What You Need To Know About Cellulite

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cellulite-introIllustrated by Sydney Hass.
There's something about cellulite that brings out the absolute worst in some women. Normally self-assured, intelligent ladies tend to go bat-shit crazy in an attempt to eradicate their bodies of the dimpled menace. A menace, we might add, that's perfectly normal — with over 80% of women afflicted with cellulite, we'd go so far as to say thigh dimples are the status quo.

So, why, then, are we so obsessed with ridding our bodies of something that is just a natural part of being a woman? How do we explain the epic amounts of money we drop each year on body-contouring regimens — those creams, patches, and gadgets that common sense tells us can't possibly do what they claim, and yet, a tiny voice whispers in our ear, What if this just might be the cure we were looking for?

As one of those 80% of women with cellulite, I've had plenty of regrettable moments in the great cellulite war. If there was a pill, potion, or crazy at-home device that promised to blast away my thigh dimples, I was, naïvely, the first in line to give it a shot. What I got in return was really smooth skin but no improvement in my cellulite. Oh, I also discovered that cellulite can crop up ANYWHERE — I'm just now experiencing the joys of arm cellulite, which is so wrong that I can't even handle it.

After a decade of dimple fighting, you know what I've learned? The average woman really doesn't know jack about cellulite. Sick of seeing the ladies in my life waste their time, cash, and sanity on an endless parade of treatments that did absolutely nothing, I've taken it as my personal mission to cut through the BS (and there's a lot of it) on all things dimpled. From what actually causes it to what works to get rid of it (and what really doesn't), the lumpy, bumpy truth about cellulite is straight ahead.
Cellulite_introIllustrated by Sydney Hass.
So, What Exactly Is Cellulite?
Cellulite is a puckering caused by the connective fibers under the skin (more on those later) pulling it down. As Dr. M. Christine Lee, dermatologist and director of The East Bay Laser & Skin Center in Walnut Creek, California, explains, think of your skin like a mattress. If you look at the top of a mattress, it has all those dimples from the springs that are holding down the mattress top, and then there's the stuffing that's caught in between them.

Those connective fibers (called septum) function the same way, pulling down the skin and keeping it attached to the muscles. In between those bands are deposits of fat, and as those grow, the fat begins to form pockets that bulge through the bands and create a dimpled appearance. The more fat deposits there are, the more pronounced the bulges become.
Cellulite_slides-01Illustrated by Sydney Hass.
What Doesn't Cause Cellulite
The biggest myth around cellulite is that it's caused by fat. According to Dr. Neal Schultz, an NYC dermatologist and founder of DermTV, this is not the case. "The important thing to remember is that men don't get cellulite, but women do, which underscores that it's not just about fat, but rather about the structure of the skin. If fat were the only cause of cellulite, then why don't fat men get cellulite?" The answer: While women have vertical bands holding their skin and muscles together, Dr. Lee says men have crisscrossed bands, which is what makes their skin so tough.

Add to this our naturally thinner skin, our estrogen production, and the fact that we tend to have a thicker layer of fat because of those hormones, says Dr. Schultz, and we've got a perfect storm where our bodies are both more susceptible to cellulite and more likely for it to be highly visible. Sucks, doesn't it?

Dr. Schultz also says that many people believe things like eating sugary foods or not drinking enough water are a direct cause of cellulite. While those can lead to dry skin or more fat deposits, which enhance the appearance of the bumps, they aren't actually causing the cellulite itself.
Cellulite_slides-03Illustrated by Sydney Hass.
What Does
Cellulite boils down to the structure of our skin and the distensibility of those bands. While Dr. Schultz notes that no one knows for sure what causes the cellulite to manifest after puberty in women, doctors' best guess is that as we age and our estrogen production increases, this causes our bodies to gain more fat. Because those bands don't stretch as the fat accumulates, it pushes up the skin and causes the bumps.

But, just because it's the bands — and not the fat — that are causing the cellulite itself, that doesn't mean fat doesn't play some part in just how bad your cellulite affliction is. "If you have cellulite and you gain weight, it's going to get worse," says Dr. Schultz. Adds Dr. Lee, "There is fat between those skin puckers [the bands cause], and as you get more fat, it bulges up more between those puckers." Once again: If you have cellulite, the more fat you gain, the more pronounced it will become. So, while you can keep beating yourself up over that cheesecake you ate or for not going for a run, the truth is those things don't have any correlation with why you have cellulite.
Cellulite_slides-02Illustrated by Sydney Hass.
The Bad News
Are you sitting down? We don't want to be the one to break it to you, but there is no over-the-counter cream that is going to "cure" your cellulite. "I really don't understand how smart, responsible people can think a cream or topical product can make a difference," laments Dr. Schultz.

