Cellulite, whose proper name is Oedematous Fibrosclerotic Panniculopathy (OFP), derives from an alteration of the panniculus, a subcutaneous tissue layer rich in fat cells.

Cellulite progresses through three phases:

  • The first stage of cellulite occurs when the blood and lymphatic circulation slows down and micro-lesions appear in capillary walls. Liquids and toxins, instead of being conducted into the circulation tend to leak into the surrounding tissue. Oedema, or swelling, develops mostly around ankles, calves, legs, hips, thighs and arms. Fluids that accumulate and that the body can no longer eliminate make the skin excessively soft to the touch, resulting in a loss of tone and elasticity.
  • The second stage of cellulite occurs when fat cells tend to distance themselves from each other under the pressure of the accumulated interstitial fluid and to fail in the performance of their normal metabolic functions, i.e. energy release. Elastic fibres are compressed by the enlargement of the fat cells and lose functionality. Consequently, the skin begins to appear less elastic and to lose its brightness. Additionally, collagen fibres, which act as tissue scaffolding, begin to degenerate and capillaries harden. Fine nodulation occurs due to reactive fibrosis, giving the skin that classic orange peel appearance typical of second stage cellulite.
  • The third stage of cellulite occurs when blood and lymphatic circulation continues to decline, resulting in increasingly large nodules that are painful to the touch. The initial fibrosis becomes tissue sclerosis that entrap the seed micro-nodules in large clusters. The number of enlarged capillaries increases, bruises appear and the skin surface is no longer homogeneous and smooth but appears like the surface of a mattress. The skin is cold to the touch, due to circulatory failure, and is painful when modest pressure is applied, leaving a depression that disappears only after a few seconds. This is the last stage of cellulitis.

Causes of cellulite

It is often said that cellulite is due to genetic (e.g. that white women are more affected than others) or family traits, suggesting that you can try to fight cellulitis through diet and lifestyle, but that if a woman is ‘unlucky’ then there is little to be done. However, it is enough to look at athletes of sports requiring a lean body to realize that cellulitis is a problem that only concerns women who are overweight or sedentary. Indeed, the elimination of both of these two factors is required to prevent cellulite from forming, because a sedentary woman, though perhaps ‘thin’, may, in fact, have a high relative percentage of fat. It is not uncommon to see ‘thin’ women with cellulite among the participants of beauty contests, with such ‘fake skinny’ women having thin yet flabby legs due to a lifestyle lacking in physical inactivity. On the other hand, since cellulite mainly affects adipose, or fat, tissue, if there is little fat, there will also be little cellulite, and even when cellulite has genetic causes, in a lean and strong body it will hardly be noticeable at all.

Remedies for cellulite

Anti-cellulite creams have no value in reducing cellulite. It should, by now, be known to all that while anti-cellulite creams may improve the surface appearance of the skin thanks to their moisturizing power, they do absolutely nothing to prevent or reverse the formation of the underlying cellulite. Diet and physical activity, aimed at the achievement of a target weight, is clearly the best weapon against cellulite. However, if tissue has reached the third stage of cellulitis, the fat locked into permanently altered tissue cannot be mobilized and another strategy is required. Note the futility of all the qualitative advice outside of a logic of slimming. If you do not lose weight, it makes little impact on cellulite to reduce sodium or salt (though generally positive for health), drink a litre and a half of water per day and avoid foods that strain the liver. Also, most of this advice is automatically accounted for in following a general low-calorie balanced diet. Physical activity that burns a higher number of calories should also be considered, for example, aerobic sports such as swimming, running and cycling, and these should generally be practiced for at least four hours per week. Various massage techniques (e.g. lymphatic drainage, pressure therapy) may be somewhat effective for mild forms of cellulite, but not in more severe cases (i.e. advanced second stage and third stage cellulitis). These cases require tougher methods and, in extremes, surgical techniques. In ultrasonic hydrolipoclasis, the affected area is injected with a physiological solution, and then ultrasound is applied at 3 MHz, which interacts with the injected liquid resulting in mechanical action that breaks up fat cells. Mesotherapy, and one of its derivatives, microtherapy, work via the injection of drugs that do not cause mechanical damage to the capillaries or bruising. But the technique that gives immediate results is liposculpture, an evolution of liposuction that eliminates cellulite by physically removing the degenerated subcutaneous tissue and reshapes the remaining tissue to achieve an optimal profile for thighs and buttocks.


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