Cellulite

Last updated
Cellulite
Other namesAdiposis edematosa, dermopanniculosis deformans, status protrusus cutis, gynoid lipodystrophy, orange peel syndrome
Dimpled appearance of cellulite.jpg
The dimpled appearance of cellulite
Specialty Plastic surgery

Cellulite or gynoid lipodystrophy (GLD) is the herniation of subcutaneous fat within fibrous connective tissue that manifests as skin dimpling and nodularity, often on the pelvic region (specifically the buttocks), lower limbs, and abdomen. [1] [2] Cellulite occurs in most postpubescent females. [3] A review gives a prevalence of 85–98% of women of European descent, [4] but it is considerably less common in women of East Asian descent. [5] [6] It is believed to be physiological rather than pathological. It can result from a complex combination of factors, including diet, sedentary lifestyle, hormonal imbalance or heredity, among others.

Contents

Causes

The causes of cellulite include changes in metabolism, physiology, diet and exercise habits, obesity, alteration of connective tissue structure, hormonal factors, genetic factors, the microcirculatory system, the extracellular matrix, and subtle inflammatory alterations. [1] [3] [7]

Hormonal factors

Hormones play a dominant role in the formation of cellulite. Estrogen is thought to be an important hormone in the development of cellulite, and it has been proposed that an imbalance of estrogen relative to progesterone may be associated with cellulite. However, there has been no reliable clinical evidence to support the claim that estrogen levels are linked to cellulite, and many women with elevated estrogen levels do not get cellulite. [8] Other hormones—including insulin, the catecholamines adrenaline, cortisol and noradrenaline, thyroid hormones, and prolactin—are believed to participate in the development of cellulite. [1]

Genetic factors

There is a genetic element in individual susceptibility to cellulite. [1] Researchers have traced the genetic component of cellulite to particular polymorphisms in the angiotensin converting enzyme (ACE) and hypoxia-inducible factor 1A (HIF1a) genes. [9] Evidence for the heredity of cellulite is supported from studies showing that both the presence and degree of cellulite is similar between females within the same family. [6]

Predisposing factors

Several factors have been shown to affect the development of cellulite. Sex, ethnicity, biotype, distribution of subcutaneous fat, and predisposition to lymphatic and circulatory insufficiency have all been shown to contribute to cellulite. [1] It has been found to be considerably less common in women of East Asian descent, than in white women. [5]

Lifestyle

A high-stress lifestyle causes an increase in the level of catecholamines, which have also been associated with the development of cellulite. [1] Inactivity can cause vascular stasis, contributing to cellulite formation. [5] Excessive carbohydrate consumption may also be related to cellulitis in some instances. [5]

Treatments

Cellulite can be resistant to a variety of treatments. [10] Aside from "topical" products (creams, ointments) and injectables (collagenase), treatments for cellulite include non-invasive therapy such as mechanical suction or mechanical massage. Energy-based devices include radio frequency with deep penetration of the skin, ultrasound, [11] cryotherapy chambers, [12] laser and pulsed-light devices. [13] [14] Combinations of mechanical treatments and energy-based procedures are widely used. [13] Ionithermie, a form of electrotherapy using electrical muscle stimulation, has been described as ineffective. [15] [16] More invasive 'subcision' techniques utilize a needle-sized microscalpel to cut through the causative fibrous bands of connective tissue. Subcision procedures (manual, vacuum-assisted, or laser-assisted) are performed in specialist clinics with patients given local anaesthetic. [14]

Epidemiology

In European populations, cellulite is thought to occur in 80–90% of post-adolescent females. [9] [17] Its existence as a real disorder has been challenged, [18] and the prevailing medical opinion is that it is merely the "normal condition of many women". [19] It is rarely seen in males. [1]

