From the FMS Global News Desk of Jeanne Hambleton (UK)
By Kathleen Doheny –Reviewed by Louise Chang, MD – WebMD Feature -Reviewed on March 16, 2009
From radiofrequency waves to lasers, a host of new treatments promises to help you get rid of cellulite.
At 39, Julie wears a svelte size 4 and works out regularly to stay lean. Still, she struggles with one frustrating figure flaw that most women can relate to: cellulite.
“I started getting it in my early to mid-30s,” says Julie, who lives in Chicago and asked that her last name not be used. It mostly cropped up on her buttocks and the backs of the upper legs.
When extra workouts did not seem to make a difference, she resorted to a new deep-heating technique that relies on radiofrequency technology to tighten collagen and firm up the dimply, cottage cheese-like skin that affects thin and heavy women alike.
After the treatment, she was pleased. “I am so happy I had it done,” she says. “My cellulite is drastically reduced.”
Julie’s heat treatment is not the only new option for banishing or reducing cellulite. In the past few years, a host of new options has become available. Which of these new cellulite treatments are the most promising and which ones should you skip? Read on for details.
Cellulite: Understanding It
Before seeking treatment for cellulite, it helps to understand what it is and why it occurs, experts say. “It is largely genetic,” says Carolyn Jacob, MD, a dermatologist and associate clinical instructor of dermatology at Northwestern Memorial Hospital, Chicago. “Ninety percent of women have it.”
Cellulite is fat, but with a different appearance than other fat. It looks like dimpled skin, sort of cottage-cheesy, and most often shows up on the thighs, hips, and buttocks. If it is mild, it can only been seen when the skin is pinched. But in more severe cases, the bumpiness and peaks and valleys show when the skin is not pinched.
Cellulite is much more common in women than in men, experts say. Why? Fat in women often accumulates in the thighs, hips, and buttocks. Underneath the skin, the fat contains fibrous bands.
In men, these bands are typically in even rows, says Robert Weiss, MD, president of the American Society of Dermatologic Surgery and a dermatologist in Hunt Valley, Md. But in women, even in women at a healthy weight, the bands are not in regular, even rows but are in more of a zigzag pattern, he says, probably due partly to hormonal influences. That allows the fat to push through the connective tissue that typically keeps it distributed evenly, resulting in the bumps, peaks, and valleys that appear as cellulite.
Genetics play a role in whether you will get noticeable cellulite, and so does the amount of fat in your body. Excess weight can make the cellulite more noticeable.
Cellulite Treatment: Exercise and Diet It Away?
Has anyone ever exercised away cellulite? “I think you can improve it somewhat with repetitive, low-weight exercises on the leg,” says Weiss. He presented new data on cellulite treatments at the 2009 annual meeting of the American Academy of Dermatology.
If you want to try to exercise away cellulite, he says, “use free weights or machines. Use 5- to 10-pound weights.” Include cardio exercise, too, for overall fat burning, he says.
Others agree diet and exercise can help. If you have excess weight, you should focus on reducing calories to shed the extra pounds, as well as doing regular strength training and cardio exercise to see improvement in cellulite, says Wayne Westcott, PhD. He is a fitness expert and fitness research director at the South Shore YMCA in Quincy, Mass., and co-author of No More Cellulite: A Proven 8 Week Program for a Firmer, Fitter Body.
In one study, he evaluated changes in 79 women, average age 45, who completed his eight-week cellulite reduction program. They trained three days a week, with each session including about 25 minutes for strength training and another 25 for endurance training such as jogging or cycling. The women lost fat and increased muscle, reversing the two problems Westcott blames for cellulite accumulation — muscle loss and fat gain in the hips and thighs.
When the underlying muscle is strengthened, he tells WebMD, “that makes the fat lay smooth, not crinkled.” His program includes 10 basic strength exercises — such as the leg curl, leg press, and hip adduction — as well as endurance exercise. In his study, the women who also reduced their calorie intake lost more weight — nearly 8 pounds compared to 1.5 pounds — and more fat — more than 9 pounds compared to a little more than 3.
Cellulite Treatment: Heat It Up?
