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The Truth About Cellulite and What You Can Do to Be Free of It

09 Oct, 2018
By Daniela Massenz
Summer beach holidays are coming up, and if  the sight of your corrugated thighs is enough to send you screaming for the nearest chocolate, get ready to be empowered with the full inside story on how to get rid of cellulite.

Cellulite is a funny thing. Some (even medical experts) say there's no such thing, while others (also medical experts) say it's actually an indicator that something is not entirely ticketyboo on Planet You.

Whatever your beliefs, we can all recognise it. After all, if you're a woman, chances are you have it - it affects over 90 percent of us (and only about 10% percent of men, grrrr, although the numbers are said to be increasing). Yet not all overweight women have cellulite and many thin, fit women do. Many of us find that when we gain weight, it piles on to the thighs, knees and bottom, yet when we lose weight, it disappears from our upper body... curiouser and curiouser.

Why do so many women and so few men get cellulite? Blame our female hormones. The fact that by the time we've passed through adolescence, most women will see some signs of cellulite is a tell-tale sign. While we all have them, the levels of oestrogen are much higher in women than in men. And then there's the fact that men have much thicker, stronger connective tissue and skin, and even the way our fat is laid down is different to men's fat distribution (!), so the fat is less likely to pop through.

If you're worried about whether you will get cellulite, take a look at your mother and grandmother, because it is true that cellulite runs in families, although it's only a small part of the puzzle. Sad to say, our cellulite will probably worsen during pregnancy, when we start taking 'the Pill', and with age (those hormones again at menopause). As the appearance of cellulite is associated with poor circulation, the decrease in oestrogen that happens as women age can also mean a decrease in collagen production and the breakdown of connective tissue.

Something to Ponder

One medical professional, aesthetic doctor Dr Elisabeth Dancey, does distinguish cellulite from plain old fat. In her well-known book The Cellulite Solution, she couches it as a lifestyle problem - a hangover from our cave-dwelling ancestors.

The gist is that our bodies were designed to be physically active - to store energy in case of famine and to ensure that we are able to breed. The stores of fat on our legs, buttocks and tums are necessary for pregnancy and childbearing (that still doesn't explain why we also get it on our upper arms and the backs of our necks!). And there's the hormonal influence.

However – yes, we've heard it all before, but it is important -  as our modern selves become less active, and we eat processed foods with artificial additives and hormones, are exposed to free-radical-triggering pollution, smoking, sun, and become stressed (with that cellulite-triggering adrenaline), the product of our unhealthy lifestyle is showing up on our thighs as well, and it's not pretty. More seriously, it may also inflict damage on our bodies.

She makes the distinction between ordinary fat, and the fat that results in cellulite...
Fat cells are little factories that produce, store (increasing in size up to 100 times) and release the energy reserves we need to run our bodies. The reason for our lopsided weight gain and weight loss, according to Dancey, is that there are two different types of fat cell - with fat-storing or fat-releasing receptors.

Unfortunately, as she explains, in most women, the fat cells in the dreaded thigh, knee and bum area has six times more fat-storing receptors than fat-releasing receptors. The opposite is true on the upper body (kind of makes sense).

So What Is Cellulite?

According to the book of Dancey (and which is being increasingly understood by the medical profession), cellulite - while being mostly fat - is not ordinary fatty tissue; it's fatty tissue that has been damaged due to malfunctions in the body's systems. Three main factors, which interact with each other, cause the damage:

1. Insufficient blood supply via the microcirculation
  • The microcirculation delivers vital oxygen and nutrients to cells for repair, growth and division.
  • It carries away waste products like water, carbon dioxide, lactic acid and toxins.
  • Fat release also depends on a good blood supply to the area.
  • Insufficient blood supply means cells are starved and there's a build-up of toxic waste.
  • Poor oxygenation also allows thick, tethering fibres to form around the fat cells, which is where we get the lumpy effect.

2. Veins become damaged
  • With poor microcirculation, the larger veins eventually become damaged and inflamed due to a build-up of toxins (which feels painful and looks swollen).
  • They then become leaky, causing bruising, discoloration, spider veins and even varicose veins.

3. Insufficient fluid drainage by the veins and lymphatic system
  • Lymph is as important as blood for removing excess fluid and toxins, but the lymph drainage system is extremely fragile.
  • When the lymph flow slows down, fluid becomes trapped and the tissue becomes waterlogged. Flows slows down further.
  • Blood is also prevented from flowing through the tissue, so it flows around the area - which is why you get warm and cold, mottled patches on the thighs in advanced cellulite.
  • This also makes the situation worse as fat is unable to be released and the area doesn’t receive oxygen. Eventually, it forms hard, uneven lumps.

