Cellulite: What Is It? How Can You Treat It?

Spring is here. You can finally stop salting your icy sidewalk and start focusing on summer issues, like cellulite.

What is cellulite?

It’s the dimpling and nodularity that occurs in women on the thighs, pelvis and abdomen. Cellulite is the result of fat pouching out of holes in the connective tissue on the skin. It occurs in 98% of girls and women post puberty. That’s right. Essentially all females have cellulite. It is a normal characteristic of sexually mature women.

Here’s what cellulite is not:

  • Cellulite is not fat. It is the appearance of the superficial fat held loosely beneath the skin. The fat is held more tightly in men which is why we do not develop cellulite.
  • Obesity doesn’t cause cellulite. Look around and you will see that skinny women have cellulite (in real life anyway).
  • Cellulite is not an accumulation of toxins or fluids; it is normal fat.

How Can You Get Rid of Cellulite?

The best treatments for cellulite have at most shown mild improvements in the appearance. Unfortunately, in almost all cases, the improvements are not maintained over time. This is because it is hard to change the loose connective fibers under the skin, which are the primary cause.

  • Weight loss can improve cellulite, but not always. Losing weight can make the skin sag, and weight loss has been shown to actually worsen the appearance of cellulite in some women.
  • Endermologie is a kneading system (like my grandmother would knead the pizza dough). Although there is some evidence it can reduce thigh circumference, how long the effects last is questionable.
  • Liposuction removes fat through suction. It is not a good treatment for cellulite because the fat is too superficial. Liposuction combined with a laser to treat cellulite sounds interesting, but has not been shown to work better than ordinary liposuction.
  • Subcision, which targets the connective tissue bands by snipping them, is a great idea, but in practice has not been shown to be very effective. There is some concern that snipping the connective fibers might actually make the fat looser, worsening the problem.
  • Mesotherapy is the injection of medications under the skin to dissolve the fat. Although it has worked for some, the results are unpredictable and can cause adverse side effects such as bruising or pain.
  • Radiofrequency treatments like TriActive or VelaSmooth generate heat under the skin damaging the fat and connective tissue, hopefully smoothing the cellulite. Improvements have been reported, but no long term efficacy has been demonstrated.
  • Herbal creams have been studied and had no effect on cellulite. It is unlikely that any topical treatment can penetrate far enough down and be potent enough to have any effect.
  • Diet has no effect on cellulite.
  • It is possible that regular exercise can improve the circulation of cellulite areas, improving the appearance, but no studies have shown that it has a significant impact. Work out because it is good for you, but stop looking at your behind in the gym mirror.
  • There are some upcoming technologies that are promising. I’ll post about them later.

What Should You Do About Cellulite?

Because it is a normal occurence in women, it’s reasonable to simply tell yourself: “Hey, this is normal!” and stop killing yourself trying to eliminate it. Many women have been pleased with any of the above treatments, but they’re all expensive and likely all temporary. If it is worth spending $500 to have a 50% improvement in your cellulite, then make an appointment with your dermatologist or plastic surgeon to discuss your options.

Keep in mind that your friends or partner might not notice that your cellulite is 50% better (what does 50% better cellulite look like anyway?). If you’re worried that you might be featured in a magazine, don’t fret. You will receive the only known cure for cellulite: Photoshop.

Do you have cellulite? Have you tried to eliminate it? How successful was it?

Photo: Tassoman

Caffeine Plus Exercise Protects Against Skin Cancer

Do you love your morning coffee? Do you love to exercise? Well, so do I. Here’s another reason why we should keep it up: caffeine and exercise might reduce the risk of skin cancer.

A laboratory study of mice found that caffeine and exercise boosted the elimination of ultraviolet light (UV) damaged cells. Disposal of these damaged cells before they can grow reduces the risk of a skin cancer developing.

The study compared the effects of caffeine, exercise, and the combination of both in three groups of hairless mice. Hairless or nude mice are particularly vulnerable to ultraviolet light radiation and are prone to skin cancer.

One group of mice drank caffeinated water, the equivalent of one to two cups of coffee a day. Another group ran on an exercise wheel, the equivalent of a 2.5 mile jog for us.  A third group drank caffeinated water and ran the wheel. All of the mice were exposed to UV radiation. The rate of elimination of damaged cells was highest in the third group that both drank caffeine and exercised.

