In the previous instalment (Peeling Back The Truth of Cellulite) we saw that cellulite is not truly a real discrete thing. It is however a perfect storm of contributory factors which lead to three primary manifestations: abnormal connective tissue, adipose excess and dysfunction, and local circulatory insufficiency. So to permanently reduce cellulite, all three of these symptoms, and more pertinently, their causes need to be addressed. The majority of treatments touted as cellulite ‘cures’, not only fail to use that simple premise, but by virtue of the mechanisms of some of the treatments (usually the ‘premium’ modalities) often exacerbate the issue in the long run.
The following are a few of the current treatments that propose to cure cellulite:
Laser
The use of laser therapy comes in a few different flavours, but the versions that are sufficiently powerful are obviously regulated and only available via medical professionals. The low power laser therapies offered by your local beauty therapist have an effect by a totally different mechanism.
The current professional therapies use a cannula with an integrated laser that is used to disrupt the fat cells and collagen fibers. This disruption will obviously change the structure in the area and temporarily improve the appearance of cellulite. However, it doesn’t change the environment that caused the cellulite to appear in the first place, so can’t prevent the re-appearance of the abnormal infrastructure. And because the treatment causes very rapid destruction of the tissues, it will feed into the chronic inflammatory cascade that is a prevalent factor in the cellulite condition. So it’s not unfeasible that the use of this invasive and highly destructive process could actually accelerate the condition. Of course this won’t be evident in the first 12 months or so as it will take time to re-grow the tissues, but once it does, the likelihood is that the situation will be even more aggressive than before the treatment.
Acoustic Wave
Therapies based on acoustics use a high energy wave, it is proposed, to disrupt the adipose tissue that is pushing through the connective tissue matrix. There is limited evidence that this occurs, but even so even if it did work, like the laser therapy it doesn’t address the cause of the cellulite, and again may actually act as a promoter of subsequent development.
Mesotherapy
Mesotherapy uses injections to ‘dissolve’ the fat cells through the use of many different chemicals. The chemical used depends on the practitioner. Although the word ‘dissolve’ is often used for marketing purposes, the injections aim to cause cellular apoptosis (cell death) in the fatty tissue. If the treatment is successful in achieving what it suggests, it too will suffer from the same issues as the above two therapies. Tissues don’t simply dissolve and flush out of the body, it requires a huge local and systemic immune response to remove the debris, which as previously suggested will feed back into the process that promoted and maintained the development of cellulite.
Thermotherapy
Like the laser therapies there are a few different versions of this, the premium treatments again need to be performed by a medical professional. These premium treatments use radio-frequencies to target the underlying structures and generate high levels of local heating which like the above therapies cause cellular apoptosis and the resultant widespread debris caused by the death of cells in the tissues. There are side-effects of the treatment that do improve, temporarily, the cosmetic appearance of cellulite.
There are many other therapies that also claim to reduce cellulite such as Iontophoresis that uses galvanic currents to increase the permeability of the skin in an attempt to pass various substances through to the lower layers, or Electrophoresis that creates an electrical field that is suggested to alter the flow of nutrients in the area to increase the structure of the connective tissue to a more normal pattern and also assist in lipolysis (fat breakdown). Neither treatment has shown conclusive evidence of improvements in studies on cellulite.
In the more accessible treatments available to the public such as low level laser, iontophoresis, lymphatic drainage, wraps, and pressotherapy, the one common factor (whether overtly evident or not) is massage. Part of the issue with cellulite especially in the higher stages is localised oedema (swelling or fluid retention) which is a symptom of the inflammatory environment and various mechanical factors. The use of massage temporarily shifts the fluid out of the compartment and reduces the pressure being placed on the connective tissue matrix, giving the appearance of reduced cellulite. Given a few days or often hours, the osmotic pressures normalise and the fluid re-enters the area, and you’re back to square one. This is mostly how the crèmes and lotions ‘work’ too, via the fact that during application you are giving the area a daily massage. Massage does assist in the treatment of cellulite, and is a helpful part of the equation, but don’t confuse the temporary appearance change caused by some of the more aggressive treatments with anything being done to the actual structures. The main benefit of massage is to assist in the circulatory flow in the region, which needs to be a continual presence, not a once or twice a week temporary cosmetic illusion.
The above treatments cannot result in permanent alterations of the presence of cellulite, simply because they treat, with various efficacy, the symptoms of cellulite whether individual or in combination. They do nothing to address the underlying causes and will therefore allow the situation to continue, or as we have seen may actually intensify the progression of cellulite. In the next post we’ll look at how cellulite develops and once we’ve understood this environment we can then consider solutions to mitigate and even reverse the condition
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