A guide to cellulite: why it appears and what to do about it

What is cellulite?

Dermatocosmetologist, expert of the Council on Cosmetic Safety of the European Union, founder of Meder Beauty Sciences Lab (Switzerland), Tiina Orasmäe-Meder describes cellulite as follows:

“Cellulite today is defined as an age-related estrogen-dependent structural pathology of subcutaneous fat tissue, manifested by lymphostasis, venous stagnation and fibrosis of certain areas.
Despite the fact that this problem is certainly aesthetic and does not fall under the definition of a “disease,” under certain conditions, severe cellulite leads to discomfort and a deterioration in the quality of life, and is sometimes even accompanied by health problems. The psychological significance of the defect can be extremely high and often leads women of a certain psychological type to depression, nervous breakdowns and dysmorphophobia.”

Structure

The main reserves of fat in the body are located in subcutaneous fat. This is part of the deepest layer of the skin - the hypodermis. There are also collagen and elastin fibers, nerve endings, blood vessels, lymphatic vessels, and sweat glands.

A fat cell consists of 90-95% fat, it can greatly increase in size, accumulating more and more fat inside itself, and “deflate”, losing fat and decreasing in size (but not completely disappearing from the body). You can read more about fat here.

Subcutaneous fat also contains connective tissue fibers - collagen and elastin, which surround fat lobules, that is, groups of fat cells, and form a network with cells.

Walking on your buttocks

There are many exercises for the hips and buttocks, but not all of them are suitable for doing at home, and they also do not always give quick results. The most effective and ideal for independent performance is considered to be “walking” on your butt. There is no titanic effort, and the smoothness of the skin returns within a month.

You need to walk on the fifth point back and forth and in circles for a quarter of an hour - 2 minutes of walking alternated with 30 seconds of rest. The first lesson should start with 10 minutes, and then in a week increase to 15. During the exercise, they constantly change direction, it should be taken into account that it is always more difficult to walk backwards, and also increase the pace, but be sure to take a break of half a minute between approaches. If you do the exercise daily, then in a month the skin on the fifth point will become smooth.

Walking on the buttocks for weight loss

Walking on your butt is beneficial not only for the buttocks, but also for the waist, abdomen, and sides. It is an excellent prevention for problems of the lumbar spine, which inevitably sooner or later make themselves felt when a person spends most of his time in one position and practically does not move. To make walking fun and interesting, you can turn on your favorite rhythmic music.

Among other exercises, in addition to “walking” on the fifth point, squats from the knees to the side, oblique lunges from a standing position, as well as squeezing the buttocks when performing a bridge on the shoulders are suitable for variety in home training.

Why does cellulite appear?

Cellulite is a change in the structure of subcutaneous fat in problem areas where blood circulation and lymph flow deteriorate, congestion and swelling appear, where tissues lack nutrients and oxygen.

Cellulite has four signs that mutually reinforce each other:

1. Violation of microcirculation of blood and lymph.
2. Increase in subcutaneous fat (layer of subcutaneous fat).
3. Increase and thickening of connective tissue.
4. Action of sex hormones.

Violation of microcirculation of blood and lymph

This is often where cellulite begins.

The skin has a branched and deep vascular network, represented by both large vessels: arteries, veins, lymphatic vessels, and small ones - capillaries. It is through the walls of capillaries that cells exchange water and gases with the blood (they receive oxygen and give off carbon dioxide), receive nutrients and hormones. Lymphatic capillaries remove excess fluid, proteins and metabolic products from tissues.

The effective operation of the capillary system directly depends on the condition of large vessels - if the venous outflow is disrupted, the circulation of blood and lymph slows down. Stagnation of fluid in the vessels stretches their walls, disrupts their elasticity, leads to an increase in the permeability of the walls and the release of fluid out into the space between the cells. As a result, swelling occurs and pressure in the tissues increases.

