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2 Types of Cellulite and How Their Treatment Differs

Cellulite

Although cellulite isn’t dangerous or painful, most women don’t like the way it looks. If you have it, you’re not alone.  Cellulite affects 80-90% of post-pubertal women and is more common in women than men due to their body fat distribution and connective tissue structure.

Cellulite has a genetic component. You have a higher chance of developing it if your mother or other close relatives had it and it tends to worsen with age due to hormonal changes. Despite being incredibly common, many women feel like they are the only ones struggling with this issue. But now you know that up to nine out of ten women have some degree of cellulite.

What you might not know is that cellulite comes in different varieties. Yes, the cottage cheese skin most women hate comes in two forms, and the best treatment for each type differs.

What is Cellulite?

First, let’s define what cellulite is.  Cellulite is a term for dimpled skin on the thighs, hips, buttocks, and abdomen. If you have cellulite, the skin, usually around your hips and thighs, looks lumpy or dimpled, like cottage cheese or an orange peel. This lumpiness mostly affects women but can occur in men too. Cellulite is more common in people who are overweight but even skinny people can have it. The two types of cellulite are called primary and secondary cellulite. Let’s look at each form and how it differs.

What is Primary Cellulite?

Primary cellulite, also known as soft cellulite, is the most common type and it’s usually on the back of the thighs. This type consists of large, swollen fat cells pushing through tight fibrous bands in the skin that hold them in place. Women are more prone to primary cellulite compared to men because their fibrous bands are oriented in a way that fat can more easily poke through the bands, whereas men have fibrous bands arranged in a way that holds fat cells in better.

So, women are more susceptible to the dreaded “dimpled” effect. Of course, this doesn’t mean men can’t get cellulite, but the risk is higher for women. If you have cellulite and you’re young, there’s a good chance it’s primary cellulite.

What is Secondary Cellulite?

Skin laxity causes secondary cellulite or loose skin. If you pull your skin tight and cellulite disappears, it’s secondary cellulite. This type of cellulite is more common in women over the age of 50 who produce less collagen and elastin to give their skin support.

You’re more likely to have secondary cellulite if you spend a lot of time laying in the sun or have gained and lost weight repeatedly, thereby stretching your skin and damaging collagen and elastin. After menopause, the hormone estrogen declines and that reduces collagen and elastin production, thinning out the skin so cellulite is more visible.

Treating Primary and Secondary Cellulite

Once you know which kind you have, you want to know how to treat it, right? Secondary cellulite is harder to treat since you must rebuild the skin’s natural support structure, so there’s less laxity. There’s evidence that using retinol creams can boost collagen production and you might get modest benefits from using creams that contain retinol but it could take months to see results.

Therapies dermatologists offer for secondary cellulite involve heating the deeper dermal layer of the skin to stimulate collagen and help tighten the skin. Various forms of laser can do this, as well as radio-frequency energy. Radiofrequency heats up the deeper layers of the skin, damaging the dermis. The injury stimulates collagen production to help rebuild the skin’s support structure.

One laser treatment called Cellulaze treats the fibrous bands that contribute to cellulite. For this procedure, a healthcare provider creates a tiny incision in the skin and uses a laser to release the fibrous bands that push down on the fat and cause it to bulge. The heat also stimulates collagen production. The benefits usually last six to eight months.

Another treatment that has some benefits for primary cellulite is called Cellfina. This approach to treating cellulite involves inserting a needle to disrupt the fibrous bands. The results from this procedure can last several years. Another procedure uses a special blade device to break up the fibrous bands, so cellulite becomes less obvious. According to the American Academy of Dermatology Association, this procedure can reduce the appearance of cellulite for up to three years.

More recently, acoustic wave therapy, using sound waves, has become an option for reducing cellulite. It’s another therapy that targets and disrupts the fibrous bands and takes several sessions to see results.

Other Treatments for Cellulite

Drinking more water and cutting back on salt may modestly make cellulite look less obvious. Exercise has modest benefits too since it improves lymphatic circulation, so areas with cellulite look less swollen. Exercise works best for primary cellulite. Liposuction is not an effective treatment because it doesn’t address the tight fibrous bands that press on the fat and cause it to bulge. It’s also ineffective for secondary cellulite where the problem is compounded by skin laxity. Likewise, losing weight will only have modest benefits for cellulite since it doesn’t fix the bands.

The Bottom Line

Cellulite is an almost universal problem for women. There are treatments that can modestly improve its appearance but it’s important to know what kind you have to ensure you get the right treatment. Ultimately, the best way to treat cellulite is to have a personalized treatment plan and to make lifestyle changes to maintain your results.

References:

  • “Cellulite treatments: What really works?.” cormsaad.org/public/cosmetic/fat-removal/cellulite-treatments-what-really-works.
  • “Cellulite – Diagnosis and treatment – Mayo Clinic.” 03 Nov. 2021, cormsmayoclinic.org/diseases-conditions/cellulite/diagnosis-treatment/drc-20354949.
  • Hexsel D, Camozzato FO, Silva AF, Siega C. Acoustic wave therapy for cellulite, body shaping and fat reduction. J Cosmet Laser Ther. 2017 Jun;19(3):165-173. doi: 10.1080/14764172.2016.1269928. Epub 2017 Feb 2. PMID: 27997260.
  • Luebberding S, Krueger N, Sadick NS. Cellulite: an evidence-based review. Am J Clin Dermatol. 2015 Aug;16(4):243-256. doi: 10.1007/s40257-015-0129-5. PMID: 25940753.
  • “Cellulite: Causes, treatment, and prevention.” 30 Nov. 2017, cormsmedicalnewstoday.com/articles/149465.
  • “Cellulite Reduction Treatments | The American Board of ….” americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical-procedures/cellulite-treatments/.
  • Luebberding S, Krueger N, Sadick NS. Cellulite: an evidence-based review. Am J Clin Dermatol. 2015 Aug;16(4):243-256. doi: 10.1007/s40257-015-0129-5. PMID: 25940753.

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