History

The growing interest in cellulite has historically been linked to the growth of the cosmetic industry in the west, as well as globalization. The term was first used in the 1920s by spa and beauty services to promote their services, and began appearing in English-language publications in the late 1960s, with the earliest reference in Vogue magazine, "Like a swift migrating fish, the word cellulite has suddenly crossed the Atlantic." [20] According to Italian researcher Martina Grimaldi, cellulite has often been pathologized as a "disease" in Western European news media, and it has been shown that French magazines promoting this misinformation are often funded by pharmaceutical companies that manufacture anti-cellulite skincare products. [21] American journalist Susan Faludi notes that the Western beauty advertisements have attempted to portray cellulite as a symptom of women's social progress; that cellulite is caused by being a working, independent woman. Faludi writes that such messaging is motivated by a fear within the cosmetic industry that women's social progress might lead to declining profits in the beauty industry as a whole, noting that profits did decline in the 1970s and 1980s, the era of second-wave feminism. [22]

Related Research Articles

<span class="mw-page-title-main">Acne</span> Skin condition characterized by pimples

Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to lack of confidence, anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.

Mesotherapy is a form of alternative medicine which involves intradermal or subcutaneous injections of pharmaceutical preparations, enzymes, hormones, plant extracts, vitamins, and/or other ingredients such as hyaluronic acid. It has no proven clinical efficacy and poor scientific backing. Mesotherapy injections allegedly target adipose fat cells, apparently by inducing lipolysis, rupture and cell death among adipocytes. The stated aim of mesotherapy is to provide the skin with essential nutrients, hydration, and other beneficial compounds to rejuvenate and revitalize its appearance.

<span class="mw-page-title-main">Rosacea</span> Skin condition resulting in redness, pimples and swelling, usually on the face

Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often, the nose, cheeks, forehead, and chin are most involved. A red, enlarged nose may occur in severe disease, a condition known as rhinophyma.

Antipruritics, abirritants, or anti-itch drugs, are medications that inhibit the itching often associated with sunburns, allergic reactions, eczema, psoriasis, chickenpox, fungal infections, insect bites and stings like those from mosquitoes, fleas, and mites, and contact dermatitis and urticaria caused by plants such as poison ivy or stinging nettle. It can also be caused by chronic kidney disease and related conditions.

<span class="mw-page-title-main">Periorbital dark circles</span> Medical condition

Periorbital dark circles are dark blemishes around the eyes. There are many causes of this symptom, including heredity and bruising.

<span class="mw-page-title-main">Telangiectasia</span> Small dilated blood vessels

Telangiectasias, from Greek: tel- (end) + angi- + ectasia, also known as spider veins, are small dilated blood vessels that can occur near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. These dilated blood vessels can develop anywhere on the body, but are commonly seen on the face around the nose, cheeks and chin. Dilated blood vessels can also develop on the legs, although when they occur on the legs, they often have underlying venous reflux or "hidden varicose veins". When found on the legs, they are found specifically on the upper thigh, below the knee joint and around the ankles.

<span class="mw-page-title-main">Stretch marks</span> Form of scarring

Stretch marks, also known as striae or striae distensae, are a form of scarring on the skin with an off-color hue. Over time they may diminish, but will not disappear completely. Striae are caused by tearing of the dermis during periods of rapid growth of the body, such as during puberty or pregnancy, in which they usually form during the last trimester. Usually on the belly, these striae also commonly occur on the breasts, thighs, hips, lower back, and buttocks. Pregnancy-related striae are known as striae gravidarum. Striae may also be influenced by the hormonal changes associated with puberty, pregnancy, bodybuilding, or hormone replacement therapy. There is no evidence that creams used during pregnancy prevent stretch marks. Once they have formed there is no clearly effective treatment, though various methods have been attempted and studied.

The management of hair loss, includes prevention and treatment of alopecia, baldness, and hair thinning, and regrowth of hair.

<span class="mw-page-title-main">Pattern hair loss</span> Medical condition

Pattern hair loss (also known as androgenetic alopecia (AGA)) is a hair loss condition that primarily affects the top and front of the scalp. In male-pattern hair loss (MPHL), the hair loss typically presents itself as either a receding front hairline, loss of hair on the crown (vertex) of the scalp, or a combination of both. Female-pattern hair loss (FPHL) typically presents as a diffuse thinning of the hair across the entire scalp.

