While beauty standards are always evolving, it’s undeniable that one of the most common fitness goals is still to get rid of cellulite. Yeah, we get it. We’ve all been told through pop culture, media portrayals of the “ideal” body, and maybe even our friends and family that cellulite is ugly. But the truth is, it’s really, really normal, and for many women, unavoidable.
Cellulite is a normal occurrence, affecting almost 90 percent of women and 10 percent of men during their lifetime. On the surface, cellulite appears as lumpy or dimpled skin. However, the process of developing cellulite is more than skin deep.
The puckering of skin happens when the layer of fat beneath the skin pushes against connective tissue and bulges, causing the characteristic orange-peel or cottage cheese appearance. For women, the risk of developing cellulite increases with age and peaks near menopause.
Hormonal changes, specifically a decline in estrogen levels, may contribute to changes in circulation and a reduction in the production of collagen.1,2 A combination of fat cells becoming larger or increasing in number, a thinner collagen layer and change in blood supply may lead to cellulite.
Technically, cellulite is not dangerous or even a nuisance, but it can be cosmetically unappealing to some people.
Almost all women have it.
“Cellulite is an exceedingly common concern for women, affecting up to 90 percent of women and approximately 10 percent of men,” says Stephen T. Greenberg, M.D., a plastic surgeon based on Long Island. “Cellulite is considered normal and very, very common,” he emphasizes.
Most people think that cellulite is simply fat, but it’s a little more complicated than that. Cellulite is actually caused by fibrous tethers that run through your fat and pull on the fascia that lies underneath your skin, creating a dimpled appearance, meaning that it’s not just fat accumulation, but rather the structure of the fat, that causes it.
Risk Factors That Increase Potential for Cellulite Development
The medical term for cellulite is gynoid lipodystrophy. The visible changes resulting in cellulite occur when there is a change in fat distribution or metabolism resulting in a change in structure of fat cells and connective tissue.
The exact etiology and pathophysiology are difficult to pinpoint to one causative factor as there are many processes that take place sequentially and simultaneously, affecting the development of the condition.
Structural changes may be prompted by hormonal imbalances. Reduction in estrogen during menopause significantly increases your potential to develop cellulite.
Other risk factors include high levels of insulin and catecholamines, both integral in the breakdown and storage of fat molecules.
High levels of carbohydrates in the diet increase the risk of hyperinsulinemia, which supports lipogenesis, or the formation of fat cells and growth of current cells. Other hormones that may play a role are noradrenaline, thyroid hormone and prolactin.
Women have a higher risk of developing cellulite as there is a significant difference in the way their connective tissue and fat cells are arranged compared to men. Fat cells in women tend to be arranged vertically under the skin.
As they grow, the tops bulge and poke through the tissue layer. Fat cells in men are typically arranged horizontally and lay flat against each other.
Prolonged sitting and an inactive lifestyle may change circulatory patterns and increase the risk of developing cellulite. Some researchers have also linked chronic inflammatory changes to an increased risk, finding macrophages and lymphocytes in cellulite tissue.
Smokers also have a higher risk of developing cellulite, as do those who stand in one place for long periods of time. The best time to start making smart decisions is before cellulite begins to appear. There are four stages of development which may begin in women as early as age 16.
Grade 0: No cellulite present
Grade 1: Smooth skin while standing, bumps and dimples appear while sitting.
Grade 2: Orange peel or cottage cheese appearance sitting or standing.
Grade 3: Orange peel appearance present while sitting or standing with deep raised and depressed areas.