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Fighting Cellulite: 'Jean' Therapy to Creams

No cellulite treatments work permanently, but we keep trying them anyway

Reviewed by Brunilda Nazario, MD on June 30, 2004
From the WebMD Archives

The world's relentless war on cellulite has a new front. This year, anItalian clothing company released the first line of anticellulite pants. As youcasually sashay about town, the friction between your body and the jeansreportedly releases an anticellulite cream -- all for $139. Does it work? Theworld's dermatologists are unconvinced.

Jeans saturated with skin cream are only one of many remarkable cellulitetreatments. We've all seen other miracle cures: creams, herbs, massagemachines, and lasers. But let's cut to the chase: Is there any treatment outthere that will get rid of cellulite?

"There's really nothing that works well," says Lisa Donofrio, MD,associate clinical professor of Dermatology at Yale University.

But this stark fact -- there is no cure for cellulite -- doesn't stop usfrom hoping and shelling out a lot of money. Even the most savvy and cynicalamong us tend to get wide-eyed and trusting when we read the claims on a tubeof a miracle cream.

While there aren't any permanent cures, there are some cellulite treatmentsout there that might -- might -- help some people get temporaryimprovement. So to guide you in the right direction, here's a survey of what'sout there: from the harmless (and maybe just a little bit effective) to theunproven and potentially dangerous.

What Is Cellulite?

From a medical standpoint, the fat in cellulite is just fat, the same as anyother fat on your body. The term cellulite has only been used in the U.S. forabout 30 years -- it was popularized in 1973 by a book-writing spa owner. Theterm refers to the dimpled appearance of the skin seen in areas of the hips,thighs, and buttocks. It is more commonly seen in women because of the way awomen's body distributes fat. Experts estimate that about 85% of women developcellulite.

"You often see it at times of hormonal surge, like pregnancy orpuberty," says Elizabeth Tanzi, MD, co-director of laser surgery at theWashington Institute of Dermatologic Laser Surgery in Washington.

Tanzi says that men may be less likely to have cellulite because they havethicker skin, which is much better at hiding the fat beneath.

While many look at cellulite as a disease -- a harmful build-up of toxinsthat must be healed -- it's no such thing. It's a perfectly normal and naturalway of carrying fat.

The Treatments

Even though cellulite isn't an illness and doesn't need a cure, there areplenty of cellulite treatments nonetheless. Here's the rundown:

Exercise and Diet

Getting regular exercise, eating a healthy diet lower in calories, andmaintaining a normal weight may work as a cellulite treatment for some people.No special diet is necessary: just a commonsense one that's high in fruits andvegetables and low in fat.

But exercise and diet won't necessarily solve the problem. Losing weightwill reduce the proportion of fat in your body, and hence a proportion of thefat that's trapped in cellulite.

However, the appearance of cellulite is really genetically predetermined."I always recommend exercise and a good diet as a way to deal withcellulite," says Tanzi. "But it's true that in some women, exercise anddiet don't do a thing."

Creams

There are countless creams available as cellulite treatments. Many are overthe counter and a few are by prescription. Most have some eye-catchingingredient -- prehistoric mud, the pollen of the most rare Alpine weed, and soon.

Do any of them work? According to some doctors, these cellulite treatmentsmay work in some people. However, even proponents caution that the effects aremodest and not permanent.

"I don't recommend creams, but if patients want to try one, I generallydon't have a problem with it," Tanzi tells WebMD. She suggests looking forcreams that contain caffeine or theophylline. There are some studies that showthese ingredients might have an effect on cellulite, causing fat cells todissolve. Other studies disagree.

Even if these ingredients might cause fat to dissolve theoretically,slathering it on the surface of your skin isn't going to do much, Donofriosays. Your skin is designed to keep things out, after all. Expecting a topicalcream to "soak into" the fat is kind of like placing a sandwich on yourbelly and expecting it "soak into" your stomach. The cream will neverget near the fat deposits.

"I think that the effects of any cream are doubtful," says Donofrio."But I do have some patients that swear by them." If you want to trythem, she strongly advises that you go with an $8 bottle you can pick up from adrugstore. "The ingredients are really no different from the fancy onesthat cost $100 a bottle," she says.

Endermologie

One of the best-known cellulite treatments is Endermologie, a"deep-massage" approach to reducing cellulite developed in France. Ituses a device that suctions the skin with a vacuum and kneads it with a set ofrollers.

"Some studies have shown the deep-tissue massage can break up some ofthe fibrous bands, help circulation, and improve the appearance of theskin," says Tanzi. She says that while it works for some women, the effectsdon't last. You'll need regular maintenance treatments to keep upappearances.

