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Cellulite

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Last updated: December 2023

Also known as…Orange-peel skin, cottage-cheese skin

What is cellulite?

Cellulite is a very common condition. It is the skin dimpling and lumpiness on the skin surface of the thighs, buttocks and abdomen and is seen in up to 90% of women in various degrees.1

Who gets cellulite?

Cellulite is seen in nearly all women and rarely occurs in men. It does not usually appear until puberty or later in life. Other contributing factors include:

  • Genetic predisposition,
  • Hormones
  • Ethnicity (it is less common in Asian people)
  • Diet
  • Obesity
  • Weight change
  • Lifestyle
  • Pregnancy

What causes cellulite?

Cellulite is not really a “disease” and is not related to any internal medical conditions. Cellulite does not usually cause any worrisome symptoms or problems other than the undesired appearance of the skin.

The exact cause of the appearance of cellulite is uncertain but it is believed to be the result of three different physical factors:

  • Localised out-pouching of skin fat tissue;
  • A lattice or net-like fibrous tissue distorting the skin fat; and
  • Localised build-up of fluid in the skin from microcirculation and lymphatics.        

The female hormone oestrogen is thought to contribute to the distribution of fat that causes the appearance of cellulite.

What does cellulite look like?

Cellulite typically presents as dimpled, uneven and slightly lumpy skin over the buttocks, thighs and other areas.

Cellulite 1_thigh_Adrian Lim

Figure 1. Cellulite on the thigh. Image reproduced with permission of Dr Adrian Lim

Cellulite 2_R_hip_Adrian Lim

Figure 2. Cellulite on the right hip. Image reproduced with permission of Dr Adrian Lim

How is cellulite diagnosed?

Cellulite is usually diagnosed clinically without the need for further testing.

How is cellulite treated?

The condition remains difficult to treat with few studies demonstrating impressive, long-standing results despite the “commercial hype” of advertised products.  

Since cellulite is not strictly related to excess body fat, losing weight through dieting and/or exercise may not always resolve the problem.

Most topical creams that promise to remove cellulite do not deliver on their claimed effects. Many natural botanical products claim to reduce the appearance of cellulite but there is limited evidence that they have any effect. For example, topical creams containing caffeine, vitamin A derivatives (Retinols and Retinoids), and aminophylline are well advertised. However, there is very weak evidence regarding the success of these creams and most have a minimal impact on the cellulite, even with regular long-term use.

Similarly, various dietary supplements such as gingko balboa, soy lecithin, bioflavinoids, evening primrose oil have been promoted, without solid clinical studies, to improve cellulite through antioxidant effects, improving micro-circulation or fat metabolism.

Physical treatments such as massage, injection of temporary fillers and various light and laser devices can, in some cases, reduce the appearance of cellulite. Ultrasonic, acoustic wave and radiofrequency devices can also improve the appearance of cellulite.  However, these anti-cellulite devices require multiple treatment sessions that can be expensive, and long-lasting results are not guaranteed. 

Surgical techniques such as liposuction and subcision can be considered but these procedures are not always successful and, in some cases, may make the condition worse.

What is the likely outcome of cellulite?

Cellulite causes no physical harm but may be a cause of embarrassment for the individual. However, there is no single highly effective cure for cellulite.

  1. Gabriel A, Chan V, Caldarella M, Wayne T, O’Rorke E. Cellulite: Current Understanding and Treatment. Aesthet Surg J Open Forum. 2023 Jun 21;5:ojad050. doi: 10.1093/asjof/ojad050.
Dr Adrian LimDecember 2023
Dr Adrian LimMarch 2017

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