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Therefore, now that we know half the world are referring to cellulite, what is it, what causes it, how can you grade it and it is there any treatment available for the condition. For a start, many may be surprised to understand that the term cellulite is simply not a medical term and there's some dispute about the etiology of the condition. Many people claim that French and Italian doctors used the term cellulitis over one century ago to explain a condition of fats located under women's skin, which give a dimpled or peau d'orange appearance. The problem was extremely common and most physicians from the period considered it to be normal and were more interested in the fact that Felix Hoffman had just invented Aspirin. The decades passed, the planet went to war twice and conventional medicine was not interested in treating a condition, which didn't reflect an underlying illness.

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Even in the early seventies, when Martin Luther King cleared his throat and addressed a quarter of a million people by the Lincoln Memorial, the condition was still largely uncommon. However, everything was about to alter in 1973, when New York beauty salon owner Nicole Ronsard wrote her book 'Cellulite, Those Lumps, Bumps and Bulges you could not lose before'. In that year, fat should have began to bug the conscience of coastal America since the New York Times best seller non-fiction list best seller for that month was Dr. Atkins' Diet Revolution.

In that year, Ireland joined the most popular Market and the comely maidens at the crossroads danced to Driving while impaired, but in America the game was up....the condition cellulite was now out in the open and the world would never be the same again! Even worse, as more and more women learned that they too had these lumpy deposits throughout their bodies, many charlatan doctors and fly by night companies started offering all sorts of dubious cures and preyed them upon their insecurities. One Italian chemist called Gianfranco Merizzi invented a brand new tablet that contained ginko, soya, omega-3 fatty acids, evening primrose oil, bioflavins, and many of the other normal suspects with a promise it would cure the dreaded condition. The CEO from the company, Rexall even continued CNBC in March 1999 claiming 90% rate of success for their product. Of course, they could not provide any scientific evidence to validate their results when challenged.

Another company, Relax-Cizor, then appeared available on the market with a kind of new cellulite machine, using iontophoresis paddles and Faraday current to remove the offending dimples. It wasn't long before they ran foul of the FDA who charged all of them with fraudulent advertising. They forgot to say that the machine also was responsible for inducing hernias, creating abnormal cardiac rhythms, and inducing miscarriages. The device was apparently repackaged and later sold in Europe where laws are thought not as stringent. It never ceases to amaze me how these companies can flourish about this side of the big pond and no-one seems to question them whenever they use eighteenth century terminology like Faraday current or iontophoresis to explain a simple thing like electromagnetism or electricity. Imagine trying to sell the latest pc to someone using Pascal or Babbage terminology. It is fair to say most people would immediately recognise the spoof!

However, this was not the case with cellulite because nobody had bothered to scientifically evaluate what exactly the problem was. Believe it nor not, it took until 1996, for Dr. Neil Solomon from the Johns Hopkins University to appear more closely at the phenomena of cellulite. Inside a paper of this period, this doctor concluded that under the microscope cellulite looked no different from ordinary fat. In 1998, some researchers in the Rockefeller Institute examined the situation more closely plus they concluded that there wasn't any significant difference between your appearance or purpose of fatty tissue or the regional blood flow between people who had cellulite and those who did not. Additionally they stated there was some characteristic within female skin that made them more prone to developing the problem.

Meanwhile, because the new wonder pill Viagra hit the planet market, the sale of miracle creams containing caffeine, green tea extract, theophylline and theobromine from cocoa continued and something company even produced a tablet that promised to take away cellulite while the patient slept. Things went from the sublime to the surreal as the second company promised to get rid of the cellulitic condition by wrapping their customers in a kind of snap wrap that caused water loss by perspiration and compression from the swollen tissues. The merchandise was marketed through television also it caused the U.S. Federal Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) to consider notice and produce regulations and guidelines for the advertising of cellulitic products. The industry quickly realised that they needed to be more scientific within their approach plus they quickly produced literature stating that caffeine used topically had the ability to reduce fat content in cells by blocking an enzyme that inhibits fat breakdown. As the pace quickened, others claimed that the alkaloid in cocoa called theobromine could penetrate towards the subcutaneous fat layer and help stimulate the discharge of stored fat. Into this modern of scientific enlightenment came other prophets who claimed that horse chestnut contained a chemical called aescin, which could reinforce the effectiveness of veins, support circulation and prevent swelling. Despite the rash of scientific opportunism, there is little available on the market that could really reduce the cellulitic condition. It didn't take a genius to understand that it would require a lot more than tablets to remove those stubborn fibrous bands of tissue.

