Cellulite is not a mystery and the cause of cellulite need not be a mystery either. Skin with cellulite looks different simply because of how it is arranged. Everyone has strands of connective fat tissue that separate fat cells and skin. In women, these fibers form a honeycomb-like pattern, so any increase in a given area tends to appear as a bulge.

You don't see cellulite in men very often as their fibers run in a horizontal, crisscross pattern that prevents bulging or dimpling. Successful treatment of cellulite requires an understanding of the cause of cellulite. Cellulite occurs for two reasons. (1) Our tissue changes with age. Those strands of connective tissue thicken, and our skin gets thinner. (2) More important, the average woman loses 5 pounds of muscles and replaces it with about 15 pounds of fat every decade of her adult life. As fat is exceptionally soft, it doesn't keep our skin taut as muscle does. Fat also takes up more space than muscle so it bulges out like cottage cheese; this is the cause of a dimpled cellulite appearance.

Due to the composition of the female skin structure, as adipose (fat) tissue increases, it expands into the upper layers of the skin, or the dermis (Drs. Rosenbaum et al.). It is the expansion of this adipose (fat) tissue that causes the overlying skin to protrude (Drs. Nurnberger and Muller). Along with the adipose (fat) tissue there is also slight edema in the affected areas. The edema is caused by the retention of water in the skin. Also frameworks of collagen form, causing subsequent sclerosis (Drs. Lotti, Ghersetich, Grappone, and Dini). Cellulite is a condition known as "dimpling of the skin of the thighs and buttocks." This "Cause and Effect" cellulite condition is known to affect women more frequently than men (Dr. Rosenbaum et al). The two most common terms for cellulite are the "mattress phenomenon" or the "orange-peel phenomenon" (Drs. Scherwitz and Braum-Falco).

Stages of cellulite:

  • Degree 0: Results in no cellulite or apparent visible alterations to the skin surface.
  • Degree I: Results in no cellulite or apparent visible alterations to the skin surface. Orange peel appearance of the skin becomes visible by the pinch test or muscular contraction.
  • Degree II: Results in a visible case of cellulite. Orange peel appearance of the skin is evident to the naked eye, without the help of any manipulation.
  • Degree III: Results in a visible case of cellulite. Presence of the same alterations as described in degree II with raised areas and nodules (Drs. Hexsel and Mazzuco).

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