appearance of their skin through weight loss, exercise, massage, and creams marketed as a solution for cellulite. There are also medically proven treatment options, although the results are neither immediate nor long-lasting.

Symptoms

Cellulite has the appearance of dimpled or bumpy skin. It is sometimes described as having a cottage cheese or orange peel texture.

Mild cellulite can only be seen if you pinch the skin in an area where you have cellulite, such as the thighs. More severe cellulite makes the skin appear wrinkled and lumpy, with areas of peaks and valleys.

Cellulite is most common around the thighs and buttocks, but it can also be found on the breasts, lower abdomen, and upper arms.

When to see a doctor

Treatment is not necessary. But if you are concerned about the appearance of your skin, talk to your primary care doctor or a skin disease specialist (dermatologist) or plastic surgeon about treatment options.

Causes

Little is known about what causes cellulite. It involves fibrous connective cords that hold the skin to the underlying muscle, with fat located in between. As fat cells accumulate, they push up against the skin, while the long, tough cords pull down. This creates an uneven or dimpled surface.

Additionally, hormonal factors play an important role in the development of cellulite, and genetics determines skin structure, skin texture, and body type. Other factors, such as weight and muscle tone, affect whether you have cellulite, although even very fit people can have it.

Risk factors

Cellulite is much more common in women than in men. In fact, most women develop some cellulite after puberty. This is because women's fat is typically distributed in the thighs, hips, and buttocks, common areas for cellulite. Cellulite is also more common with aging, when the skin loses elasticity. Weight gain can make cellulite more noticeable, but some thin people also have cellulite. It tends to be hereditary, so genetics might play the biggest role in whether you develop cellulite. An inactive lifestyle can also increase your chances of having cellulite, as can pregnancy.

Diagnosis

Diagnosis of cellulite involves examining the skin to assess dimpling and what may have caused it. This helps determine what treatment may improve the appearance of your skin. Some methods treat fat but do not eliminate dimpling. And methods that remove cellulite are not intended to remove excess fat.

Treatment

There are a variety of treatment approaches available to improve the appearance of cellulite, at least temporarily. Each has its own set of potential outcomes and side effects. Some studies indicate that a combination of treatments may produce the most satisfactory results.

• Laser and radiofrequency treatments. There are several ablative (damaging) laser treatments available to treat cellulite. In one method, a thin fiber is slid under the skin to deliver laser heat that destroys the fibrous bands that bind fat. This approach has been shown to reduce the appearance of cellulite for six months to a year. More studies are needed. There is also a device that uses heat (radiofrequency) for non-ablative treatment that improves the appearance of the skin. You will probably need several sessions before you notice an improvement in the appearance of your skin. Non-ablative treatments generally need to be repeated more frequently than ablative treatments.
• Acoustic wave therapy. With this technique, a technician applies gel to the affected skin and passes a small handheld device (transducer) over the area. The transducer sends sound waves to your body, breaking up the cellulite. You will probably need several sessions before you notice an improvement in the appearance of your skin.
• Massage. Some cellulite treatments are based on the concept that vigorous massage will increase lymphatic flow, remove toxins, and reduce excess fluid in areas prone to cellulite. One method uses a handheld machine to knead the skin between rollers (Endermologie). Endermologie has FDA approval as a medical device with little potential to cause harm. You might notice a slight improvement in your skin after several sessions. The results are short-lived.
• Surgery. Your doctor may offer one of several procedures that use needles, blades, or other special tools to separate the fibrous bands under the skin (subcision) in an effort to smooth the skin. One method also uses fat grafts to improve the appearance of the skin. The results of these techniques can last from two to three years. Complications from these techniques can include pain and bleeding under the skin.

Laser and radiofrequency treatments. There are several ablative (damaging) laser treatments available to treat cellulite. In one method, a thin fiber is slid under the skin to deliver laser heat that destroys the fibrous bands that bind fat. This approach has been shown to reduce the appearance of cellulite for six months to a year. More studies are needed.

There is also a device that uses heat (radiofrequency) for non-ablative treatment that improves the appearance of the skin. You will probably need several sessions before you notice an improvement in the appearance of your skin. Non-ablative treatments generally need to be repeated more frequently than ablative treatments.

Surgery. Your doctor may offer one of several procedures that use needles, blades, or other special tools to separate the fibrous bands under the skin (subcision) in an effort to smooth the skin. One method also uses fat grafts to improve the appearance of the skin. The results of these techniques can last from two to three years.

Complications from these techniques can include pain and bleeding under the skin.

Cellulite treatments are generally not covered by insurance. Additionally, any of the procedures may have side effects, so be sure to discuss them with your doctor. Make sure your dermatologist or plastic surgeon is specially trained and experienced in the technique you are considering.

Possible future treatments

Researchers are studying possible medical treatments. Some that show potential use a combination of liposuction and ultrasound or laser. Liposuction alone will not remove cellulite, and it could worsen the appearance of your skin. But when combined with ultrasound or laser treatment, it could be effective for tightening the skin. More studies are needed.

Home remedies and lifestyle

Self-care can help improve the appearance of your skin.

• Medicated creams. Applying 0.3% retinol cream has been shown to improve the appearance of cellulite. Retinol helps thicken the skin, which reduces dimpling. These products are applied once or twice a day. Any effect of a retinol cream will not be noticeable for six months or more.
• Weight loss. If you are carrying extra weight, losing pounds and toning muscles can help improve the appearance of dimpled skin.
• Physical activity. Activities that tone the muscles can help improve the appearance of dimpled skin. They also help with circulation and lymphatic drainage. Find one or more activities that you enjoy and can include in your routine, such as yoga, Pilates, swimming, walking, cycling, climbing stairs, and dancing.

Preparing for your appointment

Preparing a list of questions will help you make the most of your time with your doctor. For cellulite, some basic questions to ask your doctor include:

• What is the best course of action?
• What are my treatment options and the pros and cons of each?
• How much will the treatments cost?
• What results can I expect?
• What type of follow-up, if any, will I have?