What Causes Cellulite?

Several factors contribute to cellulite, including diet as well as a sluggish blood and lymphatic circulation, which allows wastes to accumulate. But three contributing agents determine whether you develop cellulite: heredity, estrogen, and fat. If just one of those ingredients is missing, you don't have cellulite, just plain ordinary fat.

You usually inherit cellulite, that is, if your mom has it -- and by "it" we mean loose connective tissue, which fat globules pop up through -- chances are you do or will too, even if you're thin. As connective tissue weakens with age, the dimpling becomes even more pronounced. If you have thin skin, which is also hereditary, cellulite is even easier to see than it is on thicker skin. If your mother has cellulite, you've probably inherited her loosely woven connective tissue and poor lymphatic drainage, which leads to bunched-up fat cells. And as you now know, cellulite is more than just fat: It's fat trapped by a network of connective tissue fibers. If the underlying network is loosely woven, the fat bulges through the fibers, causing a "cottage cheese" effect on the skin. As connective tissue weakens with age, the dimpling becomes even more pronounced.

The fibers that extend from the muscle up through the fat and connect to the undersurface of the skin run directly up and down, perpendicularly, at a 90-degree angle, which allows bulging and puckering. In men, the fibers I mentioned run in a crisscross, at a 45-degree angle, so the fat is less likely to bulge up like it does in women.

The Estrogen Factor

Once women reach puberty, the body's ovaries begin to produce the hormone estrogen, which helps to store fat in the hips, thighs, and buttocks, in preparation for childbearing. We can also thank estrogen for adding to cellulite's puckered appearance: It makes fat cells sticky, so they bunch together like grapes, contributing to the appearance of cellulite.

Can Dieting Eliminate Cellulite?

Diet plays only a small role in curbing cellulite, because cellulite is basically a genetic, hormonal, and anatomic problem. Dieting can help, especially if you are overweight, but it definitely won't totally solve the problem. In fact, some anorexic women have cellulite. Some overweight women don't show it at all. Danielle M. Schupp, a registered dietitian and sports nutritionist at Reebok Sports Club, New York, New York, who also owns a private consulting practice, recommends that you exercise regularly and eat a low-fat diet in which 20 to 25 percent of your daily intake of calories comes from fat. The example below can serve as a quick guide. You should also realize that individual servings and calorie intake will vary. A registered dietitian can provide you with a customized diet based on your individual weight goals and level of physical activity. Sample 1500 Calorie Plan Breakfast: 1 cup whole grain cereal (5 grams of fiber per serving) with 1 cup skim or low-fat soy milk 1 Tbs. crushed nuts 1 small banana Lunch: 3 ounces turkey on two slices whole grain bread with lettuce and tomato and mustard or low-fat mayonnaise Salad (include red, green, yellow vegetables) with 2 Tbs. vinaigrette dressing Snack: 1 cup nonfat yogurt 1 cup cantaloupe Dinner: 4 ounces grilled fish, chicken, or lean red meat 1 small baked sweet potato with one tsp. whipped butter 1 cup steamed broccoli Snack: 1 glass skim milk 1 apple Serving Guide: 80-100 Calories per Serving Corn and peas: 1/2 cup Yam and potato: 1 small potato (3 oz.) 1/2 bagel: 2 oz. Pasta/grains/rice: 1/2 cup Pretzels: 3/4 ounce A diet high in insoluble fiber (wheat bran, fruits, veggies) and with plenty of water and accompanied by lots of physical activity is the best way to achieve a "clean" system. Green tea also can help clean out your system. Remember, when you reduce the amount of fat in your diet, you reduce the amount of calories you consume. For instance, there are only four calories per gram of carbohydrates and protein, but there are nine calories per gram of fat. So, for every gram of fat you eliminate from your diet, you get double the benefit in terms of weight loss that you would get for every gram of protein or carbohydrates that you eliminate from your diet. But, do not eat less than 20 percent of your calories from fat. Cellulite Treatment that Don't Work Creams and Potions Cellulite is a three-dimensional problem that involves the entire fatty layer and extends all the way from under the surface of the skin down to the muscle. Consequently, topically applied creams have little chance of success at busting cellulite. No cream applied to the skin's surface can penetrate completely through the skin, cause the fat cells to detach from each other, improve the lymphatic circulation, and reduce the skin's swelling. If applying lotion seems to bring any improvement at all, it's probably due to massaging or rubbing in the cream, which can lessen the swelling and improve the lymphatic drainage in the area. However, whatever minor, and temporary, improvement you might gain has nothing to do with the active ingredient in the cream, which does nothing at all to cellulite. Ultrasound Ultrasound is an interesting concept for combating cellulite. Unfortunately, no benefit in terms of reducing or eliminating or in any way changing the composition of cellulite has ever been derived from zapping it with ultrasound. Liposuction Contrary to popular belief, cellulite is not an indication for liposuction. Liposuction is terrific for removing excess deposits of fat or bulges (places where fat cells clump together). That's why it's perfect for love handles, bulges at the thighs, abdomen, hips, upper arms, and other such fat deposits. So, if you need to debulk unwanted fat cells, lipo works. However, if you have a good silhouette (no obvious bumps or lumps) when wearing leggings and a bodysuit, but you still have cellulite, then liposuction won't get rid of the ripples and dimples. Bottom line: Liposuction can remove excess fat cells, but it cannot affect how they organize themselves or their general structure. The Newest Discovery: Cellasene Again, put your money back in your pocket and don't waste it on Cellasene, the expensive new herbal anticellulite product from Italy. This is merely a magical-sounding mixture of common supplements, which are touted by the product's manufacturer to increase blood circulation, reduce fluid buildup, and stimulate metabolism. None of the cited studies have been peer-reviewed, and the studies lacked proper controls. Cellasene seems to contain nothing more than several herbs that have no effect on the biology of the human body. Bottom line: Save your money.

