Cellulite – Causes, Symptoms, Prevention & Treatment

What is cellulite?

The word cellulite in modern cosmetology is a term defining a skin condition in which the structure of the skin is distorted due to an uneven accumulation of subcutaneous fat and circulatory problems.

Unlike cosmetology, medical cellulite is a different condition associated with potentially serious infection affecting the skin and subcutaneous tissue.

The formation of cellulite and five possible causes.
Source: https://commons.wikimedia.org

These fat deposits forming cellulite are also called “orange peel skin”, affecting 90% of women after puberty and 10% of men, being a problem that is exacerbated especially by modern lifestyles.

Cellulite deposits are localized to the greatest extent in the area of the hips, thighs, and abdomen, but can rarely affect the areas of the calves and the back of our hands.

Cellulite on the hips
Source: https://commons.wikimedia.org

There are many theories about what exactly is the cellulite and how can we determine it: is it a physiological condition or a serious health problem. The border between the two statements can be easily crossed because with the already occurring cellulite it is extremely difficult or impossible to restore the original condition of the skin.

Because of the specific way cellulite is formed, it can be present even after significant reduction of the subcutaneous fat tissue and can be observed even in relatively slim people.
After puberty, the skin begins to deteriorate, meaning the microcirculatory system (blood vessels and capillaries) that ‘feeds’ the skin, slowly begins to break down and the septa (fibrous bands) begin to weaken.

This is how the subcutaneous fat cells retain more fat, often swelling 2-3 times their original size.

These cells may also clump together, which causes isolating the blood vessels even further and therefore causing fluid to accumulate in the tissue.It makes the fat pull on the septa, causing the fascia (or connective tissue) to tighten and protrude into the dermis, causing the dimpling effect.

Over time, as the circulation of the blood in the smallest blood vessels continues to deteriorate. As a result,  visible nodules are formed, which appear as obvious wave-like structures on the surface of the skin.


The reason for the appearance of cellulite is most often associated with a complex of many factors. On the one hand, these are internal factors associated with metabolic and hormonal changes, genetic predisposition, oxidative stress and circulatory disorders in the skin. On the other, there are external factors such as poor diet, lack of physical activity, uncomfortable clothes, bad habits (smoking, alcohol), and chronic stress.

While many of the internal factors cannot be avoided because of the combination of modern and harmful lifestyles, the development of cellulite can be significantly accelerated and lead to irreversible changes in our bodies.

Stages of cellulite

According to Naturale Clinic Aesthetic Medicine and Vascular Surgery [1], the Cellulite comes in four evolution stages.

In the first stage of cellulite are present mostly circulatory disorders related with delayed circulatory and lymph fluid in the subcutaneous tissue. There are no visible skin changes, but when pinching the skin the uneven surface and the dimples can be easily observed. This stage is the most appropriate for taking measures to prevent the further development of cellulite.

In the second stage of cellulite progression, the processes of skin swelling are getting more dramatic. The pressure on the venous and the lymphatic system increases. Adipose tissue is compacted and the skin begins to form bumps. Bumps and sagging in the problem areas become significantly visible.

In the third stage of cellulite, the fat accumulation and the swelling in the tissues press capillaries, causing disturbances in the blood supplementation to the skin. Processes related to the growth of scar tissue begin. These processes encapsulate the aggregations of fat cells, forming small nodules. The uneven skin looks pale, often hemorrhages appear and bruises affecting this area disappear slower than usual. After this stage, the reduction of cellulite is extremely difficult.

The fourth stage of cellulite deepens the processes that appeared at the third stage and the formation of scar tissue remains. Small nodules are united in separated areas. The skin in the affected areas is pale, unhealthy. Cellulite is strongly expressed in all affected parts of the body and while pinching the skin it is hard and compacted. In more severe cases, the condition may even cause severe pain.


There are various classifications for types of cellulite, but they are always related to its structure, consistency, and localization. In general, cellulite is divided into soft and hard, but often there can be a third category: Edematous cellulite.

