Dear Alice,

My sister has cellulite, especially in her legs. She went to one of these health clubs to look for a treatment and they put her on something like "lymphatic draining," and gave her some type of algae (Asiatic star or something like that), which is in a spray form that she has to apply to her legs once a week, and in pills once a day. The lymphatic draining worked as follows: they put a gel on her legs and then they covered them with a pair of "air trousers" which was inflating and deflating periodically, like massaging her legs.

Do you have any idea what this is about? Do these treatments really work? I mean, do they eliminate the fat accumulated on local spots, or do they merely "redistribute" it? Where can I read about treatments for cellulite — not those in popular magazines, but something more scientific? Thank you.

Dear Reader,

Dimples may be cute when smiling, but in other places they may not give you much to smile about. In fact, pick up a fashion or health magazine and chances are you’ll see an article or advertisement about miracle cures for that “pesky” and “stubborn” cellulite. Although cellulite is often characterized as unwanted or unsightly, it’s not considered a serious condition and is actually extremely common in adolescent and adult women. The term cellulite refers to a dimpling effect of fat, which is caused by the way fat cells lie in or between connective tissue in the body, primarily in the hips-thighs-buttocks region. Several treatments and creams claim to erase or diminish the appearance of cellulite, including the one you describe, by promoting drainage of fluids and altering the architectural framework of the skin. While there might be a number of these products and services on the market, there’s a widespread lack of scientific evidence to support their effectiveness.

Before diving into the treatments for cellulite, here’s a bit more information: Fat cells, especially when they accumulate and get bigger, "push up" against the connective tissue that extends from the skin to the muscle below. This creates the uneven surface or dimpling that your sister has attempted to treat. Cellulite tends to run in families and therefore may be partially caused by genetics. However, certain factors may increase the chances of developing cellulite, including advanced age, weight gain, an inactive lifestyle, and pregnancy. As mentioned earlier, cellulite may be more of an aesthetic fixation informed by cultural ideals than a serious medical condition, so treatment isn’t necessarily required or even recommended. 

Despite it not having any negative medical side effects, many consider cellulite undesirable, thus leading to the development of a multitude of creams and treatments that claim to get rid of it. Most studies have found that commercial anti-cellulite creams aren’t very effective and if they're successful in treating cellulite, it’s likely only a short-term fix. The treatment your sister tried, known as manual lymphatic draining (MLD), uses gentle maneuvers to drain fluid in the spaces within the layers of skin, thereby pushing those fluids toward the bloodstream and boosting circulation. There currently isn’t much reputable scientific literature or evidence for this treatment, but the thought behind the technique is that cellulite is made worse by the excess fluid among the skin and connective tissue. Therefore, pushing the fluid out of the surrounding tissue and back into the bloodstream may be beneficial. Moving on, the algae spray you speak of may be some form of an anti-cellulite cream that is supposed to tighten and plump up the skin. However, creams aren’t able to actually remove the fat cells under the skin but rather are most often used to reduce the topical appearance of the cellulite by adding moisture and smoothing the skin. No robust or comprehensive studies currently support the longevity or effectiveness of these types of creams. Given this, if you're concerned about the treatment that your sister is receiving, you may consider chatting with her about why she's interested in getting rid of the cellulite in the first place.

At this time, there's limited efficacy of any type of product or treatment on the market to address this issue. However, there may be some do-it-yourself strategies that Mayo Clinic notes, including regular physical activity and a balanced diet. This may address dimpling as it may enhance weight loss, minimize (though not totally eliminate) the appearance of cellulite, and prevent further cellulite from dimpling up. As an added bonus, many folks who adopt these healthy behaviors in pursuit of minimizing cellulite stand to reap other benefits as well! To learn more about those benefits, take a look at the related Q&As and the Go Ask Alice! Nutrition and Physical Activity archives. Alternatively, some have embraced their cellulite as a natural part of their body, rather than trying to get rid of it. So another option for your sister could be to simply do nothing. In fact, it may be worth having a conversation with her to consider all of her options, to reflect on and critique popular beauty ideals, and who stands to benefit from these treatments that lack efficacy.

Here’s to waiting on a “popular” scientific study to answer your questions!

Alice!

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