In a vicious circle, swelling contributes to even greater disruption of microcirculation, and substances released when the walls of blood vessels are damaged cause the thickening of connective tissue partitions, which, squeezing the lobules of adipose tissue, create unevenness on the skin.

If a fat cell loses connection with the microvasculature (with capillaries), the transport pathways are disrupted, and something like a “sewer blockage” is formed.

Thus, lymphostasis and impaired venous circulation are one of the causes of cellulite in the early stages.

Tiina Orasmäe-Meder: “Cellulite and varicose veins almost always form a vicious circle. Varicose veins aggravate the severity of cellulite. Stage 3-4 cellulite, in turn, can cause difficulty in venous outflow in the lower extremities and contribute to the development of varicose veins.”

Increase in subcutaneous fat

When the body takes in more calories than it expends, the excess energy is stored in fat cells. The enlarged adipocytes become crowded, they begin to put pressure on each other and go beyond the cells of the connective tissue, pushing through it, like a mattress through a mesh bed frame.

Connective tissue fibrosis

Slender women have cellulite, and this suggests that excess weight is an important, but not the main cause of cellulite.

Swelling and an increase in the viscosity of the intercellular fluid lead to cell deformation and compression of blood vessels, which causes hypoxia (lack of oxygen) in the tissues. The production of lactic acid under these conditions activates proline hydroxylase, an enzyme that is involved in collagen synthesis.

As a result, the connective tissue loses its elasticity, becomes stiff, and the fibers themselves become larger and knots appear. This subsequently leads to fibrosclerosis in the connective tissue septa: the formation of hard, inelastic fibrous tissue similar to scar tissue.

Hormones

Another “trigger” for the formation of cellulite is female sex hormones.

Estrogens increase the activity of enzymes responsible for storing fat, which causes fat cells to increase in size. On the membrane of each fat cell there are two types of receptors that control the processes of accumulation/breakdown of fat inside it:

1. Alpha receptors. They stimulate the formation of new fat and its accumulation (lipogenesis).
2. Beta receptors. They stimulate the release of fat from the fat cell for its subsequent breakdown (lipolysis).

Women's buttocks and thighs have much more receptors responsible for lipogenesis. Fat accumulation under the influence of estrogen occurs first in these areas, and it is difficult to get rid of it using traditional methods. It is assumed that this fat is used as a source of energy for breastfeeding in case the energy supply from food is insufficient.

Estrogens also increase the level of hyaluronic acid in the dermis, which increases the amount of intercellular fluid and converts soluble collagen into insoluble. All together, this leads to the formation of nodes of different sizes, visible on the surface of the skin (see previous paragraph).

Why does cellulite appear and what factors contribute to its formation?

Orange peel is the result of fluid stagnation, which leads to the accumulation of large amounts of collagen fibers in adipose tissue. This interferes with microcirculation. The lack of active lymph and blood flow, impaired metabolism lead to the restructuring of adipose tissue.

Among the factors that provoke cellulite are the following:

• smoking;
• pregnancy and childbirth;
• eating disorders;
• weight gain and loss, especially as a result of crash diets;
• abortion;
• lack of physical activity.

Female representatives are most susceptible to the problem.

There is no miracle cure that can completely remove cellulite from your thighs, legs and butt. If you resort exclusively to massage or body wrap, you cannot lose 5-15 kilograms. Measures must be comprehensive.

An extremely versatile approach, which includes four mandatory conditions, allows you to achieve an effect:

1. special nutrition (anti-cellulite), supplemented by walking;
2. lymphatic drainage dry massage;
3. a special exercise aimed at combating orange peel;
4. wrap performed on problem areas.

If you strictly follow each point, the results will not take long to arrive, and your skin will regain its smoothness.

Stages of cellulite

Cellulite occurs in several stages, and each has its own symptoms.

Stage 1

Edema. There is an increase in the permeability of capillary walls, accumulation of intercellular fluid between fat cells. The fluid compresses the lymphatic vessels, which disrupts the outflow of lymph, which results in the appearance of local swelling. Cellulite becomes visible under pressure or under certain lighting.

