What is cellulite?
Cellulite is the dimpled, uneven appearance created when the fat tissue just beneath the skin bulges towards the skin between the thin bands of connective tissue that attach the skin to the tissues below. It is seen most often on the buttocks, thighs, abdomen and the backs of the arms.
Medically, cellulite is not a disease and does not harm health. The great majority of women have some degree of cellulite after puberty. This is why many experts see cellulite not as a problem but as a normal feature of the body; wanting treatment is entirely a personal choice.
Why is it more common in women?
In women, the connective tissue bands under the skin run mostly vertically; this structure makes it easier for the fat tissue to bulge towards the skin. In men, the bands form more of a criss-cross network, so cellulite is much less common. Hormones, especially oestrogen, are also thought to play a role.
Other factors that can affect how visible cellulite is include:
- Genetic predisposition and family history
- Thinning of the skin and loss of elasticity with age
- Weight gain or weight fluctuations
- An inactive lifestyle and loss of muscle mass
- Pregnancy and hormonal changes
Cellulite is also seen in slim people and in people who exercise regularly. Having cellulite does not mean you are living an unhealthy life.
What may help?
No method is known that removes cellulite completely. Some lifestyle changes may affect the appearance to some extent:
- Keeping your weight stable: excess weight can make cellulite more visible. However, losing weight does not reduce cellulite in everyone; in some people the appearance may not change because of loose skin.
- Regular exercise and muscle strengthening: stronger leg and buttock muscles may help the area look firmer.
- Sun protection and avoiding smoking: help to preserve the structure of the skin.
- Self-tanning lotions: do not reduce cellulite; however, the colour difference may make the dimples less noticeable.
What can creams and massage do?
Many creams, gels and massage tools are sold for cellulite. For a significant proportion of them, the effect has not been shown scientifically, or the evidence is weak.
- Creams containing caffeine: may improve the appearance briefly by temporarily tightening the skin and changing its moisture balance. There is no evidence of a lasting effect; the effect disappears when you stop using them.
- Creams containing retinol: there are limited studies showing that, with regular use over a long period, they may slightly affect the appearance by thickening the skin a little. The evidence is limited; they can cause irritation.
- Massage and massage tools: massage may improve the appearance briefly by temporarily reducing swelling in the area; the effect does not last long.
- Products promoted as “fat-burning”, “cellulite-melting” or “detoxifying”: there is no reliable evidence to support these claims.
It is a widespread belief that cellulite forms because of a “build-up of toxins”; however, there is no scientific evidence to support this view. “Detox” products and programmes are not recommended for cellulite.
Cellulite is not a disease but a common tissue feature seen in the great majority of women. Be cautious about products and procedures that promise to ‘get rid of it completely’; think carefully about the time and effort you would spend on methods with limited evidence.
Dr. Hamza GemiciMedical Director, DoktorClub · Aesthetic Medicine Physician
Medical methods: what is available, and what is the evidence?
There are various medical procedures aimed at the appearance of cellulite. None of them removes cellulite completely; results are mostly moderate, vary from person to person and may fade over time. Whether these procedures are suitable should be decided together with a physician after an examination.
| Method | Aim | State of the evidence |
|---|---|---|
| Cutting the connective tissue bands (subcision and similar procedures) | Correcting distinct, individual dimples | Benefit reported in some studies for certain types of dimples; risk of bruising, swelling and irregularity |
| Radiofrequency, acoustic wave and similar energy-based methods | Heating or stimulating the skin, firming the area | Limited evidence; the effect is generally moderate and temporary, and repeat sessions are often needed |
| Laser treatments | Targeting the connective tissue and the skin | Limited evidence, varying with the device |
| Mesotherapy and “fat-dissolving” injections | Reducing the appearance of cellulite | Insufficient evidence for cellulite; infection and irregularity have been reported |
| Vacuum massage devices | Massaging the tissue with suction | Short-lived effect; regular repetition is needed |
For more information on mesotherapy, see the article “Mesotherapy”, and for energy-based methods, the article “Radiofrequency Skin Tightening and Radiofrequency Microneedling”. Methods for reducing localised fat are not designed to correct cellulite.