  • Soft cellulite

This type of cellulite gives the skin an undulating appearance and, as its name implies, it is soft to the touch. Soft cellulite is mostly present in areas where there is a build-up of fat, such as upper arms and legs, and is often accompanied by varicose veins or spider veins; as you walk or move, soft cellulite will also move. It tends to increase with age or weight gain, and it’s aggravated by lack of muscle tone. In general, improved circulation and skin tone will help, as will weight loss.

  • Hard cellulite

Also known as solid cellulite, this type is more common in younger women, and is mostly found in the hips and upper thighs. It is usually one of the first outward signs of cellulite.The skin is tight and grainy or dimpled like orange peel, and the appearance doesn’t alter when walking or moving; the skin seems to be firmly attached to the muscle.

  • Edematous cellulite

This is the least common type of cellulite and also the most difficult to treat. It results from problems of poor circulation aggravated by significant fluid retention. It mainly occurs in the legs, which lose their defining shape and become more columnar. The skin is pasty and may be painful when touched or when the sufferer is seated for a long time.

Is cellulite genetically predisposed?

Even the cellulite cannot be described as a typical disease, the fact is that many of the reasons why we have it are based on our physical state.

It has been scientifically proven that the formation of cellulite to some extent is genetically determined and is directly related to the hormonal system of the female body. So, if a person is genetically predisposed, on the one hand, and the hormones contribute to water retention on the other, it is very likely for him/her to develop cellulite.

Is there a connection between the sedentary lifestyle and cellulite?

A sedentary lifestyle that causes the body to burn a reduced amount of calories favors the formation of cellulite, and so does the decrease in collagen production, which comes with age.

Lack of exercise has a very adverse effect on the venous and lymphatic system. The reason for this is muscle contraction and pumping that cause the movement of venous blood and lymph in the body.

The active lifestyle and prevention of congestive processes may make the formation of cellulite more difficult and also improve our overall health.

It should not be forgotten that the problems associated with congestive processes in problem areas and limbs provoke very strong from a sedentary lifestyle. Lack of exercise has a very adverse effect on the venous and lymphatic system.

Myths and misconceptions about cellulite

While every modern human being is very well informed about that cellulite is, there are still some remaining Myths and misconceptions about this skin condition. One of the main reasons for this is the lack of reliable information.

And this is related to the fact that modern medicine considered “orange peel” more of an aesthetic problem and not a significant disease which is not present in the medical literature. On the other hand, the advertising industry often presents incorrect or incomplete information in the pursuit of profit.

Only women are affected by cellulite

The truth is that cellulite mostly affects women, but in some cases, it can also affect the stronger sex.

In general, women are much more prone to unevenness of the skin due to the different structure of the connective tissue and delicate skin related to female hormones. It has been scientifically proven that the hormone estrogen plays an important role in the formation of cellulite.

The most common reason for cellulite occurrence in men is due to hormonal problems, intake of anabolic steroids or treatment with hormonal formulations. The “male” cellulite affects mostly the abdomen and front thighs.

Cellulite affects the thighs and hips only

The area of the hips and thighs is really a place where women are most likely to accumulate fat and form cellulite, but it can affect other parts of the body as well.

Those are usually the abdomen, the back of the hands, the lower legs and others. Cellulite usually appears first in the thighs and hips, and later the cellulite is spreading to other parts of the body.

Cellulite affects overweight people only

The truth is that cellulite affects both obese people and in people with normal weight. In fact the in obese individuals, the problem is considerably more visible and more severe. This is because as the more fat accumulates, the more they grow bigger and lead to skin deformation.

Once formed, even after a significant reduction of body fat, cellulite may still be present. So, even if you have normal weight, you may be affected by the “orange peel”.

The fact is that cellulite is subcutaneous fat accumulation, but he is a kind of distorted and modified fat. In this context, cellulite is a variation of normal adipose tissue that serves as a nutrition reserve and has thermal insulation and protective function. In contrast, cellulite deposits have no specific function and can be hardly removed.

 Cellulite is hereditary disease

It is true that heredity is a factor for the formation of cellulite. This means that even if the mother has a significant cellulite, her daughter can be slightly affected, and vice versa. The predisposition to cellulite cannot be regarded as something inevitable.

Birth control pills lead to formation of cellulite

The direct link between intake of birth control pills and the formation of cellulite is not fully proven.

