Cellulite

The dimpled appearance of cellulite

Cellulite (also known as adiposis edematosa, dermopanniculosis deformans, status protrusus cutis, gynoid lipodystrophy, orange peel syndrome and cottage cheese skin) is the herniation of subcutaneous fat within fibrous connective tissue that manifests topographically as skin dimpling and nodularity, often on the pelvic region, lower limbs, and abdomen.[1][2] Cellulite occurs in most postpubertal females and rarely in males.[3]
Contents

* 1 History
* 2 Epidemiology
* 3 Causes
* 4 Treatment
* 5 References
* 6 External links

History

The term was first used in the 1920s, and began appearing in English language publications in the late 1960s, with the earliest reference in Vogue magazine, “Like a swift migrating fish, the word cellulite has suddenly crossed the Atlantic.”[4] Its existence as a real disorder has been questioned,[5] and the prevailing medical opinion is that it is merely the “normal condition of many women”.[6] One cosmetic company has noted its historical place in industrialised societies as an “inappropriate term used by women to describe curves which they judge to be too plump and not very aesthetic”.[7]

Epidemiology

Cellulite is thought to occur in 80-90% of postpubertal females.[8][9] There appears to be a hormonal component to its presentation. It is rarely seen in males,[1] but is more common in males with androgen-deficient states, such as Klinefelter’s syndrome, hypogonadism, postcastration states and in those patients receiving estrogen therapy for prostate cancer. The cellulite becomes more severe as the androgen deficiency worsens in these males.[citation needed]

Causes

The causes of cellulite [10] include changes in metabolism, physiology, dieting too hard or too much, sex-specific dimorphic skin architecture, alteration of connective tissue structure, hormonal factors, genetic factors, the microcirculatory system, the extracellular matrix, and subtle inflammatory alterations.[3][1][10][11]

Hormonal factors

Hormones play a dominant role in the formation of cellulite. Estrogen may be the important hormone to initiate and aggravate cellulite. However, there has been no reliable clinical evidence to support such a claim. Other hormones, including insulin, the catecholamines adrenaline and noradrenaline, thyroid hormones, and prolactin, are all believed to participate in the development of cellulite.[1]

Genetic factors

There is a genetic element in individual susceptibility to cellulite.[1] Researchers led by Enzo Emanuele have traced the genetic component of cellulite to particular polymorphisms in the angiotensin converting enzyme (ACE) and hypoxia-inducible factor 1A (HIF1a) genes.[8]

Predisposing factors

Several factors have been shown to affect the development of cellulite. Sex, race, biotype,[12] distribution of subcutaneous fat, and predisposition to lymphatic and circulatory insufficiency have all been shown to contribute to cellulite.[1]

Lifestyle

A high-stress lifestyle will cause an increase in the level of catecholamines, which have also been associated with the evolution of cellulite.[1] Certain dieting practices can also diminish the level of these chemicals, and decreasing body fat typically results in the appearance of cellulite.
Formation of Cellulite.jpg

Treatment

Numerous therapies for the treatment of cellulite are available, but empirical evidence for the efficacy of these strategies is limited[3]. In an interview with the New York Times, Molly Wanner, an instructor in dermatology at Harvard Medical School and an author of a 2008 evidence-based review of existing treatments, asserted: “At this point, there is no outstanding treatment for cellulite.”[13] Michael F. McGuire, a clinical associate professor at the David Geffen School of Medicine at the University of California, Los Angeles, confirmed that “realistically, there is no cure for cellulite.”

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