Acne fulminans is a severe form of the skin disease, acne, which can occur after unsuccessful treatment for another form of acne, acne conglobata. The condition is thought to be an immunologically induced disease in which elevated level of testosterone causes a rise in sebum and population of Cutibacterium acnes bacteria. The increase in the amount of C acnes or related antigens may trigger the immunologic reaction in some individuals and lead to an occurrence of acne fulminans. In addition to testosterone, isotretinoin may also precipitate acne fulminans, possibly related to highly increased levels of C acnes antigens in the patient's immune system. Acne fulminans is a rare disease. Over the past several years, fewer cases of this disease have occurred, possibly because of earlier and better treatment of acne. Approximately 100 patients with acne fulminans have been described.

<span class="mw-page-title-main">Cutis verticis gyrata</span> Medical condition

Cutis verticis gyrata is a medical condition usually associated with thickening of the scalp. The condition is identified by excessive thickening of the soft tissues of the scalp and characterized by ridges and furrows, which give the scalp a cerebriform appearance. Clinically, the ridges are hard and cannot be flattened on applying pressure. Patients show visible folds, ridges or creases on the surface of the top of the scalp. The number of folds can vary from two to roughly ten and they are typically soft and spongy. The condition typically affects the central and rear regions of the scalp, but sometimes can involve the entire scalp.

Feminizing hormone therapy, also known as transfeminine hormone therapy, is hormone therapy and sex reassignment therapy to change the secondary sex characteristics of transgender people from masculine or androgynous to feminine. It is a common type of transgender hormone therapy and is used to treat transgender women and non-binary transfeminine individuals. Some, in particular intersex people but also some non-transgender people, take this form of therapy according to their personal needs and preferences.

Carboxytherapy is a non-surgical cosmetic medicine treatment for dermatology. Carboxytherapy employs injections or transdermal application to infuse gaseous carbon dioxide below the skin into the subcutaneous tissue through a needle or skin. It has a necrotizing effect on fat tissue fat cells, stimulate blood flow, improve the skin's elasticity and reduce the appearance of cellulite It has also become a popular treatment for stretch marks. It is non-toxic and less invasive than operations like liposuction. Carboxytherapy leads to a temporary decrease in subcutaneous fat but has shown to reoccur again after a 28 week period. It can be applied for those with androgenic alopecia or alopecia areata.

Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. Effects of menopause can include symptoms such as hot flashes, accelerated skin aging, vaginal dryness, decreased muscle mass, and complications such as osteoporosis, sexual dysfunction, and vaginal atrophy. They are mostly caused by low levels of female sex hormones that occur during menopause.

Genital leiomyomas are leiomyomas that originate in the dartos muscles, or smooth muscles, of the genitalia, areola, and nipple. They are a subtype of cutaneous leiomyomas that affect smooth muscle found in the scrotum, labia, or nipple. They are benign tumors, but may cause pain and discomfort to patients. Genital leiomyoma can be symptomatic or asymptomatic and is dependent on the type of leiomyoma. In most cases, pain in the affected area or region is most common. For vaginal leiomyoma, vaginal bleeding and pain may occur. Uterine leiomyoma may exhibit pain in the area as well as painful bowel movement and/or sexual intercourse. Nipple pain, enlargement, and tenderness can be a symptom of nipple-areolar leiomyomas. Genital leiomyomas can be caused by multiple factors, one can be genetic mutations that affect hormones such as estrogen and progesterone. Moreover, risk factors to the development of genital leiomyomas include age, race, and gender. Ultrasound and imaging procedures are used to diagnose genital leiomyomas, while surgically removing the tumor is the most common treatment of these diseases. Case studies for nipple areolar, scrotal, and uterine leiomyoma were used, since there were not enough secondary resources to provide more evidence.

<span class="mw-page-title-main">Psoriatic onychodystrophy</span> Medical condition

Psoriatic onychodystrophy or psoriatic nails is a nail disease. It is common in those with psoriasis, with reported incidences varying from 10% to 78%. Elderly patients and those with psoriatic arthritis are more likely to have psoriatic nails.

