Cellulite is not a medical disease but a harmless condition where fat underneath the skin gives it a dimpled, bumpy, or “orange peel” appearance.

For many people, the idea of being able to reduce cellulite with an over-the-counter cream is an attractive one. A large industry has built up to market and sell such creams and lotions as a result.

These creams are typically applied to affected areas of skin. Manufacturers claim that they can help reduce the bumpy appearance of cellulite. But are they worth the expense?

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Fat deposits pushing through the skin gives cellulite its bumpy appearance.

The lumpy appearance results from fat deposits pushing through the connective tissues beneath the skin. Cellulite usually affects the buttocks, thighs, hips, and waist.

It is significantly more common in women than men due to gender differences in the structure of these fibrous tissues. Indeed, it is estimated that between 85 and 90 percent of women over the age of 20 have some cellulite.

Cellulite is classed as either mild, moderate, or severe based on the amount of skin dimpling and sagging.

Causes and risk factors

It is unclear why some people develop cellulite and others do not. The following risk factors are thought to play a role:

  • Genetics: Certain genes linked with metabolism, circulation, fat distribution, and hormone levels may make people more likely to develop cellulite.
  • Age: The skin loses some of its elasticity and flexibility as it ages, which can worsen the appearance of skin dimples and sagging.
  • Hormones: The release and balance of hormones such as estrogen, insulin, thyroid hormones, prolactin, and norepinephrine may play an important role in cellulite development.
  • Diet: An unbalanced diet that is high in fat and low in fiber may worsen the appearance of cellulite by adding to the fatty deposits beneath the skin.
  • Lifestyle: Lack of exercise and weight gain may add to the worsening appearance of cellulite. However, cellulite can develop in people who get plenty of exercise who are of normal weight. Other lifestyle factors such as inadequate fluid intake, smoking, and high stress levels may also aid the development of cellulite.
  • Skin creams and lotions are among the most commonly used methods to help reduce the appearance of cellulite. The presumed effect of these creams is through the active ingredients, which often include:
  • Methylxanthines – the most common type of these chemicals used in cellulite creams are caffeine, aminophylline, and theophylline. Caffeine is thought to increase fat metabolism. Aminophylline and theophylline are muscle relaxants that may help promote smoother skin and break down fatty deposits.
  • Retinol – a vitamin A derivative that may improve blood flow to the skin and improve skin thickness and strength.
  • Botanical derivatives – such as Gingko biloba, Centella asiatica, and horse chestnut. The potential aims of including these in cellulite creams are to slow the formation of fat, help to break down fat, and reduce inflammation.

A recent study in the American Journal of Clinical Dermatology reviewed the evidence on the effectiveness of various treatment options for reducing cellulite.

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There is little evidence that topical treatments have a positive effect on the appearance of cellulite.

They identified a total of 17 studies, involving more than 600 participants, which published results on the treatment of cellulite with creams and lotions.

Around half the studies looked at complex mixtures combining caffeine and retinol with other ingredients. Two studies tested the effects of caffeine alone, and two assessed retinol alone.

Of the four studies that tested a single active ingredient, only one showed that treatment with a cream was more promising at reducing cellulite than treatment with a placebo or dummy cream.

Of the 14 studies that tested complex mixtures, only five showed an improvement in cellulite after treatment with the active cream.

Overall, the team concludes that “there is little evidence that topical [skin cream] treatments have a potential positive effect on the appearance of cellulite.”

There are many other treatments available for cellulite. A few examples are below.

Massage

Massage therapy for cellulite usually involves machines that use either rolling cylinders, suction devices, or other apparatus to manipulate the skin, pulling and squeezing affected areas. A number of massage sessions, lasting up to 45 minutes each, are usually needed to show any notable effects of areas of cellulite.

Any decrease in the appearance of dimply skin is likely to be short-lived, needing further sessions to maintain the effect. The effects of this treatment are likely due to the redistribution of fat under the skin, rather than any lasting reduction in cellulite.

Mesotherapy

Mesotherapy involves injecting a mix of enzymes, amino acids, and vitamins under the skin to help break down fat. This may result in a slight improvement in the appearance of cellulite.

Multiple injections are needed over time. The procedure may also have side effects such as swelling, and carries a risk of infection.

Laser or light treatment

There are different types of laser and light treatments for cellulite. They are sometimes combined with suction and skin manipulation, or massage. In general, they all aim to achieve a reduction in cellulite by melting fat and breaking down tissues under the skin.

Although this treatment has shown some success, multiple costly sessions are needed. Results only last for a few months before further sessions are needed.

Collagenase

A relatively new treatment for cellulite involves the injection of collagenase. This natural enzyme breaks down collagen. Early trials of the treatment have proved promising, but further research is needed to determine whether it is an effective and safe treatment.

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Grape seed extract is one of the ingredients in supplements available for treatment of cellulite.

Dietary supplements

These supplements contain various ingredients, such as:

  • Caffeine
  • Gingko biloba
  • Grape seed extract
  • Extract of focus
  • Fish oil

However, there is no evidence to support the use of such supplements for the reduction of cellulite. Some may even interfere with the action of prescription medications.

Acoustic wave therapy

This form of therapy involves targeting cellulite with sound waves from a hand-held device. Its aim is to improve blood flow, skin stretchiness, collagen production, and reduce fatty deposits under the skin.

There is some evidence to suggest that acoustic wave therapy may be effective at reducing cellulite, but further studies are needed to confirm any benefits.

Liposuction

Liposuction involves removing body fat by suction through small tubes inserted into the skin. It is not recommended as a treatment for cellulite and may make the appearance of dimples worse.

Conclusions

The best ways of preventing cellulite are avoiding gaining weight, maintaining a healthy diet, and exercising regularly. These would also appear to be the best ways to reduce the appearance of cellulite through weight loss. It may take some time before the effects become noticeable, however.

Although there appears to be little evidence to back up claims made by some manufacturers of anticellulite creams, they may work for some people. This may be the case when combined with a healthy lifestyle and weight loss.

People should also be cautious about surgical treatments, dietary supplements, or other complex methods claiming to reduce cellulite that are not backed-up by scientific evidence. People should consult with their doctors about what might work best for them.