However, factors such as poor nutrition, chronic stress, and hormonal disorders were proven related to provoking “orange peel”. Contraceptive pills alone cannot be considered the reason for the formation of cellulite. Their intake can be related to other factors, causing cellulite.

Cellulite is removed with liposuction

Liposuction can save you a few extra kilos in the hips area, the abdomen, and the thighs, but such procedure cannot erase cellulite accumulations. During this procedure, a vacuum removes part of the fat deposits, but it cannot recover the skin structure.

In some cases, liposuction itself can even lead to circulatory disorders and connective tissue problems.


Although cellulite is not harmful to human health, it is one of the things that most women will get at some point. There are many things you can do in order to try to reduce the risk of getting cellulite. The first thing you can do is take some weight training. Aerobic exercise is one of the things most people will recommend as a way to prevent cellulite, as this is a good way to burn fat.

Start exercising

Weight training really is a very good way to prevent cellulite as it will tone the muscles while increasing the level of movement within the deep tissues. Increasing the movement in the tissue will help prevent cellulite, as it will move the toxins out of the body. Aerobic exercise, which is fast, is another good way to prevent such problem, i.e. cycling, running or even fast walking.

Try to avoid sugars and fat

Another way to prevent cellulite is to limit the number of sugars and fat consumed. It’s a good idea to start eating more nuts, vegetables, and fruits as part of your diet. These will help the body functioning and will promote metabolism. Consequently, you will lose the excessive body weight and will have healthy skin as well.

Reduce alcohol consumption

Reducing the amount of alcohol and cigarettes you drink and smoke or even quitting can help prevent cellulite. When you drink and smoke you are in fact adding more toxins to your body and this will cause cellulite. According to HealthGuidance For Better Health

People who drink alcohol, use street drugs or smoke cigarettes have a much higher chance of developing unsightly cellulite than people who live a cleaner and healthier lifestyle.

Another good way to prevent a cellulite problem is to use cellulite treatment products that are provided to combat this problem. These products will work best when using in addition to regular exercising. Usually, such formulations contain various ingredients which can even prevent further cellulite formation

Sometimes, it will take even longer than a month before any changes can be observed.


These are easily accessible options you can find at your local drugstore and on the Internet without a prescription. Such products include topical creams, gels, and exfoliants and usually aim to improve the blood circulation in the underlying layers of the skin.

After a thorough research, we have found the best-selling ones and analyzed their every single aspect. The information provided will help you find the one that meets your expectations and will improve the condition of your skin.

  • Mesotherapy

Anti-cellulite mesotherapy [2] is injecting small doses special mixtures – vitamins and medications into the skin and subcutaneous adipose tissue in order to heal the orange peel. Injecting is implemented with a designed instrument called „Mesogun (injector)”.

The procedure involves multiple injections of clinically specialised ingredients such as hyaluronic acid and/or platelet rich plasma (PRP) into the layer of skin just below the surface using a very fine needle.

However, „Experimental studies using individual mesotherapy ingredients for other conditions suggest a number of mechanisms, including lipolysis, disrupting connective tissue and augmenting circulation, which may theoretically improve cellulite. Peer‐reviewed studies have not evaluated whether these effects translate clinically.”

  • Laser procedures

A minimally invasive, laser-assisted procedure [3] performed by a qualified physician, laser treatment is a new anti-cellulite treatment clinically proven to increase skin’s natural thickness for a smoother, healthier look that lasts

The author evaluates the efficacy, safety, and duration of clinical benefit associated with a pulsed laser that delivers 1440-nm energy to the dermal-hypodermal interface for the treatment of cellulite. The changes in the dermal structure that affect the appearance of cellulite are also examined.

  • Ultrasound treatment

One of the latest treatments for cellulite is ultrasound cavitation [5]. This technique uses machines that are able to direct high-energy waves. Once these waves hit the body, they create micro bubbles that are comprised of vapor. These bubbles occur within the fat tissue and among interstitial liquid. The technique causes the interstitial liquid to transition between several phases. It starts to expand and contract. Before long, fat cells implode and the water and fat within them is released into the body’s tissue. Thise liquid and fat are then absorbed and processed out of the body by the liver. Essentially, it causes fat to be consumed and removed by the body.