Aesthetic medicine is a branch of modern medicine that focuses on altering cosmetic appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, and spider veins. Traditionally, it includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery, surgical procedures, non-surgical procedures, and a combination of both. Aesthetic medicine procedures are usually elective. There is a long history of aesthetic medicine procedures, dating back to many notable cases in the 19th century, though techniques have developed much since then.

<span class="mw-page-title-main">Mitchel P. Goldman</span> American dermatologic surgeon (born 1955)

Mitchel P. Goldman, is an American dermatologic surgeon, cosmetic surgeon, dermatologist, and phlebologist, and the founder and director of Cosmetic Laser Dermatology. He is also a past president of the American Society for Dermatologic Surgery, the American College of Phlebology, the San Diego County Dermatology Society, and the Sonoran Dermatology Society.

<span class="mw-page-title-main">Gynecomastia</span> Endocrine system disorder of human male breast

Gynecomastia is the abnormal non-cancerous enlargement of one or both breasts in males due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Gynecomastia can cause significant psychological distress or unease.

<span class="mw-page-title-main">High-dose estrogen therapy</span> Type of hormone therapy

High-dose estrogen therapy (HDE) is a type of hormone therapy in which high doses of estrogens are given. When given in combination with a high dose of progestogen, it has been referred to as pseudopregnancy. It is called this because the estrogen and progestogen levels achieved are in the range of the very high levels of these hormones that occur during pregnancy. HDE and pseudopregnancy have been used in medicine for a number of hormone-dependent indications, such as breast cancer, prostate cancer, and endometriosis, among others. Both natural or bioidentical estrogens and synthetic estrogens have been used and both oral and parenteral routes may be used.

