Cellulite is considered to be a common topographical alternation of the human skin, which mostly occurs in the dermis and hypodermis. 80 to 90% of post-pubertal women are affected by some form of cellulite. The main causes of this skin condition are heredity, unhealthy lifestyle and hormonal changes.
The prevalence of cellulite in women is much higher than in men. Compared to men, women have a larger number of fat cells (adipocytes) in the subcutaneous tissue (hypodermis), which also has a greater propensity to deposit fat. Due to this predisposition, excessive calorie intake in women will cause an increase in adipocyte enlargement.
The fat cells are located in chambers (lobules) which are separated by vertical and horizontal connective tissue septae. Due to the increasing number (hyperplasia) and size (hypertrophy) of the adipocytes, the fat chambers become distended and are pushed up against the skin surface. Moreover, the collagen in female skin has different arrangements – fibres of connective tissue are oriented perpendicular to the skin surface, while male collagen bonds form approximately 45° angles.
Shortening of these septae due to ﬁbrosis and loss of their elasticity provokes retraction and causes depressions that are characteristic for cellulite. Previously described anatomical alternations lead to a dimpled and uneven surface of the skin, generally known as the orange peel, mattress or cottage cheese skin appearance. As a consequence the capillary system is constrained by the enlarged adipose tissue, resulting in a reduction of blood and lymph flow, and increased storage of waste products.
Cellulite in itself is not a disease but confidence in our bodies, and our emotional well-being can be negatively affected by its presence. Treating the appearance of cellulite can help to improve self-esteem and reduce the negative emotions many women feel as a result. Importantly, cellulite is not uncommon with many estimates that 90% of women have cellulite.