Without compression, it may appear in the second half of the cycle. Many women have this form of cellulite.

Stage 2

Chronic stagnation of lymph, venous stagnation in the subcutaneous fatty tissue of problem areas. Cellulite becomes visible when standing and disappears when lying down (“soft” cellulite).

Stage 3 (A and B)

In addition to chronic stagnation of lymph and blood, changes in connective tissue are added. At stage 3A, fibrosis may remain local, i.e. appear in small areas. At stage 3B it becomes widespread.

Microcirculation deteriorates even more, the skin turns pale, becomes colder, and burst blood vessels appear. Cellulite is visible both in a standing position and locally in a lying position (“hard” cellulite).

Stage 4

Fusion of micronodules of connective tissue with the formation of macronodules, mobile and painful when pressed. Cellulite is visible both in a standing position and in a lying position along the entire surface of the thigh. Widespread fibrosis and local sclerosis (scars in connective tissue).

How to get rid of cellulite?

There is no magic method; everything works only in combination and depends on the stage of cellulite. An integrated approach consists of three areas:

1. Home care: proper nutrition and diet, sports, active lifestyle, giving up bad habits and everything that falls under a healthy lifestyle, as well as self-massage and creams.
2. Professional procedures.
3. Treatment of varicose veins.

Proper nutrition

Fat- and cellulite-burning products do not exist in nature. Neither grapefruits, nor ginger, nor spices, nor detox diets work for these purposes. The internal processes occurring in the subcutaneous fat tissue, as well as the level of hormones, cannot be directly influenced by food.

By following a diet with a calorie deficit, you can reduce the volume of problem areas, and by reducing the layer of fat on the hips and buttocks, cellulite will visually become smaller. By giving up foods that are too salty and high in carbohydrates, you can partially get rid of swelling. But you shouldn’t hope to completely get rid of cellulite through diet.

Eliminate smoked, pickled, salty, fatty, and alcohol from your diet. Choose minimally processed whole foods - vegetables, grains, meat, fish, poultry, healthy (vegetable and omega-3) fats. Drink enough clean water.

In the second half of the cycle, many women are prone to swelling, which makes cellulite more visible. Therefore, it is especially worth excluding salty and pickled foods here. You can also use herbal teas with a mild diuretic effect if you have no contraindications (consult your doctor).

Sport

A sedentary lifestyle impairs venous outflow and lymph circulation, which increases cellulite.

Both strength training and cardio improve blood circulation, strengthen the walls of blood vessels, help get rid of swelling and, of course, excess fat. But there are no special “anti-cellulite” exercises, and it is impossible to lose weight in the desired area by working it in different ways, be it the stomach, buttocks or thighs. The pumped muscle and fat are not directly related, and a burning sensation in the muscle is not an indicator that the fat is “melting.”

Mobility during the day outside the gym also plays a big role: walk more, don’t sit in one position for a long time, use elevators and transport less. If you are on your feet for a long time, wear comfortable shoes. Avoid clothes that are too tight.

Massage

Massage improves blood circulation and lymph flow, eliminates intercellular swelling. But it does not get rid of fat: fat cannot be mechanically squeezed out of a fat cell with your hands. Under no circumstances should the massage be painful or cause bruising or damage to blood vessels. Instead of benefiting, such a massage can worsen the problem.

Creams, wraps

At stage 1, creams can help in combination with other methods, improving microcirculation (especially against the background of massage).

Professional treatments

LPG (endermology)

The method has been used for more than 40 years. Its essence is a mechanical effect on the skin and subcutaneous layer using a “handle” - two simultaneously rotating rollers that grab a layer of skin, form a fold from it and simultaneously apply a light vacuum to it. The procedure is aimed at eliminating congestion and swelling, but not at getting rid of fat.