Whatever procedure is considered, who performs it and under what conditions matters. The article “Who Can Perform Medical Aesthetic Treatments?” can guide you on this. Be cautious about practices that promise a definite result, claim to get rid of cellulite in a single session or offer injections of unknown content.
Cellulite and cellulitis are not the same thing
Although their names are similar, cellulitis is a completely different condition. Cellulitis is a bacterial infection of the skin and the tissue beneath it. It usually shows itself as redness, warmth, swelling and pain in a single area, most often on the leg, which can spread quickly; fever and feeling generally unwell may accompany it.
Cellulitis is an infection that needs treatment and does not go away with massage, creams or heat at home. A small scratch on the skin, an insect bite, a fungal infection or a recent procedure can be the entry point for the infection.
See a physician without delay in these situations
- Rapidly spreading redness, warmth, swelling and pain of the skin
- Fever, chills or feeling generally unwell together with the redness
- Increasing pain, redness or pus-like discharge in an area where an aesthetic procedure or injection was done
- Sudden swelling and pain in one leg (urgent assessment is also needed to check for a blocked vein)
- Bruising or blistering of the skin, or severe pain, together with a rapidly worsening general condition
When should you consult a physician?
The appearance of cellulite on its own does not require a visit to a physician for health reasons. However, if you have persistent swelling in the legs, pain, hardening of the skin, a tendency to bruise easily, or symmetrical and painful fat build-up in certain areas of the body, it is advisable to see a physician. These signs may point to conditions other than cellulite, for example circulation problems or a fat distribution disorder called lipoedema, and should be assessed through an examination.
If you are considering a medical procedure, it is important to discuss your expectations openly and to ask about the evidence for the method.
Questions to ask your physician
- Is what I have cellulite, or another condition?
- Do I need a separate assessment for the swelling or pain in my legs?
- How strong is the evidence for the method you recommend for cellulite?
- How much realistic change do you expect for me, and how long will it last?
- How many sessions are needed, and will repeat treatment be needed to maintain the effect?
- What are the possible side effects and risks of this procedure?
- Who will perform the procedure, and who can I contact if a problem arises?
Frequently asked questions
Is cellulite a disease?
No. Cellulite is a difference in appearance seen in the great majority of women after puberty, and it does not harm health. Wanting treatment is a personal choice.
Will my cellulite go away if I lose weight?
Excess weight can make cellulite more visible, and losing weight may reduce its appearance in some people. However, cellulite is also seen in slim people, and losing weight does not have the same effect in everyone.
Do cellulite creams work?
Creams containing caffeine may give a temporary improvement; the evidence for the effect of creams containing retinol is limited. No cream is known that removes cellulite completely.
Can cellulite be got rid of for good?
No method is known that removes cellulite completely and permanently. The effect of medical procedures is mostly moderate and may fade over time.
What is the difference between cellulite and cellulitis?
Cellulite is a harmless dimpled appearance of the skin. Cellulitis, on the other hand, is a bacterial infection of the skin and the tissue beneath it; it comes with redness, warmth, swelling and pain and needs to be treated by a physician.
Does drinking water or detox reduce cellulite?
Getting enough fluids is important for general health; however, there is no reliable evidence that drinking water or detox products reduce cellulite.
Sources
- Cellulitis — NHS (United Kingdom)
- Cellulite: a review of its physiology and treatment (Avram MM) — Journal of Cosmetic and Laser Therapy, 2004
- Cellulite: a review (Rossi AB, Vergnanini AL) — Journal of the European Academy of Dermatology and Venereology, 2000
Medical Aesthetics Expert Board
This article has been reviewed by the DoktorClub Medical Aesthetics Expert Board.