During this time period, another technology entered the market. It had started its earlier life in France as a deep tissue massage for horses until a business called LPG systems decided to try its effect on cellulite. The organization called the procedure, Endermologie(r) and claimed it might increase circulation by 200%, by expelling toxins and water build up while the underlying connective fibres were stretched. The product was again heavily marketed in gossip columns and on the TC networks. Despite many clinical trials, the clinical proof of the procedural effect remains ambiguous. One study performed in 1998, showed a mean index decrease in body circumference of between 1.34 and 1.83cms. It was the same year that President Bill Clinton risked impeachment over his affair with Monica Lewinsky. Regardless of this evidence, another clinically controlled trial by Collins yet others, Cellulite Treatment, A Myth Or Reality. A controlled trial of two therapies Endomologie and Aminophylline cream' was published in Plastic and Reconstructive Surgery 104:1110-1114, 1999. This research found no objective difference in the thigh girth or thigh fat depth of 52 ladies who were measured by ultrasound. It further showed that only 3 of 35 patients with aminophylline-treated legs and 10 of 35 patients with Endermologie-treated legs actually felt that their cellulite appearance had actually improved. The authors concluded that neither of the two treatments was good at improving the appearance of cellulite. Despite these bits of information, the Endomologie (r) procedure continues to be widely marketed and also the process has gained popularity in some quarters. My very own impression in the experience of many colleagues is that the procedure typically takes 10 to 20 treatments to determine any results and the patient needs to do one or two maintenance treatments per month to maintain any beneficial effect.

Therefore, where does that leave us concerning the scientific evaluation of cellulite? There is no doubt; most doctors now agree that cellulite is much more often seen in women because of hormonal reasons. The scientific rationale behind this has not been fully evaluated along with a cynic would suggest that this conclusion isn't particularly hard to make. We know that cellulitic fat is arranged in large chambers of macromolecules that are separated by columns of collagen fibres. It does not take a University qualification to figure out that whenever excess fat is stuffed into these fibrotic compartments, it'll cause them to bulge out, giving the top dimply appearance of cellulite. Scientists also realize that the 'dimpling' is made worse due to underlying bloating and fibrosis caused by impaired circulation and destruction from the tissues in this area. This is the major reason that many treatments can provide a temporary means to fix the problem. The result is only temporary because in effect, cellulite is localised fat 'caught in a jail' of surrounding scarring and these fibrotic walls should be broken down before we can see a more long-term means to fix the problem.

Recently, there has been two substantial alterations in the continuing war against those offending dimples. In 2003, the Lipodissolve (r) procedure was brought to the Irish market. During this procedure, phosphotidyl choline is injected directly into subcutaneous fat in an effort to dissolve it. It's not surprising that this method would be evaluated in order to see its impact on cellulite. In 2004, Network Lipolysis invited me to become European Group Leader for that evaluation of the pharmaceutical within the treatment of cellulite. The injections are quite painful as well as in my experience not necessarily successful in treating the resilient condition. It takes multiple treatments to determine any reduction in size and also the dimpling effect often remains. We have treated nearly 500 patients with this compound in differing areas to date and our results will quickly undergo scientific evaluation as part of a European trial.

This year, a new medical device arrived, which offers to be the most fascinating development to date in the battle against cellulite. This product is called the VelaSmooth (r) and the machine has already undergone rigorous medical testing in the United States. The products functions by using a combination of bipolar Radio Frequency, Infrared light, and suction in an effort to safely and effectively re-contour your skin surface. In numerous studies in both Israel and also the United States, it looks the most effective treatment available to date. The unit apparently works by allowing radiofrequency to heat fat tissue to a depth of 10mm and also the makers claim this process increases oxygen intracellular diffusion. The infrared light part of the product heats subcutaneous fat to a level of 3mm and increases skin elasticity.

The suction system is similar to Endomologie (r), in that it can manipulate and lessen the skin. The procedure requires two treatments per week for five to six weeks and the effects last about six months before requiring a top up treatment. The total cost is about e750 for that complete package. Our clinic was selected to trial the new technology for that European market and that we shall start evaluating our produces a few months.

So where does that leave us? I feel it will take a mix of the above treatments to eventually solve the problem of cellulite. Like the old spaghetti westerns, we'll need technology like Velasmooth (r) to break down the walls from the jail along with a compound like Phosphotidyl Choline to dissolve the baddies contained within. The trials surrounding this mixture therapy have already begun in Canada and Italy and gradually patients are realizing medicine and doctors finally becoming interesting in dealing with this tenacious condition.