Pressotherapy

Mechanical lymphatic drainage. During the session, the body is alternately exposed to periods of vacuum and barocompression, which are created by the movement of a wave of compressed air in the cuffs worn. There is an improvement in blood and lymph circulation and elimination of edema. The procedure does not remove excess fat.

Ultrasonic cavitation

Under the influence of low-frequency ultrasound with parameters of 38-41 kHz, a pressure of 0.6 kPa and a certain flow density, a cavitation effect occurs in the fat cells of the treated area - the formation of a large number of microbubbles. They increase in size and liquefy fat. When bubbles collapse inside a fat cell, a hydrodynamic shock occurs, a kind of micro-explosion that damages the cell membranes, and first of all, the most crowded ones. Most of the fats that enter the intercellular space (up to 90%) are excreted through the lymphatic system, 10% enters the bloodstream.

The procedure is not recommended for diseases of the liver and biliary tract and is not used for general weight loss if you are overweight.

RF therapy

RF therapy is high-frequency electric current. Electrical impulses create an electric field in the subcutaneous fat, heating it. When heated, the fat in the cells breaks down into its constituent glycerol and fatty acids, which are then removed from the body with the help of lymph, and then through the excretory system. It is also not recommended for diseases of the liver and biliary tract.

Liposuction

Heavy artillery. A surgical operation in which fat is removed using vacuum suction. The method is suitable when local fat deposits are very pronounced and cannot be removed by other methods. Disadvantages - the operation is traumatic and the consequences of surgical intervention can be lymphostasis and sclerosis of the tissue, as well as hematomas and a long recovery period. With an excess of calories in the diet, fat will be deposited in other areas. That is, liposuction does not solve the problem of excess weight unless the lifestyle is changed and proper nutrition is not established.

Mesotherapy

Mesotherapy is the introduction of active substances using numerous injections into the subcutaneous fat. The substances are designed to break down fat cells or fibrous connective tissue, improve vascular tone, etc. Thus, these are means of local fat loss.

The method has its drawbacks:

There are complications in the form of bacterial contamination of subcutaneous fat when using an injection gun. This can cause inflammation of the deeper layers as a result of infection with streptococci, often living on the surface of the skin.

The disadvantages also apply to the compositions of cocktails for injections. Many drugs have a damaging effect (dissolution of the membranes of fat cells or fibrous nodes). Thus, the well-known phosphatidylcholine is prohibited in France, since there are known cases of tissue necrosis due to its inaccurate administration.

In addition, regular and numerous injections can worsen cellulite - due to local stress, the release of inflammatory mediators and possible fibrosis at the site of damage.

Tiina Orasmäe-Meder: “Every year there are lawsuits regarding complications. In the USA, several years ago, the Association of Plastic Surgeons and Dermatocosmetologists vetoed the use of mesotherapy and refused to provide legal assistance to doctors who work with it - it is too expensive. In general, the method came from veterinary medicine: mesotherapy was used to increase milk yield and introduce circulation stimulants into the udder tissue of cows. He should have stayed there."

What Science Says

Science is not encouraging. “There are a huge number of cellulite reduction products and treatments available on the market, but no systematic review has been conducted to date to assess their effectiveness.”

A systematic review of the scientific evidence on the effectiveness of cellulite treatments was carried out (Luebberding S, et al. Cellulite : an evidence-based review.

Am J Clin Dermatol. 2015)

What is a systematic review? This is a type of scientific research in which scientists search for all existing studies and publications that meet strict criteria. Then they are systematized, the results are summarized and a conclusion is drawn. This review is of greater value than a single study because it allows us to exclude various random and methodological errors and bias of the authors of individual studies.

A total of 67 scientific articles were examined for compliance with the following conditions:

• the presence of a control group (for comparison with the one receiving treatment);
• randomization (distribution into groups in random order);
• blind method;
• a large number of participants so that there are no statistical errors;
• description of the statistical methods used;
• results and level of evidence.