Cellulite Treatments that Can Work

Because cellulite is a three-dimensional problem under the skin all the way down to the muscle, and because it has to do with fat cells swelling up and sticking and bunching together, no topical cream is likely to have much effect. Therefore, the only treatment options with any chance of success are those that involve manipulation of the full thickness of the fatty layer.

Deep Tissue Massage

Currently, the only treatment available that has been shown to offer any benefit at all for cellulite is deep tissue massage. This procedure goes by several trade names, including Endermologie, by LPG, and Silhouette, by Luxar. This course of therapy consists of a series of treatments, usually two treatments a week, each lasting about 35 minutes, for 8 to 10 weeks.

How It Works: A physician or a physician's assistant moves a machine, basically a vacuum with two rollers attached to the end of a hose, across the cellulite-plagued area. The suction action of the machine results in a very deep massage. Supposedly, as the machine massages, the motion "wrings" the extra fluid out of the swollen fat cells and out from between the cells, in the process improving the lymphatic drainage. The effect is to convert the fat from a group of clumped-up, swollen grapes to rows of eggs all neatly stacked in a row, letting the skin lie smoothly on top. In theory, this sounds wonderful. In real life, the results can vary from modest to rather impressive.

Cost: $100 a session; a minimum of 14 sessions performed twice a week for several weeks are recommended.

Drawback: The improvement is temporary. If you decide to undergo the deep massage process, you must commit to a long treatment time (at least 14 treatments).

Exercise

One way to specifically target the fat under the loose skin is to firm up the muscle under the skin, which will make the skin look tighter and smoother. Fitness expert Joyce L. Vedral, Ph.D., in her cellulite-fighting book Bottoms Up! (Warner), uses super sets, doing two exercises one after another quickly, with each exercise hitting a different muscle group, which allows one set of muscles to relax while another set is being worked to exhaustion. This helps to build tone and muscle, which smooths out the appearance of cellulite and makes the skin look firmer. An added benefit of exercise: It helps get your circulation going.

However, because of the swelling of the fat cells and the matrix of the connecting fibrous bands, exercise alone won't solve the problem. I see many patients who are in excellent shape and condition, including professional athletes, who suffer from cellulite. Others are couch potatoes and have no cellulite. Go figure.

Tanning

Tanning the area where you have cellulite can make it appear less noticeable. However, the sun causes collagen in the skin to stretch and change, which can actually magnify the look of cellulite. So, nix the sun. A better bet is to apply a self-tanning product (Try either Neutrogena Sunless Tanning Spray or Physicians Formula Sunless Tanning Lotion.) To self-tan: First, gently rub an exfoliating cream onto the area to rid it of all dead skin cells. Rinse it off in the shower, and dry thoroughly with a towel. Next, apply the self-tanner, using a circular upward motion. Lie on your stomach on a towel as the cream dries.