Tanzi estimates that individual sessions cost anywhere from $100 to severalhundred dollars. They're usually done weekly and take about an hour.

"If you've got a lot of disposable income, I think Endermologie is thebest way to go," says Donofrio. "It's going to cost some money, butsome people will get pretty nice results. A lot of people will get no results,but at least they're not going to get hurt."

Mesotherapy

Another cellulite treatment originally developed in France, mesotherapy,involves a series of injections into small pockets of cellulite. They contain asolution -- a cocktail of homeopathic medications and supplements -- thatsupposedly break down fat and flush it away.

"It's pretty well accepted by women in Europe," says Tanzi. "Butit hasn't been studied scientifically here. There's a lot ofskepticism."

She also points out that any cellulite treatment that requires injections --in this case, a lot of injections -- heightens the risk for side effects andproblems. It's also very expensive, with individual sessions costing perhapshundreds of dollars.

"I consider mesotherapy a snake oil," says Donofrio. "If youlook at the literature, there just isn't good evidence that it works and it canalso cause really serious infections."

Herbal Medicines

The fact is that no combination or herbs or vitamins is known to have anyeffect on cellulite whatsoever. If you want to try one anyway, check with yourdoctor first, since some can cause dangerous interactions with othermedications. Remember, just because a remedy is "natural" or"traditional" doesn't mean it is safe, let alone a good cellulitetreatment.

Liposuction

You might think that if cellulite is just fat, liposuction is just what youneed. But that's not the case.

"We get a lot of patients who think that liposuction will help,"says Tanzi. "We try to correct them very quickly. Not only does liposuctionnot help, but it can actually make cellulite look worse."

The problem is that liposuction can really only get at fat that's deep downbeneath the skin. Cellulite is generally too close to the surface forliposuction to help. Besides, it's the fibrous bands that really give celluliteits appearance anyway -- getting rid of fat alone wouldn't really do much.

Other Treatments

A number of cellulite-treatment devices have been developed that combinedeep tissue massage with other features, such as light and radio frequencytherapy.

Tanzi is taking part in a clinical trial of one such device called theVelaSmooth, manufactured by Syneron. Although the results won't be known for afew months, Tanzi is optimistic about the treatment.

"In general, I think the future of cellulite treatment is verypromising," says Tanzi. "In the future, we're going to have treatmentsthat, if not permanent, will certainly be longer lasting than what we havenow."

But Donofrio says that future is a long way off.

"We're not even close," she tells WebMD. Donofrio likens treatingcellulite to changing your hair color: You might be able to get a temporaryeffect, but there's no way to do anything permanent. Achieving that wouldrequire genetic changes -- a lot more than dyes or creams can do.

What Can Be Done?

Obviously, there's little evidence that any of these cellulite treatmentswill do much. Until that miraculous cure appears, if it ever does, we'll alljust have to muddle through. If you're dying to try something -- and providedthe therapy you want has no risks -- both Tanzi and Donofrio say you can giveit a shot. However, keep a level head: at best, the results are going to bemodest. Think hard before investing too much money.

If you're considering treatment in a doctor's office, Donofrio recommendsshopping around. Don't sign on to a treatment after only talking to one doctor.Donofrio observes that some doctors who have ponied up for an expensivecellulite-treatment machine might be tempted to use it even in cases where itprobably won't work. If you do decide to get a series of treatments, make sureyou understand how many you'll need and how much you're paying.

Since the war on cellulite is unlikely to be won any time soon, you may needto learn to change your attitude a little too. The next time you're lookingover your shoulder, staring unhappily at the reflection of your backside inyour bedroom mirror, remember this: Celebrities, the demigods of our society,have cellulite too.

So think of cellulite as the great leveler. Despite her wealth and the armyof dermatologists, plastic surgeons, personal trainers, and make-up artists ather beck and call, even J. Lo has cellulite, according to the tabloids. And ifprofessional sex symbols can have cellulite, why can't you?

Show Sources

SOURCES: Lisa M. Donofrio, MD, associate Clinical professor, dermatology, Yale University School of Medicine, New Haven, Conn.; also in private practice, The Savin Center, New Haven, Conn.; and Laser & Skin Surgery Center of New York. Elizabeth Tanzi, MD, co-director, Laser Surgery, Washington Institute of Dermatologic Laser Surgery, Washington. Sainio E. European Journal of Dermatology, December 2000; vol 10: pp 596-603. The American Academy for Dermatology web site.

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