Most studies, including laser, light, radiofrequency, and other methods, had serious methodological flaws, did not include all conditions, or did not provide sufficient statistical analysis. Therefore, of the 67 studies, only 19 were eligible and included in the systematic review.

Conclusions: No clear evidence of effectiveness was found in any of the cellulite treatments examined in the review. However, there was some evidence of potential effectiveness for shock wave therapy and the 1440 nm Nd:YAG laser.

Treatment of varicose veins

Considering the close relationship between cellulite and varicose veins, in addition to anti-cellulite procedures, it is necessary to engage in the diagnosis and treatment (prevention) of varicose veins. To do this, you should contact a phlebologist.

For varicose veins, the following are contraindicated: strong mechanical pressure, vacuum, warming procedures. It is necessary to carry out gentle lymphatic drainage, apply external agents that have a venoprotective effect, wear compression garments and take medications (both are prescribed only by a doctor).

dietary supplements

Various nutritional supplements deserve a separate point as the easiest way for women to get rid of cellulite.

What does not work:

Diuretics - diuretics

With the loss of fluid, body volumes decrease, and the manifestations of edematous cellulite go away quite quickly. But diuretics have many side effects and complications. External: dryness and flaking of the skin, decreased tone, the appearance of fine wrinkles in the eye area and around the mouth. Internal, hazardous to health: heart rhythm disturbances, increased blood viscosity, risk of blood clots, kidney failure. A bonus is the addiction to the drug and the body’s inability to independently remove fluid that develops over time.

Calorie blockers

Medicines that block enzymes that break down carbohydrates/fats, causing unprocessed carbohydrates/fats to be eliminated from the body and fewer calories to be absorbed by the body. Side effects: bloating, flatulence and indigestion as a result of the high content of carbohydrates and fats in the stool. These drugs change eating behavior for the worse: a person gets used to eating more, because half of it is not digested. Therefore, upon withdrawal, rapid weight gain often occurs, because the person has not acquired useful and healthy eating habits.

Special anti-cellulite complexes

Plant extracts, extracts, biologically active complexes. There is no particular benefit and no particular harm - drugs that can interfere with the internal processes of the body bring not only benefits, but also have side effects, therefore they are medicines, not dietary supplements. Here, the risks can only be associated with individual intolerance to the components.

Sportspit: fat burners

Fat burners are not as effective for weight loss as they interfere with the functioning of various organs and systems, are addictive, and have many side effects. In addition, excess weight is not the only and not the main cause of cellulite.

Fat burners are divided into groups:

• Thermogenics. Stimulate the central nervous system, suppress appetite, increase motor activity. Side effects: irritability, anxiety, trembling and tremor, insomnia, palpitations, arrhythmia, there is addiction and withdrawal effects.
• Anorectics are appetite suppressants. They suppress the hunger center and stimulate the satiety center. Side effects: heart failure, heart valve damage, agitation and insomnia.
• Thyroid stimulants. These are drugs that increase the hormonal activity of the thyroid gland or are themselves hormones. Intervention in the functioning of the thyroid gland without indications can lead to secondary hypothyroidism, i.e. the organ will stop producing hormones due to constant stimulation. This threatens serious metabolic disorders and hormone replacement therapy throughout life.

What works in the complex:

Medicines for the prevention and treatment of varicose veins

They usually contain diosmin, hesperidin, etc. They increase the density and elasticity of blood vessels, thin the blood, and relieve swelling. Must be prescribed by a doctor according to indications.

Light herbal diuretics

In the second half of the cycle, many women are prone to swelling. In order to reduce swelling, you can use herbal teas with a mild diuretic effect at this time, unless you have contraindications to a specific drug (consult your doctor before taking).

Self-massage

There are many different devices for home massage - from special shower heads to massage vacuum cans. Considering that no massage can destroy fat cells (only hardware methods can do this), its task is to improve microcirculation in problem areas and lymphatic drainage. One of the effective and vein-friendly types is self-massage with a brush.

