Winning against Cellulite

Combating and reducing cellulite is a difficult mission, but not impossible. Try readingcellulite this article and you will understand.

Cellulite is a medical and aesthetic problem originally identified in France between XVIII  and XIV Century, but it is only in the 60s that arise diffusely. Cellulite not always been considered to be an anti-aesthetic problem, and indeed probably, in ancient time, full of cellulite fat women were considered attractive and at the same time the image of health and prosperity.

Why a endocrinologist gynecologist to solve this problem?

You may wonder why an expert in endocrine gynecology talk about cellulite. I immediately answer: first of all, because cellulite means woman. Second, many hormones and endocrine-metabolic situations play an important role in this disease. Last, I also am an expert of nutrition therapy. This is a disease in which it is possible hear and read everything, many have developed sometimes even strange skills and a commercial business of large proportions offering therapies and sometimes miracolous therapeutic strategies. Skin structure (derma) is progressively affected by cellulite

Disease or blemish?

Although there are those who continue to consider only an aesthetic problem cellulite is also undoubtedly a subcutaneous tissue DISEASE also called “Edema-Fibre-Sclerotic Panniculotis ” (EFSP) and characterized by a progressive evolution towards a localized panniculus fat subcutaneous fibrotic degeration. In its terminal phase it determines reduced circulation in the  affected area with aching, reduced local temperature and cicatricial contractures that cause multiple skin depressions (also called “orange peel skin”).

Epidemiology and clinical evolution.

Cellulitis (EFSP) predominantly affects female sex and prefers white women (other ethnic groups are less affected) with a really high incidence estimated around 80%-90%. Initial alteration lies in  microcirculation and in lymphatic drainage. It would lead to a local accumulation of fluid (edema phase) which would then lead to an altered metabolism of the connective and fat cells. Then, it leads to a micronodulations formation (fibrous phase) which then evolve to a progressive hardening and cicatricial retraction (sclerotic phase). In the early stages the skin is swollen, tense and often simultaneous with circulatory problems. During fibrous phase complexion becomes pale, edema is reduced and the skin takes on the typical  “orange peel” look. Sclerotic phase is characterized by permanent skin deformities, determining the disease last stage. Celluite is localized mainly on thighs, buttocks and hips, typical areas of fat distribution in women during their reproductive age, therefore particularly sensitive to estrogen.

Risk factors and causes of Cellulite.

–  There is surely a genetic (inherited) predisposition: an evident demonstration is a different ethnic distribution as I said before.

– Obesity and overweight are regarded by many as a strong element of risk, and in fact, even if skinny women are not immune to this disease have, however, more limited events;

– Female hormones (estrogen and progesterone) are important and this explains why this disease affects mainly the female sex, why it is more frequent after pubertal development, why it gets worse in some particular endocrine situations (eg pregnancy, some ovary diseases) and sometimes during the course of some pharmacological or contraceptives treatments. Thyroid, because controls metabolism, can have an important role, particularly in hypofunction states;

– Nutrition is another key moment in causing cellulite especially in situations of overfeeding, in excessive intake of salt, sugar and saturated fats;

– Circulatory and Lymphatic systems are tasked to drain fluids and metabolic waste. Alteration of these systems facilitates retention of liquids and toxins in tissue and therefore inflammatory processes of subcutaneous adipose tissue. Patients with cellulite often have circulatory problems such as peripheral venous insufficiency and insufficient lymphatic drainage;

– Physical inactivity is related directly to overweight and obesity as we have seen have an important role in causing cellulite, also plays a direct role in decreasing lymphatic drainage.

Treatment: a path to eliminate cellulite

It is obvious that it is a multifactorial disease, and only by this knowledge it is possible get to an effective strategy to combat, prevent and care. Next, there are a program that PUTS diet, physical activity, removal of some risk factors and treatment of diseases related to the EFSP in a central role.

  1. Check your Body Mass Index (BMI = weight in kg / height in m (squared) for an adult normal value ranges between 18.5 and 24.9. If you are obese (BMI> 30) or overweight (25 to 29.9), consult a nutritionist to pursue a low-calorie diet that ensures a proper intake of water, vitamins, minerals, fiber, plant-based foods; normalize body weight is an important goal for you also for your overall health (lower risk of cardiovascular disease, diabetes, cancer);
  2. If regular physical exercise is not possible, change lifestyle. Exercise is very important: increases blood circulation, ease lymphatic drainage, increases oxygenation, improves muscle tone. Consult your General Practitioner, who knows your health status and can provide useful advice. I personally recommend aerobic activity (not intense) at least three times a week, buy a pedometer and verified to walk at least 10,000 steps a day (remember that the 50% should be walked at least 3 times a week in one part without getting tired and after consultation with your doctor);
  3.  Gym can also be a great help, as well as playing a sport. The energy consumption is higher and you can act on particular muscle groups as needed. However, do not “Do it yourself”, always make medical examination and relying the tutoring of qualified professionals;
  4. If you suffer from Thyroid disorders, ovarian diseases or menstrual problems you will need a gynecological and endocrinological specialist;
  5. If you suffer from Diabetes, Hypertension, cardiovascular disease, venous or lymphatic insufficiency, you will have the need to control them in the best way and with the help of medical specialists these issues;
  6. A properly done massage is very important because helps restore local circulation and promotes drainage of the tissues;
  7. Using specific creams, mud (according to recommended methods) aims to improve metabolism and local drainage and can be a supporting tool for the massage. Many are skeptical about the effectiveness of these products used outs of a more general program as described in this article.

Your beauty and your health are important. Remember that prevention is always easier than cure, but if you already have cellulite do not expect magical solutions. Cellulite will not disappear in a night, and the care of this imperfection requires perseverance, patience and sometimes the intervention of more than one professionals, but especially requires your effort. You will be able to guide you towards a way of life certainly more healthy and enjoyable.

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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