Another option: radiofrequency waves, like Julie used, called Thermage. “Thermage uses radio wave energy through the skin to create heat, which then tightens the [fibrous connective] bands that cause the rippled appearance in your skin,” says Jacob, who treated Julie.
The Thermage technique has been used on the face for years but only recently for cellulite treatment. “The procedure takes about an hour and a half,” Jacob says. The handheld device that delivers the radio wave energy is placed on the skin in a grid pattern, Jacob says. The area is treated repeatedly. One procedure is typically all that is needed. “For some people it takes a couple months to see the results,” she says.
Jacob estimates the results may last up to 21 months or so.
In a company study, 18 of 20 women who had Thermage to improve their cellulite reported continuing improvement at up to 16 weeks after the procedure, while two saw no change.
The technique works best, Jacob says, for women ages 20 to 45 who are normal weight with a mild to moderate cellulite problem. Those beyond age 45 could try it, Jacob says, but she suspects less benefit.
The cost is about $2,000 or higher.
Cellulite Treatment: Lasers, Lights, Vacuums, Massage
Other approaches to banish cellulite work by combining treatments.
One example is SmoothShapes, which treats cellulite and subcutaneous fat by combining light energy and dynamic laser light with mechanical methods, says Weiss. He studied the approach for the company and has served as a consultant for some laser companies.
The laser is used to liquefy the fat, and then a special light increases the permeability of the cell membrane, helping to stimulate the production of collagen, the main protein in connective tissue. Suction is applied with a special vacuum to ensure consistent light penetration to the tissue, and rollers are used to gently massage the skin surface and help move the liquefied fats from the area into the body’s lymphatic system for drainage.
“The cellulite smoothes out,” Weiss says. In his study, they performed the treatment twice a week for four weeks. “We noticed improvement in some patients in as little as four treatments,” he says. The treatments run about $125 to $175 per treatment, Weiss says.
“I am going to advise our patients that it will last one or two years, assuming they maintain the same level of activity and the same dietary habits,” Weiss says.
Cheryl, 40, a Maryland attorney, went to Weiss in 2008. She hoped he could offer her a therapy to improve the cellulite that seemed to get worse after the birth of her daughter, now 5. She participated in the study he did for the company, having the SmoothShapes technique done on one leg. She had the six-month measure recently, and she definitely noticed a difference. “I could definitely see less dimpling,” she says. “It was firmer.”
Now Cheryl cannot wait to have the other leg done. “For me it will mean less hesitancy to wear shorts — and I do not mean short-shorts,” she says.
Cellulite Treatment: Lipo It Away?
Liposuction alone — the removal of fat from beneath the skin using a hollow tube inserted beneath the skin with assistance from a vacuum to suck out the fat — will change your silhouette, Jacob says.
“But do not count on it to take away the appearance of cellulite. It sometimes improves it but not every time.”
Cellulite Treatment: Creams and Potions
So-called anti-cellulite creams, widely available on the Internet and at drug stores, promise to at least improve the appearance of cellulite. Weiss tells patients to “not waste time and money on creams.”
But Jacob says those containing caffeine may have a bit of a temporary effect. “With caffeine there is some vasoconstriction,” she says. That, plus the recommended massaging of the cream into the skin, may help drain away a little fluid. “The appearance of the cellulite is improved, at least temporarily,” she says.
Cellulite Treatments on the Horizon
Scientists are looking at a treatment called cryolipolysis — basically chilling your fat — says Weiss. “It is the use of cold above the freezing mark,” he says. It can cause fat to be reabsorbed.
Viagra, the widely used erectile dysfunction drug, may someday help smooth bumpy cellulite, according to scientists in Croatia. The researchers speculate that the drug may also burn the fat underlying cellulite and improve circulation.
SOURCES: Robert A. Weiss, MD, president, American Society for Dermatologic Surgery; associate professor, Johns Hopkins School of Medicine; dermatologist, Hunt Valley, Md. Carolyn Jacob, MD, associate clinical instructor of dermatology, Northwestern Memorial Hospital, Chicago. Wayne Westcott, PhD, fitness research director, South Shore YMCA, Qunicy, Mass. Soltis Medical: White paper. Altabas, K. Medical Hypotheses, Feb. 27, 2009 online.
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