  • Massages

There are several traditional massaging techniques [4] which are not only providing comfort, but also reducing cellulite. Definitely, messages will not provide instant effect and therefore, they need to be done regularly and by professionals. Certain kinds of cellulite cream and oil can be used as massage companion to reduce cellulite formation and appearance.

Treatment of cellulite by means of an electro-mechanical skin fold massage apparatus significantly smoothens the structure of the dermis-hypodermis interface. Three-dimensional ultrasound imaging of the dermis-hypodermis junction could serve as an objective method to monitor the effectiveness of cellulite treatment.”

  • Honey massage

Honey massage is a great cellulite treatment, you should just cover the affected areas with a thin layer of honey. 2 tbsp would be enough.

Press your dry hands to your skin covered with honey and tear them away.
While this procedure is very easy at first, tearing away your hands will become more difficult with every move because the tension force increases. The message could be slightly painful, yet very effective.

You can also brush your skin from extremities toward the heart several times. It may seem strange at first but it is also an effective method for cellulite treatment.

Honey massage is beneficial not only because of mechanical stimulation of the skin but also because of all the valuable minerals, vitamins and acids contained in honey that positively affect your skin. It’s best to use raw honey.

Home remedies

Take some lard, baking soda and rose water and mix the ingredients until you obtain a creamy mixture. massaging movements should be performed from the bottom to the top of the affected area Massage problematic areas with the mixture every day after showering.

Ivy oil is a very rarely-used herbal infusing oil. Made of ivy leaves macerated into vegetable oil, it is said to be effective for reducing swollen legs and cellulite.

Since ivy oil is said to be effective for the elimination of swelling in the legs, it is good to use as a body slimming oil for massage. It is especially good for reducing cellulite, so use it around the thighs or buttocks for best results.

Use some coffee powder and add it to plain cream or moisturizer. Clear the area which is affected by cellulite with soap and water and dry it thoroughly.Rub the mixture in circular motions for about a minute, then wipe the area with a warm damp cloth. Massage with the cream twice daily.You will notice improvements after only about two weeks later. The properties of coffee

Rub the mixture in circular motions for about a minute, then wipe the area with a warm damp cloth. Massage with the cream twice daily. You will notice improvements after only about two weeks later. The properties of coffee help to tighten the skin and the circular movements help to boost the circulation of blood in the area.

Below are some additional routines you could regularly do at home in order to decrease or even remove cellulite from your skin:


  1. http://www.xn--medicinaesttica-lnb.net/english/e4_celulite.htm
    Naturale Clinic Aesthetic Medicine and Vascular Surgery: Stages of the Cellulite
  2. http://www.tandfonline.com/doi/abs/10.1080/14764170500430234
    Cellulite: Is there a role for injectables?
  3. https://academic.oup.com/asj/article/31/3/328/2770604/Treatment-of-Cellulite-Using-a-1440-nm-Pulsed
    Treatment of Cellulite Using a 1440-nm Pulsed Laser With One-Year Follow-Up
  4. https://academic.oup.com/asj/article/31/3/328/2770604/Treatment-of-Cellulite-Using-a-1440-nm-Pulsed
    Treatment of Cellulite Using a 1440-nm Pulsed Laser With One-Year Follow-Up
  5. https://www.ncbi.nlm.nih.gov/pubmed/19214861 
    High-frequency ultrasound evaluation of cellulite treated with the 1064 nm Nd:YAG laser.

About the author

Monika Hristova

Monika is the Editor-in-Chief at SkinPractice. She is a skin care addict and researcher, who feels strongly about helping people with different dermatology conditions from alopecia to warts.

You can read her recommendations and advice both here at SkinPractice or at Quora where she answers skincare-related questions frequently and is the most viewed author in the Skincare category with more than 3 million views or follow her on LinkedIn.

She is also a certified skin care specialist with certification from the Medical College in Sofia.

1 comment

  • Great article! You are sharing the best info and treatments for cellulite. I really like this article so much. Thanks and keep sharing.

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