To make things worse, lack of blood flow weakens the skin as collagen production is affected. It becomes less elastic and resilient, so the hard, lumpy bits push through the skin's supportive structure (imagine the stuffing of an old mattress that becomes lumpy).
The problem is that the more this situation continues, the worse it becomes, resulting in ever-increasing build-up of cellulite and unhealthy tissue. And the long-term health consequences of varicose veins, circulation problems and water retention can be serious.
There is no absolute cure, and you may or may not believe that cellulite is a 'thing'. However by in improving your body's resistance and strengthening its tissues, you can only improve the appearance and help make your body healthier.
Diet and exercise alone are not the answer. Become informed and practice a multi-pronged treatment strategy.

The six stages of cellulite

Dr Dancey divides the stages for easy diagnosis:
Stage one: Skin heals slowly when cut or bruised. This is the pre-cellulite stage.
Stage two: There is fluid retention; skin feels thicker and not as springy. There are signs of orange-peel when you pinch it; there may be some spider veins and mottled appearance, and easy bruising.
Stage three: The orange-peel skin is clearly visible on the surface due to retained fluid.
Stage four: The skin looks lumpy (like a mattress) and is cold to the touch. Spider veins are often visible.
Stage five: You can feel hot areas among the areas of cold tissue.
Stage six: Large areas of fat are encased and tethered by fibres, forming large lumps that distort your outline, visible whether you’re standing, sitting or lying down.

The Lifestyle Adjustments

Factors that may influence the onset of cellulite include poor diet (including crazy dieting), a lack of physical activity, dehydration, slow metabolism, hormonal changes and total body fat. Smoking reduces blood oxygenation too.
Before considering other treatments, everything you do will be improved by positive adjustments to your diet and lifestyle
  • Staying well hydrated is essential to keep connective tissue strong and supple. Apart from drinking water, add water-rich foods (such as cucumbers, lettuce, celery, tomatoes, peppers, zucchini, radishes, etc.) to your diet.

  • Eating a colour-rich, plant-heavy diet also helps to reduce inflammation in the body.

  • Exercise won't cure cellulite, but it can certainly reduce its appearance or even help prevent its onset.  Firming and toning muscles tightens the skin and can make cellulite less noticeable. While cardio is great for overall fitness and weight loss, strength training is the best to boost circulation and smooth the skin.

  • Ditch the cancer sticks!

Read More: Why a Healthy Gut Is the Key to a Happy Skin, Body - and Life

The Low-Tech Options - Moving That Mass!

  • Regular lymph-drainage massage is great for eliminating toxins and toning your body. Most good spa ranges offer body toning massage treatments. Or do it at home. Massage your thighs, buttocks, stomach and upper arms in an upwards, circular movement, then knead the skin to stimulate lymph-drainage.

  • Dry brushing 2 to 3 times a week with a soft, natural-bristle body brush is great for all sorts of reasons: it whisks away dead skin cells and stimulates circulation and lymph drainage. Before showering, work the brush over your body in gentle, fan-like motions, starting from your feet and working upwards towards your heart. Do the abdomen in a clockwise direction. Shower afterwards to remove dead skin. Follow up these massages by applying a cellulite-fighting cream as the lymph-drainage will help its action.

  • Lotions. There are various over-the-counter active ingredients that have shown scientific evidence of helping with the appearance of cellulite:
    • Retinol helps to plump up the skin's collagen and thickens it so the lumps don't show as much.
    • Others stimulate microcirculation and drainage to eliminate excess fluid from the body. These include centella Asiatica, fat-burning caffeine, antioxidant rich green tea, ruscogenine (butcher’s broom).

Products that have are widely regarded by beauty editors and industry insiders (including Harper's Bazaar, BeautyInsiders, Cosmopolitan) as effective in improving the appearance of cellulite-prone skin:
Clarins Body Lift Cellulite Control for early and stubborn cellulite. Contains caffeine-rich ingredients, menthol and escin (horse chestnut), aquatic mint and celosia cristata.
Nivea Good-bye Cellulite Gel Cream Gel Cream contains Coenzyme Q10 to improve the skin's appearance and L-Carnitine to stimulate fat metabolism.
BODYeCRACKLE Intensive Anti-Cellulite Treatment contains capsaicin (pepper) for the immediate activation and improvement of microcirculation. Ivy, birch, centella Asiatica help to decongest. Antioxidant green tea, hydrating aloe vera and a blend of ingredients to increase metabolic stimulation: carnitine, brown algae, theobromine, theophylline, caffeine and genistein. Paraben-Free. Endorsed by renowned dermatologist Dr. Ian Webster due to positive clinical results.
Read More: How to Fix Your Metabolism to Achieve a Healthy Weight

Which High-Tech Treatments Actually Work?

