Cellulite

Cellulite is a term for an appearance, not the name of a disease. It is also called “orange-peel skin” because the skin surface looks dimpled or indented rather than smooth. It mainly appears in areas with abundant subcutaneous fat, such as the thighs, buttocks, lower abdomen, and inner upper arms.

A recent review reports that it affects 80–90% of women after puberty. Some reports also suggest that it becomes more common with age and after menopause. Because it is so common, it is generally understood as a natural variation in the body.

Even in the same person, its visibility varies with lighting, posture, and muscle tension. It may look more pronounced when standing, when the muscles are relaxed, or under lighting from an angle.

Beneath the skin are small clusters of fat cells called fat lobules. These clusters are divided by thin connective tissue partitions, called septa, which connect to the dermis above and the fascia below. The septa pull the skin downward, while the fat lobules between them bulge upward. The interplay of these two forces creates a pattern of dips and bumps.

The arrangement of these partitions is often discussed as a reason cellulite is more common in women. In women, the septa tend to lie almost perpendicular to the skin, making it easier for fat to push upward between them. In men, the septa cross at oblique angles in a mesh-like pattern, so the surface tends to look relatively smooth even with the same amount of fat. A 1978 paper by Nürnberger and Müller describing this structural difference has been cited for many years.

Other factors are also thought to play a role.

• Enlargement of fat cells
• Thinning of the dermis and weakening of the support provided by collagen and elastic fibers (Skin elasticity and collagen)
• Changes in small blood vessels and lymphatic circulation
• The influence of hormones such as estrogen
• Activity levels and lifestyle habits

How much each factor contributes varies from person to person, and research is ongoing.

An increase in body fat can make cellulite more noticeable, but it is also common in people with a thin build. This is because inherent skin structure and hormones have a greater influence than body weight (Body fat percentage).

No method is known to eliminate cellulite completely, but there are various habits for caring for your skin and body.

• Try strength training regularly. When the thigh and buttock muscles become firmer, the area beneath the skin looks firmer and the body's contours look more defined (Resistance training).
• Include walking and aerobic exercise. Increasing your activity level improves your overall physical condition (Walking).
• Keep your skin moisturized. Well-hydrated skin looks smoother on the surface.
• Avoid sitting for long periods. Prolonged sitting slows circulation in the legs. Get up and move frequently.
• Ease tension with gentle massage. After a massage or scrub, your skin may temporarily look smoother or your legs may feel lighter (Massage).
• Pay attention to hydration and balanced meals. On days when you eat a lot of salty food, your legs may swell and your skin may look more uneven (Edema).

Dermatology clinics and skin care salons use various approaches, including devices, injections, and procedures that directly release the septa. The effects and how long they last vary by method and person.

If your legs and buttocks become symmetrically enlarged and feel painful when pressed or seem to bruise easily, it may be Lipedema rather than cellulite. Cellulite is primarily about the uneven appearance of the skin surface, whereas lipedema is a condition involving both subcutaneous fat distribution and pain.