What To Know About the Fact and Fiction Surrounding Cellulite Treatments

Photo: Stocksy/Guille Faingold
Cellulite is about as common on bodies as freckles, pimples, and stretch marks. Read: very. Experts estimate that roughly 90 percent of women have it, regardless of their weight, diet, or activity level. "In the dermatological textbook, cellulite is not considered a skin disease or abnormality," says Dendy Engelman, MD, a board-certified dermatologist. Instead, she says that it's biologically how women's bodies exist due to the complex network of tissue, fascia, and fat cells beneath the skin.

Whereas the condition is relatively rare in men because the fibrous septae—the connective tissue that connects the muscle and the skin—run in a stronger criss-cross pattern, in women the fibrous septae run perpendicular which simply allows for skin to have more dimpling.  It's important to note that there is no tried-and-true "cure" for cellulite because that would require changing the biological structures of the body. That said, there are a number of cellulite-smoothing solutions that you can choose from (if you wish to), ranging from over-the-counter creams and at-home tools to more advanced, in-office treatments.

Experts In This Article
  • Anne Chapas, MD, Anne Chapas, MD is a Manhattan-based dermatologist and dermatologic surgeon with Union Square Laser Dermatology.
  • Arash Akhavan, MD, board-certified dermatologist in New York City
  • Dendy Engelman, MD, FACMS, FAAD, board-certified dermatologic surgeon based in New York City
  • Jason Emer, MD, Jason Emer, MD is a board-certified cosmetologist and cosmetic surgeon.
  • Lisa Guidi, Lisa Guidi is an esthetician and the founder of Erase Spa in New York City.

What *is* cellulite?

You can recognize cellulite as the dimpling, lumpy appearance that commonly shows up on the legs, butt, belly, and hips. But, unlike stretch marks (which happen when the skin literally stretches) or acne (which can happen to teenagers and adults alike—clogged pores do not discriminate), cellulite shows up for not much of a reason at all.

Though it is commonly viewed as a topical condition, cellulite is really all about what's going on underneath the surface. As briefly mentioned above, Anne Chapas, MD, a board-certified dermatologist with Union Square Laser Dermatology in New York City, likens the tissue complex to a mattress, with the fibrous septae connecting to deeper layers of fascia beneath the surface that give the top layer of skin support. "As the bands get tauter, they push fat to the surface, so you get that lumpy, bumpy appearance," she says. There are three main reasons this happens.

When you age, your skin loses collagen (this begins at age 25) as it slows the production of collagen as well, which causes the skin to thin and lose elasticity. "So when you have a loss of collagen in the legs, the fat behind the fibrous bands becomes more visible," says Dr. Chapas. Circulation problems can also cause cellulite to become apparent because the skin isn't being enriched with the oxygen and nutrients that it needs to be supported. "[Once the skin has thinned], people who have varicose veins or have circulation problems tend to have more cellulite."

Second, hormonal changes also play a role in the appearance of cellulite. "Fat is very estrogen-sensitive, so when we are pre-menstrual or have fluctuations in estrogen, these hormone-sensitive tissues react," says Dr. Engelman. Being on birth control or being pregnant can cause physical changes in your body, including the appearance of cellulite since the hormone fluctuations affect the size and structure of your fat cells. "Fat is like breast tissue—you get breast tenderness or swelling when you're about to have your period, and the same happens with cellulite. You may have times when it looks less apparent than others."

Lastly, though people at any weight can have cellulite, weight fluctuations can affect how much shows up on your body. "When we gain weight as adults, the fat cells get larger, so if you're swelling that fatty layer, the dimpling will look more evident," says Dr. Engelman. Fun fact: You're born with all the fat cells you'll have throughout your life and they swell and shrink like water balloons. When fat cells expand next to the rigid fibrous bands this can cause dimpling on the skin, period—it's basic biology.

The many methods of treating cellulite

While a growing population of women are working to normalize cellulite (just look at #cellulitelove, which has over 1,500 posts on Instagram), others may be looking to diminish the appearance of it—which can be done through a number of in-office and at-home treatments. That said, there are a lot of products and services that claim to be "miracle cures" for cellulite that, in reality, won't result in much of an improvement.

Nothing will make your cellulite go away completely and forever. If your cellulite is something that you want to change, while there are some solid treatments that will help to reduce the appearance of the lumps, know that it's unlikely that you'll do away with it altogether. In order to make sure you're not throwing away your time and money on something that won't work, keep scrolling for all the intel on these treatments.

