Cellulite: Causes and Cosmetic Remedies

The term “cellulite” refers to an aesthetic condition characterised by altered skin appearance, usually localised on the outer and posterior thighs and on the buttocks.

This condition mainly affects post-pubertal women, regardless of ethnicity. In women, cellulite can worsen during periods of increased oestrogen levels, such as pregnancy, breastfeeding and in cases of chronic use of oral contraceptives.

PATHOPHYSIOLOGY

Cellulite is a multifactorial condition.

The main cause of cellulite is the inefficiency of blood and lymphatic circulation. Predisposing factors linked or not linked to circulation include disease, local infections, poor diet, overweight, sedentary lifestyle, posture, stress, smoking, clothing, female sex, oestrogens, ethnicity, age and heredity.

The mechanism behind cellulite tends to worsen over time. It begins with fluid retention in the interstitial space of adipose tissue and progresses with impaired exchanges of gases and nutrients between cells. Cells then enlarge and die, releasing their contents. This further worsens fluid accumulation, triggers inflammation and causes excessive collagen fibre production, progressively deforming tissue architecture.

The stages of cellulite are generally described as oedematous, fibrous, sclerotic, flaccid and irreversible. Main types include hard and compact cellulite, soft and flaccid cellulite, mixed cellulite, cellulite with marked adiposity and lymphoedematous cellulite.

TREATMENT OPTIONS

Several therapies have been designed, marketed and/or promoted to improve cellulite:

• Topical treatments
• Injectables
• Lymphatic drainage or vacuum massage
• Acoustic wave therapy
• Light therapy
• External non-invasive lasers
• Radiofrequency (RF)

USE OF COSMETICS FOR THE TREATMENT OF CELLULITE

Among the best-selling cosmetics are products intended to improve the visible signs associated with cellulite.

On the market there are numerous products claiming an “ANTI-CELLULITE” effect, even though this wording may be sanctionable because cellulite is an actual pathology and cosmetics, according to the definition laid down by Regulation EC 1223/2009, cannot claim therapeutic properties.

Once this key point is clarified, we can analyse the most relevant active ingredients useful to support the cosmetic treatment of cellulite-related blemishes.

“ANTI-CELLULITE” INGREDIENTS

Ingredients with lipolytic activity

METHYLXANTHINES

The best-known substance in this group is caffeine, which can activate adipocyte metabolism and favour mobilisation of stored lipids. Similar molecules include theobromine, theophylline and aminophylline.

IODINATED COMPOUNDS

Organic iodine can be found in brown algae such as Fucus and Laminaria digitata. Algae are therefore widely used in cellulite-oriented products. Iodine may increase catabolism and the activity of beta-oxidation enzymes, contributing to gradual mobilisation and improved tissue nutrition.

Vasoprotective substances

SAPONINS AND FLAVONOIDS

Saponins can increase capillary wall resistance and reduce permeability, which may support oedema reabsorption and improve water retention. Plant sources rich in triterpenic saponins include horse chestnut, ivy, centella and butcher’s broom.

Substances with vasodilating and vasoconstricting properties

Various substances acting on the microcirculation are used in cellulite products. Warm-inducing vasodilating agents include capsaicin and nicotinates. Cooling vasoconstrictors include menthol and menthol derivatives.

Draining substances

The use of draining ingredients such as escin is particularly relevant because cellulite is often associated with fluid stagnation at tissue level.