References

  1. 1 2 3 4 5 6 7 Rossi, Ana Beatris R; Vergnanini, Andre Luiz (2000). "Cellulite: A review". Journal of the European Academy of Dermatology and Venereology. 14 (4): 251–62. doi:10.1046/j.1468-3083.2000.00016.x. PMID   11204512. S2CID   18504078.
  2. ↑ Pinna, K. (2007). Nutrition and diet therapy. Belmont, CA: Wadsworth. p. 178.
  3. 1 2 Avram, Mathew M (2004). "Cellulite: A review of its physiology and treatment". Journal of Cosmetic and Laser Therapy. 6 (4): 181–5. CiteSeerX   10.1.1.506.7997 . doi:10.1080/14764170410003057. PMID   16020201. S2CID   20205700.
  4. ↑ Janda, K; Tomikowska, A (2014). "Cellulite - causes, prevention, treatment". Annales Academiae Medicae Stetinensis. 60 (1): 29–38. PMID   25518090.
  5. 1 2 3 4 Young, V Leroy; DiBernardo, Barry E (18 May 2021). "Comparison of Cellulite Severity Scales and Imaging Methods". Aesthetic Surgery Journal. 41 (6): NP521–NP537. doi:10.1093/asj/sjaa226. PMC   8129470 . PMID   32785706.
  6. 1 2 Rao, Jaggi; Gold, Michael H; Goldman, Mitchel P (2005). "A two-center, double-blinded, randomized trial testing the tolerability and efficacy of a novel therapeutic agent for cellulite reduction". Journal of Cosmetic Dermatology. Wiley. 4 (2): 96. doi:10.1111/j.1473-2165.2005.40208.x. ISSN   1473-2130. PMID   17166206. S2CID   10123904. "heredity: empirically, it has been found that the degree and presence of cellulite, as with body habitus, is often similar between females within the same family; race: Caucasian women are more likely to develop cellulite than Asian or African American women;9
  7. ↑ Terranova, F.; Berardesca, E.; Maibach, H. (2006). "Cellulite: Nature and aetiopathogenesis". International Journal of Cosmetic Science. 28 (3): 157–67. doi: 10.1111/j.1467-2494.2006.00316.x . PMID   18489272. S2CID   15618447.
  8. ↑ Bissoon, Lionel (October 2006). The Cellulite Cure. Meso Press. p. 74. ISBN   978-0-9764821-0-9.
  9. 1 2 Emanuele, E; Bertona, M; Geroldi, D (2010). "A multilocus candidate approach identifies ACE and HIF1A as susceptibility genes for cellulite". Journal of the European Academy of Dermatology and Venereology. 24 (8): 930–5. doi:10.1111/j.1468-3083.2009.03556.x. PMID   20059631. S2CID   26214159.
  10. ↑ Rossi, Anthony M.; Katz, Bruce E. (2014). "A Modern Approach to the Treatment of Cellulite". Dermatologic Clinics. 32 (1): 51–9. doi:10.1016/j.det.2013.09.005. PMID   24267421.
  11. ↑ Juhász M, Korta D, Mesinkovska NA (2018). "A Review of the Use of Ultrasound for Skin Tightening, Body Contouring, and Cellulite Reduction in Dermatology". Dermatol Surg. 44 (7): 949–963. doi:10.1097/DSS.0000000000001551. PMID   29846343. S2CID   44101405.
  12. ↑ Ingargiola, Michael J.; Motakef, Saba; Chung, Michael T.; Vasconez, Henry C.; Sasaki, Gordon H. (2015). "Cryolipolysis for Fat Reduction and Body Contouring". Plastic and Reconstructive Surgery. Ovid Technologies (Wolters Kluwer Health). 135 (6): 1581–1590. doi:10.1097/prs.0000000000001236. ISSN   0032-1052. PMC   4444424 . PMID   26017594.
  13. 1 2 Gold, Michael H. (2012). "Cellulite – an overview of non-invasive therapy with energy-based systems". Journal der Deutschen Dermatologischen Gesellschaft. 10 (8): 553–8. doi: 10.1111/j.1610-0387.2012.07950.x . PMID   22726640. S2CID   21099081.
  14. 1 2 Friedmann DP, Vick GL, Mishra V (2017). "Cellulite: a review with a focus on subcision". Clin Cosmet Investig Dermatol. 10: 17–23. doi: 10.2147/CCID.S95830 . PMC   5234561 . PMID   28123311.
  15. ↑ Feldman, Melissa (2018-03-09). "Ionithermie Cellulite Treatment Reviews: Does It Work?". Consumer Health Digest. Retrieved 2023-12-24.
  16. ↑ Coleman, Kyle M.; Coleman, William P.; Benchetrit, Arie (December 2009). "Non-Invasive, External Ultrasonic Lipolysis". Seminars in Cutaneous Medicine and Surgery. 28 (4): 263–267. doi:10.1016/j.sder.2009.10.004. ISSN   1085-5629.
  17. ↑ Wanner, M; Avram, M (2008). "An evidence-based assessment of treatments for cellulite". Journal of Drugs in Dermatology . 7 (4): 341–5. PMID   18459514. Lock-green.svg
  18. ↑ Nürnberger, F.; Müller, G. (1978). "So-Called Cellulite: An Invented Disease". The Journal of Dermatologic Surgery and Oncology. 4 (3): 221–9. doi:10.1111/j.1524-4725.1978.tb00416.x. PMID   632386.
  19. ↑ MedlinePlus Encyclopedia : Cellulite
  20. ↑ Vogue 15 Apr 1968 110/1[ non-primary source needed ]
  21. ↑ Hackett, Paul M. W.; Hayre, Christopher M. (2 December 2020). Handbook of Ethnography in Healthcare Research. Routledge. p. 166. ISBN   978-1-000-26398-5. In the text "The female body between science and guilt: The story of cellulite", Ghigi (2004) explains the role of French magazines in the construction of the concept of cellulite. It shows how two French magazines, "Votre Beaute" and "Marie Claire" have helped to show cellulite as a disease. In fact, these are two newspapers funded by pharmaceutical companies that manufacture anti-cellulite products.
  22. ↑ Faludi, Susan (18 November 2009). Backlash: The Undeclared War Against American Women. Crown. p. 213. ISBN   978-0-307-42687-1.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.