What Is (And What Isn't) Cellulite?

Cellulite develops within the deepest part of the skin — the hypodermis or subcutaneous layer. Fatty adipose tissue forms within the fibrous connective tissues that connect the skin to the muscle. As the fat accumulates, it pushes against the skin and the fibrous tissues pull down. Because of this, changes in muscles, fat, connective tissues, and other factors can affect cellulite’s appearance.

Because the fibrous tissue presses down around the fat, cellulite has a dimpled or bumpy appearance sometimes referred to as an orange peel or cottage cheese. Mild cellulite is often only visible when pinching skin, while thicker cellulite can be seen without manipulating the surface. How cellulite manifests depends on many factors and is largely unpredictable.

Despite cellulite’s controversial nature, very few trustworthy and peer-reviewed studies with cellulite as a topic have been published in the last several decades. Because of this, cellulite’s cause remains unknown. Current research indicates that cellulite may result from a complex combination 0f changes in metabolism, diet, exercise habits, physiology, sex-specific skin architecture, connective tissue structure, hormonal factors, genetic factors, the extracellular matrix, and inflammation.

Many factors indicate a potential for developing cellulite. The most important is sex, as upwards of 90% of post-adolescent females have cellulite while very few males develop it. Hormone issues involving estrogen, insulin, thyroid hormones, and prolactin may be responsible, as well. Conditions involving circulatory and lymphatic issues also have links to cellulite. Evidence shows that a highly stressful lifestyle increases the level of catecholamines, which may affect cellulite development.

Cellulite typically develops in specific locations, though factors such as genetics, hormone changes, and ethnicity may impact this. For most individuals, cellulite develops primarily around the thighs and buttocks. However, it may also form within the breasts, along the lower abdomen, and on the upper arms.

Cellulite is not harmful and is not linked with health issues. Despite persistent claims, cellulite does not result from toxins. Many health experts believe that having cellulite is natural and that a lack of cellulite is the true outlier. Additionally, many cellulite treatments have limited effectiveness or fail to affect cellulite at all. Even proven cellulite treatment options are slow and impermanent.

A variety of treatments are available to improve the appearance of cellulite, though only temporarily. Laser treatments can reduce cellulite visibility for six months to a year. Multiple treatments of cryolipolysis over several months also produces results. Applying 0.3% retinol cream can thicken the skin, masking the texture of cellulite.

Despite forming due to fatty adipose tissue, thinking of cellulite as typical fat is often a mistake. While weight loss and improved muscle tone may help with cellulite’s appearance, they do not necessarily lead to a loss of cellulite fat. Loose skin resulting from weight loss may actually make cellulite more apparent. Liposuction can temporarily reduce cellulite but the lack of fat may also make cellulite more visible. Most cellulite skin creams provide temporary and indirect visual reduction, but are ineffective in the long term and do not reduce cellulite.

Though cellulite is extremely common in post-adolescent females, it appears in less than 10% of males. Research indicates that cellulite develops more frequently in males with androgen deficiencies from health conditions like hypogonadism or Klinefelter’s syndrome, or from estrogen therapy. It is unclear what role androgens play in preventing cellulite.

Many misconceptions about cellulite stem from modern ideas. For centuries, cellulite was seen as normal and, in some cultures, beautiful. However, this changed within the last century. Spas and beauty salons first used the term “cellulite” in the 1920s, claiming to be able to reduce it with their services. The term began appearing in English publications like Vogue within the next several decades. Many groups painted cellulite as a negative, with some calling it a curable medical problem so they could sell cosmetic treatments and other products. This mentality persists to this day, despite a significant lack of scientific evidence.