Photo source: Murad.com

According to a recent Allure.com reader poll, 36% of respondees most dreamed of a cure for cellulite. And why not? Cellulite affects approximately 85-98% of women of all races. According to Dr. Leslie Baumann, it is caused by the irregular extrusion of adipose tissue (i.e., fat) into the reticular and papillary dermis (see below). This process may be exacerbated by weight loss. Baumann cites the research of Draelos et. al as having the most likely theory of the cause of cellulite: decreased circulation in the thighs and buttocks leads to increased amounts of enzymes that destroy elastin and collagen (elastase and collagenase, respectively), which in turn leads to the gaps in the dermal structure where fat cells peek through.

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There are currently four methods commonly used to treat cellulite: creams with methylxanthine; retinoids; herbal supplements; and Endermologie.

Methylxanthines include caffeine, theophylline (a component of green tea), and aminophylline. According to Draelos et. al, creams with methylxanthines are phosphodiesterase inhibitors. When phosphodiesterases are inhibited, this activates ß-adrenergic receptors, which in turn break down fat into its glycerol and fatty acid components. Methylxanthines may alternatively or additionally work by dehydrating the fat cells, decreasing their appearance through the skin. The exact mechanism by which methylxanthines work is not known; however, it has been demonstrated that methylxanthine creams should be used continuously for sustained results. Methylxanthines may be found in Neutrogena Anti-Cellulite Treatment, Retinol Formula ($18, Amazon.com) in the form of caffeine, and University Medical De-Cellulite Time-Released Anti-Cellulite System ($16.70, Amazon.com) in the form of aminophylline.

The retinoid tretinoin, available in the prescription formula Retin-A, has been demonstrated to increase the rate of cell turnover, to increase levels of collagen I in the skin, and to antagonize the induction of collagenase (Baumann). However, the effects of retinol on cellulite are not clear. (Retinol may be converted to tretinoin in the skin.) In a 2000 study by Pierard-Franchimont et. al, it was found that retinol affected skin tensions: elasticity was increased by 10.7%, while viscosity was decreased by 15.8% at retinol-treated sites, leading to a smoother skin appearance overall. However, the number of fat cells in retinol-treated areas did not appear to change, indicating that retinol may improve the skin overlying the fat cells, but not the fat itself. More research on the effects of retinoids/retinol oncellulite need to be conducted. For now, the ingredient is available with methylxanthines in Neutrogena Anti-Cellulite Treatment, Retinol Formula ($18, Amazon.com).

Herbal supplements have often gotten a bad name in the cellulite business, and for good reason: Rexall Sundown, Inc., the makers of Cellasene, an herbal supplement with ginkgo biloba, sweet clover, lecithins, and evening primose oil claiming to reduce cellulite, was sued in a class-action lawsuit in 2000 for $12 million. (more here). Today, other herbal supplements are on the market, which seem to be backed by more substantiative science. These include the Murad Anti-Cellulite Body Firm and Tone Supplement Pack ($135, Amazon.com), an A.M. and P.M. vitamin pack with numerous antioxidants and essential fatty acids. Dr. Murad, a pharmacist, dermatologist and associate clinical professor of dermatology at UCLA, treats cellulite nine ways; over the course of eight weeks, Murad’s program claims to reduce cellulite by up to 69% via vitamin supplements, creams and exfoliants (see above), increased water intake, exercise and exfoliation. Murad’s complete program is available here.

The final method commonly used to treat cellulite is Endermologie, an in-office, handheld machine that “kneads” the skin of cellulite-affected areas. The patient is covered in a nylon stocking, and his or her skin is sucked and kneaded between the rollers for 35 to 45 minutes (Baumann). The treatment is done approximately fourteen times, with 1-2 sessions per week. The cost per session is $80 to $130. However, there is strong ambiguity as to whether or not Endermologie is effective. A 1998 study in the journal Aesthetic and Plastic Surgery with 85 women between the ages of 21 to 61 found that 46 patients who completed seven sessions showed a mean index reduction in body circumference of 1.34 cm, while 39 patients who completed 14 sessions of treatments showed a mean index reduction in body circumference of 1.83 cm (Barrett). However, another study, involving 52 women, found no objective difference in thigh girth (at two points) or thigh fat depth. (Barrett) It thereby seems that Endermologie is not an effective solution to cellulite.

So what is a woman with cellulite to do? It seems that more research on cellulite needs to be conducted. At the present time, the best bet seems to be daily use of cream with methylxanthines, to improve the appearance of the fat cells, and retinol, to improve the appearance of the skin above the fat cells; both are available in Neutrogena Anti-Cellulite Treatment, Retinol Formula. In addition, although Murad’s complete eight-week anti-cellulite program is a bit pricey ($210), it promotes exercise, extra water intake, and antioxidant-rich vitamins, which are all beneficial to your health and overall well-being. The program also offers a 30-day money-back guarantee, so at the very least, you have been taking your vitamins and exercising for a month. My final bit of advice is to avoid crash-diets, which may exacerbate cellulite formation. Overall, however, more research clearly needs to be conducted in this area, and hopefully I will one day be writing with exciting, effective updates.