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Sunday, 31 May 2009 19:00

Skin Type Solutions Presents - Cellulite - From Dr. Leslie Baumann

From aromatherapy to endermologie, caffeine cream to massage, it seems that for every woman who complains about cellulite, there are 10 products or treatments on the market touted as solutions. Though completely harmless and almost ubiquitous, the lumpy, bumpy skin we call cellulite is the cause of much anguish on America's beaches–not to mention in its bedrooms and department store change rooms! Though it's virtually impossible to get rid of, there are things you can do minimize the appearance of cellulite. Keep reading to learn how to navigate the confusing world of cellulite therapies and separate the science from the snake oil.


What exactly is cellulite, anyway?

What is cellulite?Cellulite is dimpled skin typically found on the upper thighs, buttocks and abdomen that unfortunately afflicts women more often than men. The connective tissues of the skin are weakened, letting fat bulge out of the spaces in between and giving the skin a bumpy appearance similar to an orange peel. It’s possible that cellulite is caused by decreased circulation. This leads to increased amounts of enzymes that destroy elastin and collagen, which in turn leads to the gaps in the dermal structure where fat cells peek through.

My friend and colleague Dr. Doris Hexsel, a Brazilian dermatologist, has classified cellulite into four different stages:

  • Stage 0: the skin's surface is not altered.
  • Stage I: skin is smooth when the individual is standing or lying down, but some cellulite appears if the skin is pinched.
  • Stage II: skin appears dimpled without any pinching or manipulation.
  • Stage III: skin appears both dimpled and raised in some areas.

I say this because it's important to understand which stage you're in and to pick an appropriate treatment option.

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Can you keep yourself in Stage 0 forever and prevent cellulite from forming?

Unfortunately, it’s not likely that you can stop yourself from ever getting cellulite, though you can do a lot to keep it to a minimum and smooth its appearance. Eighty to 98 percent of post-adolescent females will have cellulite eventually, either now or when they get older, and no culture or ethnic group is spared. Although cellulite can be found on thin, healthy women, being overweight or obese exacerbates the condition, as does the natural process of aging. Lack of exercise, poor lymphatic drainage and having excess hormones can also make cellulite worse. Incidentally, the link between hormones and cellulite leads many to believe that female hormones are the reason women often have cellulite while men rarely do.

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What can I do to make it look better?

What can I do to make it look better?At Stage I, as at all stages, eating a healthful diet and making sure you exercise regularly are the most effective steps you can take to treat cellulite. I find a combination of cardio and weight training or yoga to be particularly effective. (The shoulder stance in yoga improves lymph flow which can lessen the appearance of cellulite).

Regular deep tissue massage fights cellulite by draining lymph fluids from your cells and works better than any creams or potions that I know of.  If you must use a topical product, the only creams I’ve found to be effective are those that contain caffeine or theophylline.

Research has found that caffeine can cause fat to break down and might also work by dehydrating the fat cells, making skin look smoother. Studies have shown that some women experience a slimming effect when they use creams that contain caffeine, but the effects are not permanent—you have to apply twice daily and use them continually. It’s also important to use a cream with a high enough percentage of caffeine. There are many cellulite creams on the market but I have not found one that my patients consistently rave about. Please visit me at in the forums and tell us if you have a favorite.

It has been suggested that prescription retinoids like Retin-A might help treat cellulite. Since these work by increasing collagen in the skin, it’s possible they could smooth skin by strengthening connective tissue and improving elasticity, but studies have so far been inconclusive.

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How do you treat cellulite at its later stages?

At Stage II, you might consider Endermologie or VelaSmooth, two non-invasive professional treatments recently approved by the FDA. Endermologie was developed in France and uses a combination of rollers and suction to smooth dimpled problem areas. It’s basically a super intense massage and probably works by increasing lymph flow to temporarily reduce cellulite.

VelaSmooth is another medical device that uses a vacuum and rollers, but it also adds radio frequency and infrared light, which are said to shrink the fat cells. Both of these treatments work best in healthy, active people who are not overweight. They can be expensive, though, requiring as many as 14 initial treatments with less frequent follow-ups thereafter.

I have never felt that these treatments were any better than a weekly body massage.  They all work by increasing lymph flow.  A new device called liposonix claims to treat cellulite.  I have not used it yet as it is not yet FDA approved so I have no idea if it will work.  Stay tuned for more information on that procedure.

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Are there any surgical options?

Surgical intervention is normally reserved for the most severe Stage III cases. As I’ve explained, cellulite occurs when fat cells bulge around fibrous connective tissue. Doctors can surgically break up that connective tissue, smoothing out the skin’s surface and allowing for more even distribution of fat. It’s an outpatient procedure.  Dorix Hexsel MD in Rio Brazil performs this procedure. She taught us at the University of Miami how to do it 8 years ago.  I have not felt that it was effective in my patients.  L Our clinic has also tried Sculptra injections into the dimples of cellulite, however, I have not felt that this was effective either.  We are constantly looking for something that works- this I can promise you!

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What are some other treatments that just don’t work?

There are all kinds of ridiculous products on the market and most of them don’t work. I’ve even heard of anti-cellulite pantyhose, which supposedly improve your circulation. Wearing these might give you a cosmetic effect by making your thighs and hips look smoother under your clothes, but they’re not going to make your cellulite go away.

Aromatherapeutic oils are said to melt cellulite away by draining “toxins” from the fat cells. That sounds bogus to me, but if essential oils are used in a deep tissue massage they could be of benefit. And they might even help you feel less stressed about having cellulite!

If there were a magic bullet out there we’d all know about it by now. Treatments can help, but there’s really no replacement for eating a healthful diet and getting enough exercise- especially yoga. It’s also important to remember that just about every woman gets a bit of cellulite eventually, even the thinnest of supermodels. So don’t feel bad—we’re all in the same boat!  Thanks goodness leggings are back in style.

Wishing you great skin!

Dr. Leslie Baumann
Dr. Leslie Baumann

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Last Updated on Monday, 24 May 2010 14:32