1. Topicals

For a slight smoothening effect on cellulite, certain skin-care ingredients can help to thicken and firm the skin. "Anything that is going to build collagen, which retinol and retinoids do, can help to thicken the skin and minimize the appearance of cellulite," says Dr. Engelman. But she points out that the amount of collagen you have to build in order to really suppress the fatty layer where cellulite lives is significant, so it will take some time to notice a difference (and the difference will be minimal).

Besides collagen-stimulating ingredients like retinoids, caffeine can help diminish cellulite (albeit temporarily) by reducing swelling. "Caffeine is a vasoconstrictor, which reduces swelling and redness from pooling under the surface of your skin when applied topically," says Dr. Chapas. Hot tip: Combine a topical cream with massage, which Dr. Engelman says will give you better at-home results.

How long it takes to work: Several months, based on skin cell turnover.

Cost: $10 and up.

2. Dry brushing

Dry brushing involves massaging your cellulite areas with an actual brush on dry skin, and it gives you a subtle skin smoothing. "Dry brushing helps promote circulation and lymphatic drainage, which can help reduce inflammation and strengthen your connective tissue, which in turn can minimize the appearance of cellulite," says Dr. Engelman. "If you do it every day, it could continue to look better, but it's more so helping with lymphatic drainage in the area rather than changing the structure of the skin," she says. In other words: It's not your best bet in diminishing cellulite.

How long it takes to work: Regular treatments can show a small improvement in the skin, but this is temporary.

Cost: $10 and up.

3. Lymphatic massage

Over the past year, lymphatic massage treatments have boomed across the country. These body-work treatments use a deep massage technique to drain the lymphatic system, because it has been posited that then the lymph system stagnates, cellulite can form. They work by increasing circulation, which results in a temporary tightening effect on the body.

How long it takes to work: You can see a slight immediate effect on your cellulite, but this only lasts for a few days. To see the best results on cellulite, Dr. Engelman says that you'd need to get regular treatments (every month or every other month). But the results will be minimal and won't do much for deeper divots.

Cost: $100 to $200 per treatment.

4. In-office procedures

Contouring: Treatments like Trusculpt Flex work to smooth light to moderate cases of cellulite through devices that use a combo of heat and massage. "This type of procedure does very well to keep the skin tight, but it will not completely remove or improve cellulite," says Jason Emer, MD, a board-certified cosmetologist, and cosmetic surgeon. It typically takes four to six treatments on average with a couple of weeks in between each session in order to see results. Prices can range from $100 to $500 per treatment.

Radiofrequency: Several in-office body contouring treatments, such as VelaShape and EmTone, work with a combination of suction massage, infrared light, and radiofrequency in order to smooth cellulite. "The combo of suction and the massage rollers help with the circulation within your body," says Lisa Guida, esthetician and founder of Erase Spa. Though VelaShape has been around for several years and is known for being relatively effective, Guida points out that it's not permanent. Typically, you'll get the best results after three to six sessions, which can be spaced out about a week to 10 days apart—but you'll need to continue doing this every year or so for maintenance. Dr. Emer notes that radiofrequency-based treatments are used to maintain and slow the cellulite growth process down, "but they don't reverse it unless you are very diligent," and get regular treatments (which run $200 to $500 per area).  A newer option, NuEra Tight, improves skin texture with radiofrequency waves without the uncomfortable heat levels that others can give you. "Essentially, it gets deep beneath your skin to smooth the skin by regulating the structures in the dermis," says Dr. Engelman.

Injectables: The newest-to-market cellulite solution is called QWO, and it was FDA approved as of July 2020 to treat moderate to severe cellulite in the buttocks (expect it at your derm's office next spring). Researchers explain that it works by helping the fibrous septae to dissolve, allowing the fat to move more evenly throughout the area, and also releases the puckering and dimpling of the skin. "This reduces the dimple type of cellulite, leading to a smoother appearance," says Arash Akhavan, MD, board-certified dermatologist. "The injections also cause collagen generation, which leads to improved skin elasticity." He notes that this type of cellulite treatment is long-lasting and will not need much as far as maintenance, and estimates the cost will be anywhere from $3,000 to $5,000.

More invasive procedures: Cellfina and Cellulaze are other more invasive options. "Cellfina uses the world's first motorized needle subcision that works very well," says Dr. Emer, who notes that these are meant for dimples in the buttocks and posterior thigh areas. Dr. Engelman compares these two treatments to liposuction, but rather than sucking out fat, they work by cutting fibrous bands with a tiny, vibrating bland beneath the skin. Both typically cost between $3,000 and $6,000.

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