Surgical or invasive treatments
  • Liposuction, where the fat is sucked out of the body, is a no-no, as it has the potential to make fat distribution more uneven than before.

  • Subcision is a safe, simple medical procedure that involves a trained doctor inserting a needle just under the skin to break up the tough bands beneath the skin that cause us to see cellulite. It improves the appearance of severe cellulite dimpling and can be safely and easily combined with other treatments, such as Carboxytherapy, Radiofrequency and Laser, to improve the condition further.

  • Injectable skin fillers, more commonly used to remove facial wrinkles or to restore sagging cheekbones, are also quite useful, although the benefit is once again temporary. According to a Dr Karcher: "It's like putting icing on a lumpy cake to make it look better." If you decide to try fillers (which may be quite costly), you need to know that results will only last a few months.

  • Non-invasive procedures such as laser, radio-frequency and massage techniques really do work, although, once again, the results are not permanent.

  • Carboxy Therapy is shown to improve cellulite by improving the venous insufficiency which causes poor circulation and the build-up of toxins. As this is addressed, it improves the appearance of varicose and spider veins. It treats localised fat deposits effectively, and tightens the skin's surface with longterm collagen stimulation. It can also improve the appearance of difficult to treat stretch marks. Available countrywide at many medical aesthetic clinics, including Skin & Body Renewal.

  • Endermologie, which uses mechanical massage with vacuum and rolling of the affected areas, has been shown to help. The theory being that deep massage will break up connective tissue. It does seem to help, but once again only for a short while. A potential down side is that some experts feel that the suction may cause skin to slacken prematurely. The treatments can also be fairly painful in the beginning, due to tissue inflammation and water retention, but it is said to improve as the treatment goes on. Available at many medical aesthetic clinics countrywide.
  • Velashape III is Endermologie on steroids (don’t quote me!), with mechanical massage that tears the fibrotic tissue bands, radio frequency which causes fat breakdown and stimulates collagen production, vacuum suction for drainage and Infrared to heat the area to encourage circulation and skin tightening. Available at many medical aesthetic clinics countrywide, including Skin & Body Renewal.

  • Cryolipolysis is a non-invasive procedure that freezes and kills fat cells. Once fat cells are dead, the body just gets rid of them. It is not indicated for cellulite elimination but rather for elimination of pockets of fat and body shaping. However, it has been shown to improve the appearance of cellulite in treated areas. Two of the most effective treatments are:
    • Cool Sculpting by Zeltiq, is available at many medical aesthetic clinics countrywide, including Lasermed Clinics.
    • Ice Cream Therapy (at Skin & Body Renewal) combines Cool Sculpting with the placement of synthetic Polydioxanone (PDO) threads into the area via a minor surgical procedure. The idea is that the threads stimulate circulation so the area is flooded with growth factors and heals better, while healing causes collagen production, improving the skin condition. They dissolve after six months or so. The result is almost double the amount of fat reduction, say Body Renewal. Not only does this combination therapy assist in fat reduction, but also the reduction of cellulite in the treatment area, thereby improving the strength and condition of the skin tissue.

Read More: The Best Cosmetic Procedures - How to Improve Your Face and Body Without Surgery
Radio frequency treatments
  • BTL X-Wave Acoustic Wave Therapy (used for decades to disintegrate kidney stones, etc.) is used in cellulite treatment, working by increasing blood supply, collagen remodelling and waste stimulation. Clinical studies showed that combining 1000mg of Vitamin C supplement and having 8 treatments has a marked improvement on cellulite appearance. It can be done every week and results become visible six to nine weeks after treatment begins. Used in combination with the BTL Lymphastim vacuum suit, which enhances lymph flow and blood circulation, the treatments are pain-free and affordable.

    Available at NewLife Aesthetics in Somerset West, Elizabeth 082 8584444. For BTL countrywide, contact BLT Aesthetics South Africa or 076 232 80 58.

  • iLipo uses low-level laser to energise fat cell mitochondria, making fat cells release their energy. The stumbler is that you have to exercise (within 4-6 hours) afterwards with 30 mins of exercise per treated area, burning 300 calories ideally, to burn the released fats. Great if you're a fitness bunny, not so if not. Available at Body Renewal.
CAUTION. While many of these light and radio freqency treatments can be carried out by qualified therapists, do your homework and ensure that they are well trained on the machines and preferably work with aesthetic doctors. They need to be aware of any medical conditions you may have before embarking on any course of treatment. If they don’t do a thorough questionnaire on your health and medication, you should probably not entrust them with your treatment.

Read More. 8 Easy (But Effective) Ways to Detox Your Body Right Now

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