A different study found that topical application of caffeine can also help prevent skin cancer. Caffeine applied 30 minutes before UVB exposure inhibited cell DNA damage by 80 percent. In other studies, caffeine has been shown to decrease the risk of breast and liver cancer.

Of course, caffeine and exercise are not a substitute for wearing sunscreen; however, they might justify splurging on a latte today. But please don’t place your Starbucks Venti coffee on the gym treadmill next to me in the morning — that drives me nuts.

Photo: Adria Richards (flickr)

Can Exercise Give You Hives?

jogging-ernst-moeksis

Hives are itchy pink blotches that develop on your skin. They come up quickly, are extremely itchy, then disappear without a trace in minutes to hours. Many things trigger hives including foods, medicines, and sometimes exercise.

Exercise-induced hives (or urticaria) develop when your skin warms during exercise. Once your skin reaches a certain temperature, itchy welts suddenly bloom. The hives favor your stomach, back, or chest but can occur anywhere. One thing is for certain: They always intensify into a maddening itch.

Eating cheese, seafood, celery, or wheat within a few hours of starting exercise can trigger an outbreak. People who have exercise-induced hives also sometimes react when they take medications such as aspirin, ibuprofen, or naproxen before exercising.

In some people, exercise-induced hives occur when they exercise in cold weather. This often happens when they jog in cold weather, ski, or swim in the ocean (especially here in California where the water is always chilly).

If you’re exercising and you develop an itchy red rash, then stop exercising. If the hives don’t go away within 15 minutes, then stop your workout. Avoid eating cheese, celery, seafood, or wheat  for 4 hours before your workout. Similarly, avoid aspirin or ibuprophen for 4 to 6 hours before exercising. Taking antihistamines such as Benedryl or Zyrtec an hour before exercising may help block an outbreak. Antihistamines also hasten the resolution if taken immediately when the rash occurs.

In rare cases, exercise-induced hives cause swelling of the throat, difficultly breathing, and even death. If you develop swelling of your mouth or throat, or difficulty breathing or swallowing, then seek immediate medical help. Patients with high-risk allergic reactions should carry an epi-pen at all times and should never exercise alone.

Photo: Ernst Moeksis

Caffeine and Exercise Protect Against Skin Cancer

exerciseCaffeine and exercise together may be up to four times as protective against ultraviolet light induced skin cancer than either alone.

A recent laboratory study found that topical application of caffeine 30 min before ultraviolet-B (UVB) exposure inhibited the formation of thymidine dimers by 70 to 80 percent — thymidine dimers are the genetic basis for UVB-induced skin cancer.

Another study found that the combination of caffeine and exercise boosted elimination of ultraviolet light damaged cells in mice. Disposal of these cells would decrease the risk of future skin cancer.

The study compared the effects of caffeine, exercise, and the combination of both in three groups of mice whose exposed skin is prone to skin cancer.

One group of mice drank the equivalent of one to two cups of coffee a day in the form of caffeinated water. Another group ran on an exercise wheel, and a third drank the caffeinated water and ran on the wheel. All of the mice were exposed to UV radiation.

Some of the mice’s damaged skin cells were eliminated through apoptosis – a programed, choreographed process that occurs when damaged cells die. The rate of apoptosis among these damaged cells was highest in the third group that drank caffeine and exercised.

Of course, caffeine and exercise are not a substitute for wearing sunscreen. But it does justify splurging on a double latte today.

Just don’t bring your Starbucks venti coffee with you on the gym treadmill in the morning; that drives me nuts.

Lu, Y-P., Lou, Y-R., Peng, Q-Y., Xie, J-G., Nghiem, P., and Conney, A. H. (2007) Proc. Am. Assoc. Cancer Res. 48:821

Can a Caffeine Cream Banish Cellulite?

Researchers in Brazil say a cream containing caffeine may make women’s thighs smaller. It makes for a nice headline, except:

It was not clear from a news release on the study if the work was a true experiment, with a control group and subjects randomly getting the treatment or a placebo.

Whether caffeine banishes cellulite is less clear. The researchers assessed cellulite changes with a handheld imaging instrument that reveals microcirculation in fat tissue. Imaging showed little change in cellulite, even in the hips and thighs that slimmed down.

Sound too good to be true? I’m sure it is. However, if you apply the caffeine cream immediately before doing 30 minutes on the elliptical five times a week for 10 weeks, then you’ll see those thick thighs melt away.

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