The Truth About Cellulite
02.19.18

I was in my mid-twenties when I noticed cellulite on the back of my thighs. It’s possible it was there for years, dormant and unproblematic, waiting to be seen as otherwise until the day I caught it in a different light. By now I’m fully cognizant of the fact that I have it, and that it’s seen as unsightly or unhealthy, at least by the swaths of health and beauty brands suggesting I try to get rid of it.

But besides them, who says I have to get rid of it? Because it’s often misunderstood and oversimplified, I asked some experts to dispel the myths about how it forms and how it ought to be treated, if at all. Here’s what they told me.

Nearly every woman has cellulite

Up to 98 percent of women have cellulite, says New Jersey-based dermatologist Asma Ahmed. It usually shows up in post-puberty years and tends to intensify with age. It’s much more common in women than men, only 10 percent of whom will ever get cellulite. (More on why in a bit.)

The data should be a good reason to not feel shame about it, says registered dietitian and Central Connecticut State University assistant professor Cassandra Forsythe, who last year penned a detailed post at Girls Gone Strong about why we have cellulite. “I have it lightly on the back of my thighs,” she says. “So does my seven-year-old daughter. I’ve looked at many other women and have finally come to realize that we all have it in some way, shape or form.”

Cellulite is a result of decreased circulation

“Cellulite is caused by fibrous bands that run from skin to muscle through the fat, and when they pull downward on the skin, the fat pushes upward,” Ahmed says. “This creates an orange peel appearance with dimpled skin, which is what we know as cellulite.”

As far as why it happens to more women than it does men, there are a few reasons, but as osteopathic physician Lionel Bissoon, who wrote The Cellulite Cure in 2006, explained to Scientific American: “When estrogen starts to decrease, you lose receptors in blood vessels and thighs, so you have decreased circulation. With decreased circulation you get less oxygen and nutrition to that area, and with that we see a decrease in collagen production.” He goes on to explain that fat cells also start becoming larger, which causes them to protrude through the collagen and become what we know to be cellulite.

He added: “Estrogen also makes fat, whereas testosterone breaks down fat. So a woman’s body is basically… genetically designed to be a place for cellulite to develop.”

That said, it has nothing to do with body fat percentage

Cellulite is not a symptom of obesity, Ahmed says. One common cellulite myth is that it only happens to overweight or unhealthy people, but that’s not the case. “Cellulite can occur in someone who is thin, normal weight and underweight, meaning it has no correlation to body fat percentage but rather the structure of the fat,” she says.

It does have to do with genetics

Among the risk factors that increase a person’s chance of developing cellulite is genetics, says dermatologist Brent Schillinger. If your mom and grandmother had cellulite, chances are you will, too. Ethnicity plays a role too — white women have a higher predisposition to get cellulite than Asian women, for example.

You can’t really get rid of it

According to several studies, there is no clear evidence that there are any effective treatments to eliminate cellulite. Anti-cellulite treatments don’t really cure or get rid of cellulite, but if you’re really bothered by it, there are some treatments and lifestyle changes that can make it less noticeable, dermatologists say.

Being genetically predisposed to it doesn’t mean you have to develop it, Bissoon told Scientific American. Being active and eating healthy can reduce the chances of getting cellulite, or at least help improve the appearance of it. In his book, Bissoon writes, “There is some connection between cellulite, diet and exercise, but not a direct one. Although a healthier lifestyle can reduce the appearance of cellulite, it’s not a real or effective treatment. Connective tissues behave like an accordion. When your weight decreases, the issues collapse onto each other; when you gain weight, the issues expand to display visible cellulite.”

Most products and services don’t work

The creams? They only offer temporary solutions, if they even work at all. “Most all creams will only address the fat,” not the connective tissue or circulation issues associated with cellulite, Bissoon told Scientific American. And while dry brushing, the technique of using a natural brush against the skin that gets rave reviews from places like Goop, can definitely exfoliate the skin, the claims that it reduces cellulite are largely unstudied and unfounded.

“Other treatments lacking evidence that they work for cellulite: Ionithermie cellulite reduction, radiofrequency, coolsculpting (cryolipolysis), mesotherapy, caffeine, grape seed extract, or ginkgo biloba supplements,” Ahmed says. Same goes for a deep massage called endermologie that uses a vacuum-like device to lift the skin. Although it’s FDA approved, there’s little evidence it’s effective.

No one ever died of cellulite and it doesn’t have a direct correlation with any underlying disease.

Laser treatments, and even surgery, are also common treatments for cellulite, but they’re not all effective, either. “There are currently a number of lasers and devices that are being offered in dermatologist and plastic surgery offices for cellulite treatment,” Ahmed says. Lasers work by actually breaking up the fibrous septae that cause cellulite and thickening the skin helping to improve the dimpling. But the cellulite then is only “gone” for about one year before another session is needed. Ahmed says more studies are still needed to determine the efficacy of lasers.

Another popular cellulite treatment is a procedure called subcision, which involves inserting a needle just under the skin to break up the fibrous bands to help release the fat herniations, improving the appearance of cellulite for up to two years. “In a study of 232 patients, 99 percent of them said they were satisfied with the results,” Ahmed says.

These kinds of treatments can be expensive though, and Schillinger says results are often inconsistent and minimal at best.

Cellulite has only been considered a problem in recent decades

Perhaps the more important conversation than treatments is why we would need to treat it at all. The first-known use of word “cellulite” appeared in 1873 in a French medical dictionary, Ahmed says. It was defined as the inflammation of the cell tissue or laminate tissue.

In 1968, the word took on a negative connotation as something that needed fixing. “The cellulite phrase and concern stayed regional to France, until 1968 when Vogue Magazine published on the front cover the title, ‘Cellulite, the fat you couldn’t lose before,’ Ahmed says. “Then the cellulite craze really took off in the U.S. at that time and has stayed since then.”

Fortunately, there’s a movement toward acceptance

“First of all, it is important to realize that cellulite is not a serious medical condition,” Shillinger says. “No one ever died of cellulite and it doesn’t have a direct correlation with any underlying disease.”

While cellulite is an aesthetic concern for some people, in recent years, there’s been push-back to the idea that cellulite is a problem. As part of the body positivity and body neutrality movements, women have taken to social media to show that there’s nothing wrong or unusual about having cellulite. A few years ago, the hashtag #CelluliteSaturdays became popular, and celebrities and athletes have spoken up about it as well. Times are changing.

Six years ago, Dodai Stewart of Jezebel astutely asked: “Years from now, will we look at our manic obsession with cellulite as a sad waste of time, energy and money — that says way more about the Human Psyche than it does about cellulite — the same way we shake our heads at the freak shows of yore?”

To me, the answer is clear: Yes — cellulite is non-threatening, common and not a problem you can fix (or a problem at all). But the question lingering on my mind is: Which is bolder: showing it, loving it or forgetting about it altogether?

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