Masks for stretch marks

A mask with added yeast will make stretch marks on the buttocks less noticeable. It has a nourishing effect, tones, makes the skin softer and silkier. 15 g of yeast are poured into 100 ml of heated cream, mixed and left in a warm place until the yeast starts working: persistent foam appears on the surface.

Then add 50 g of honey, previously melted in a water bath, to the mixture, mix and treat the skin with stretch marks. Leave for 30 minutes, then rinse with water and dry the skin with a towel.

Masks with honey and ginger will help you quickly get rid of stretch marks on your butt

The ginger mask has an irritating effect on the skin, which increases blood flow, which means skin renewal accelerates. As a result, the stretch marks are smoothed out.

It is necessary to do a preliminary test for an allergic reaction, since ginger can cause itching and burning.

In one bowl, mix 30 g of white clay powder, powdered ginger (30 g) and mineral water (100 ml). Mix all ingredients and apply to stretch marks. Leave for 15-20 minutes and then wash off with water. Dry the skin with a towel and apply moisturizer.

Bottom line

In order not to turn life into a struggle, it is worth remembering that:

• 90% of women have cellulite and this is an age-related change in subcutaneous fat tissue.
• Poor nutrition, stress, bad habits, lack of exercise and a sedentary lifestyle - all this greatly affects the manifestation and progression of cellulite.
• There is not a single drug/procedure/other method by which you can 100% get rid of cellulite, once and for all.
• Small amounts of cellulite can also occur in those who have been exercising regularly for a long time and following a healthy diet.
• The problem can be partially solved by an integrated approach, that is, changing lifestyle and using different methods simultaneously.
• There is a line where healthy care of appearance ends and the mania for getting rid of any signs of cellulite begins, requiring more and more resources (time, money).

Exercise to reduce stretch marks

It is recommended to use exercises in combination with other methods. They help achieve skin elasticity, increase its tone, and get rid of cellulite. They contribute to the activation of metabolic processes, saturation of blood with oxygen, and its flow to damaged skin. But as an independent means, exercises will be ineffective.

Here are some exercises to help reduce stretch marks on your butt and thighs:

1. The exercise is aimed at strengthening the thigh muscles. You need to sit on a chair and straighten up. Hands rest on the sides of the seat. Alternately raise and lower your legs. It is necessary to do three cycles of 20 repetitions.
2. Lay on your back, legs bent at an angle of 90°. Raise your left (or right) leg up first. Pause for a few seconds and lower your leg, returning back. Repeat the same movements for the other leg. It is enough to perform 3 cycles of 10 repetitions.
3. From a supine position, stretch the right leg up and stretch so that there is a feeling of tension in the buttocks. Repeat the exercises for the left leg. Do three cycles of 15 repetitions.
4. Lying on your stomach, spread your arms to the sides. Alternately lift one leg up and at the same time stretch the toe up. Perform two cycles of 10 exercises.
5. They do lunges. From the stand straight, hands on the belt, legs brought together, take a wide step forward and sit down, leaning on the leg in front. You need to lock in this position for 10-20 seconds, then return back. Do the same for the other leg. Repeat 5-10 times.
6. Squats. Standing straight, legs slightly apart, hands clasped at the back of the head, begin to do a slow squat, while the calves are tense. Return to the starting position. Do 5-10 repetitions per cycle and 2-3 cycles.
7. From a standing position on hands and knees, lift up either the right or left leg, and then return to the starting position. Do up to 10 repetitions. You can lift either a straight leg or a leg bent at an angle of 90 degrees.
8. Mahi. Standing with your feet shoulder-width apart, hands on your belt, make 5-10 swings with your straight leg, alternately back and forth, then to the side.
9. It is also recommended to jump rope for a few minutes a day.
10. You can combine a partial squat with raising your toes and spreading your knees. This is the so-called plie squat.

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