To Your Health

My thighs look like orange peel! I've seen this on older women, but I am only 28. My friends call it cellulite, so what is cellulite and more important, how do I make it go away?

Q. My thighs look like orange peel! I've seen this on older women, but I am only 28. My friends call it cellulite, so what is cellulite and more important, how do I make it go away?

A. Cellulite is more a condition than a substance. It looks like dimpling of the skin on the thighs and buttocks and afflicts women much more frequently than men. Cellulite seems to reflect differences in connective tissue structure in the affected regions. In affected women, a diffuse pattern of abnormal connective tissue is visible immediately below the outer skin, but this same layer of connective tissue is smooth and continuous in men. One theory is that the structure that creates this "orange peel" effect may develop as a buttress against pressure caused by fat accumulation.

Among the many purported treatments for cellulite, only a few have been tested in clinical trials and there is virtually no knowledge of the ingredients of many cellulite creams on the market. In a group of 32 cellulite remedies analyzed, 263 ingredients were used, an average of 22 ingredients per product. Caffeine was the most common "active" ingredient. In other respects the products were similar to skin creams composed of emollients and fragrances. The safety of cellulite creams seems acceptable for most users in spite of the large number of substances used, although there is an occasional allergic reaction. Almost all the research shows no improvement when the cellulite creams are used over a period of several months.

Deep massage twice a week with a special machine that combines pressure with suction has been widely promoted both in Europe and the U.S. as a treatment for cellulite. Unfortunately, in a controlled study there was no evidence of objective improvement, and two-thirds of the women in the study also concluded that this treatment did not alleviate their condition.

There is still hope that a remedy does exist. A study was done on a group of 15 women who had requested liposuction as treatment for cellulite. A cream containing retinol, the most active form of vitamin A, was applied topically to only one leg for six months while a cream without retinol was applied to the other leg. Neither the women nor the researchers who evaluated the changes knew which leg received retinol treatment. Skin elasticity increased by over 10%, and the skin surface was judged smoother on the leg treated with retinol.

Another study in 46 women using retinol plus caffeine and ruscogenine, an ingredient derived from the herb butcher's broom, saw improvement in cellulite when skin characteristics were assessed by several non-invasive methods, including appearance and blood circulation. Retinol, the form of vitamin A that is often found in anti-wrinkle creams, can penetrate the outermost skin layer and work to repair the lower layers where collagen and elastin reside. Collagen and elastin are both types of structural protein. Collagen is the "glue" that holds us together, and elastin behaves like rubber, able to recoil after being stretched.

Cellulite appears to be a condition in which the strength of connective tissue is overcome by progressive fat accumulation. At present we don't know enough about the nature of cellulite to claim any kind of victory, but the reward will certainly be generous for the company that discovers the successful remedy for it.

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