While he understands how things like caffeine and aminophylline (two common cellulite fighters on the market) are supposed to work against those bumps, Dr. Schultz notes that if they can't get through the skin, they are not doing their job: "The function of the upper layer of the skin is to keep the outside world out — it's not an open gate for things to get in." Dr. Lee adds, "The problem is not on the surface of the skin; it's all how skin is structured below the surface. Creams only work on the surface — they are not getting to the underlying problem."
Cellulite_slides-04Illustrated by Sydney Hass.
Can't They Help Even A Little Bit? Pretty Please?
As far as just making cellulite look temporarily better, Dr. Lee does say that creams can have an impact. "Most of these creams are just moisturizers," she says. "Cellulite looks worse when skin is dry, so any time you moisturize the skin, it will look better." Adds Dr. Schultz, "Moisturizing the skin creates a temporary plumping, which smooths the surface of the skin, and you get the optical effect of more reflection of light. Any time you make something more reflective, it will look more smooth."

So, those creams and potions can yield results — temporary ones that create the illusion of less cellulite. Once you stop using a product, though, your dimples will be just as visible as always. But, Dr. Schultz notes, if you're just going to create the appearance of smoother skin and less-noticeable cellulite, you're better off ditching all of those fancy (and expensive) "firming" ingredients and focusing instead on super-moisturizers, which will give you maximum plumping and light reflection.

He likes humectant (water-based) moisturizers like glycerin, hyaluronic acid, urea, and dimethicone over occlusive (oil-based) moisturizers. You want to improve the skin's ability to absorb moisture and encourage that plumping effect rather than trap moisture in the skin, as occlusive options do. Ultimately, locking in that moisture won't give you the plumping and swelling of the skin needed to create the illusion of smoothness.

Dr. Schultz says more mechanical methods like endermologie, lymphatic drainage, and even at-home body massagers like the HoneyBelle can also provide some temporary improvement. "These treatments cause so much pressure that you stretch out the bands, making them longer, so you get less puckering." However, he says, you have to do multiple treatments over the course of a couple of weeks to see a visible difference. And, the minute you stop, those temporarily damaged bands will repair themselves and contract again, pulling down the skin and causing those puckers once more.

"It's very labor- and time-intensive," says Dr. Schultz, "but that is an actual, real improvement in the structure of the skin [rather than an optical illusion]. Anything that repetitively stretches the skin is going to be helpful [in diminishing cellulite]." Just be careful of excessive rubbing, he says, as that can damage your skin's surface and cause other issues.
Cellulite_intro-1Illustrated by Sydney Hass.
So, How Do I Actually Get Rid Of It?
Now, if you're hardcore about abolishing cellulite completely and are willing to drop some serious cash, then lasers are going to be your dimpled-skin solution. But, while there are dozens of lasers on the market, Dr. Lee says they only provide temporary fixes. "You need to do a series of eight to 12 treatments every six to 12 months, and you will only see a 20% to 30% reduction in cellulite," she explains. "You do one series of multiple treatments, and then you have to keep doing that every six to 12 months."

There is, however, a new device on the market called Cellulaze that Dr. Lee and many other dermatologists are excited about. "Cellulaze is a 1,440-nanometer laser that actually works by having the doctor make a tiny incision in the skin, inserting the laser underneath the skin. It breaks up the connective-tissue fibers that cause the cellulite, severing the fibers so they release the skin so that it's not pulling down and causing the puckering," says Dr. Lee.

"With Cellulaze, you do one treatment, and you can get a reduction of 50% to 60% of cellulite with results lasting a minimum of three years," she says. "As you age, you might need touch-ups every five to 10 years. It's not that it wears off but, rather, that your body continues to age. So, when you are 40, your skin is a certain way, but when you turn 50, your skin may naturally sag more, so you may need to come in for a touch-up."

Then, of course, there's my favorite option: Just say screw it. Eighty percent of women have cellulite — 80%! Instead of freaking out about my thighs, I just decided that this is a part of my body and I'm not going to devote any more brain cells to trying to make it less noticeable or visible. No one is judging you for having cellulite — and if they are, they're clearly not anyone worth having around. The path to acceptance is not easy, but learning to love your body as is, especially when it comes to something that's both natural and abundant in the female population, will save you a lot of anxiety and agony in the grand scheme of things. Live your life — cellulite be damned.


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