Aesthetic cellulite (orange-peel skin)

Aesthetic cellulite, also known as orange-peel skin, is a very frequent alteration of the fatty tissue located beneath the skin that produces an irregular appearance with dimples and depressions.

It is not a disease and is not related to infectious cellulitis (bacterial infection of the skin). It is a completely different condition.

It is estimated to affect more than 80-90 % of women after puberty, regardless of their weight.

Aesthetic cellulite has a multifactorial origin. Several mechanisms are involved:

• Alteration of the fibrous septa that join the skin to the deep planes.
• Accumulation of subcutaneous fat.
• Changes in microcirculation.
• Hormonal factors.
• Genetic predisposition.
• Ageing of the skin.

In women, the vertical arrangement of the fibrous septa favours the appearance of the characteristic dimples.

Aesthetic cellulite is much more frequent in women. The factors that favour its appearance are:

• Genetic predisposition.
• Hormonal changes.
• Pregnancy.
• Sedentary lifestyle.
• Weight gain.
• Repeated weight fluctuations.
• Ageing.
• Decrease in muscle mass.

Slim people can also present cellulite.

The most usual areas are:

• Thighs.
• Buttocks.
• Hips.
• Abdomen.
• Inner side of the knees.
• Arms.

Several grades are usually distinguished.

Grade I. The skin looks normal at rest. The dimples only appear when compressing the skin.

Grade II. The irregularities begin to be appreciated while standing.

Grade III. The orange-peel skin is clearly visible at rest. There are multiple depressions and undulations.

Grade IV. In addition to the dimples, there may be significant fibrosis and, occasionally, discomfort on palpation.

The diagnosis is clinical. During the medical examination, the location, the grade of cellulite, the quality of the skin, the associated laxity, the amount of fatty tissue, the muscular state and the expectations of the patient are assessed.

Cellulite is frequently associated with laxity or localised fat, so the treatment must be individualised.

Currently there is no treatment capable of definitively eliminating cellulite. However, different procedures can significantly improve its appearance.

Shockwaves. They can improve local circulation and favour more uniform skin in some patients.

Radiofrequency. It stimulates collagen production and can improve firmness, skin quality and the superficial appearance of cellulite.

Collagen biostimulators. In selected patients they help improve skin firmness when there is associated laxity.

Subcision. Some techniques for releasing the fibrous septa can improve certain deep dimples. It must be performed only by trained doctors.

Subdermal laser. In some selected cases it can act on the fibrous septa responsible for certain depressions.

Physical exercise. It is one of the fundamental pillars. Muscle strengthening improves tissue support and the overall appearance of the skin.

Healthy diet. Maintaining a stable weight and a balanced diet contributes to improving the body appearance, although it does not eliminate cellulite on its own.

It is important to know that many marketed products do not have sufficient scientific evidence.

Anti-cellulite creams can provide hydration and slightly improve the texture of the skin, but their effect on established cellulite is usually limited.

The objectives are to reduce the dimples, improve the texture, increase firmness, achieve more uniform skin and improve the body contour.

Several sessions and maintenance treatments are generally necessary.

• Maintain a stable weight.
• Perform strength physical exercise regularly.
• Walk daily.
• Follow a balanced diet.
• Avoid tobacco.
• Maintain good hydration.
• Sleep adequately.

Although these measures do not eliminate cellulite, they contribute to improving the general appearance of the skin.

It is advisable to consult when the cellulite concerns you from an aesthetic point of view, there is associated laxity, there is localised fat or you want to know which treatment can best adapt to your case.

Each patient requires an individualised assessment.

• Myth: Cellulite only appears in overweight people. Fact: It also frequently affects slim women.
• Myth: Creams eliminate cellulite. Fact: They can slightly improve the hydration of the skin, but do not eliminate the structural changes responsible for cellulite.
• Myth: Drinking a lot of water makes cellulite disappear. Fact: Hydration is beneficial for skin health, but does not eliminate orange-peel skin.
• Myth: Liposuction cures cellulite. Fact: Liposuction is indicated to reduce localised fat, but does not directly treat cellulite and can even, in some cases, make the irregularities more visible.
• Myth: Cellulite is a disease. Fact: No. It is a very frequent and completely benign aesthetic condition.

• Aesthetic cellulite is a very frequent and completely benign alteration.
• It should not be confused with infectious cellulitis.
• Genetics and hormones play a fundamental role in its appearance.
• There is no definitive treatment, but there are multiple options to improve its appearance.
• Physical exercise and a healthy lifestyle are fundamental as a complement to treatment.
• The combination of techniques usually offers the best results.