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Therefore, since we know half the planet are talking about cellulite, what is it, what causes it, how can you grade it and it is there any treatment out there for the condition. To begin with, many may be surprised to learn that the term cellulite is simply not a medical term and there's some dispute about the etiology of the condition. Some people claim that French and Italian doctors used the word cellulitis over one hundred years ago to explain a condition of fat deposits located under women's skin, which give a dimpled or peau d'orange appearance. The condition was extremely common and many physicians of the period considered it to be normal and were interested in the fact that Felix Hoffman had just invented Aspirin. The decades passed, the planet went to war twice and traditional medicine was not interested in treating a condition, which did not reflect a fundamental illness.
Even just in the early seventies, when Martin Luther King cleared his throat and addressed one fourth of a million people through the Lincoln Memorial, the condition was still largely unheard of. 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 couldn't lose before'. In that year, fat must have began to bug the conscience of coastal America because the New York Times best seller non-fiction list best seller for your month was Dr. Atkins' Diet Revolution.
For the reason that year, Ireland joined the most popular Market and the comely maidens at the crossroads danced to Driving while impaired, but in America the sport was up....the condition cellulite was now outside 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 kinds of dubious cures and preyed them upon their insecurities. One Italian chemist called Gianfranco Merizzi invented a brand new tablet that contained ginko, soya, fish oil, evening primrose oil, bioflavins, and lots of of the other normal suspects with a promise it would cure the dreaded condition. The CEO from the company, Rexall even went on CNBC in March 1999 claiming 90% rate of success for their product. Obviously, they could not provide any scientific evidence to validate their results when challenged.
Another company, Relax-Cizor, then appeared on the market with a type of new cellulite machine, using iontophoresis paddles and Faraday current to remove the offending dimples. It wasn't long before they ran foul from the FDA who charged them with fraudulent advertising. They forgot to say that the machine also was accountable for inducing hernias, creating abnormal cardiac rhythms, and inducing miscarriages. The machine was apparently repackaged and then sold in Europe where laws are considered not as stringent. It never ceases to amaze me how these companies can flourish on this side of the big pond and nobody seems to inquire further whenever they use eighteenth century terminology like Faraday current or iontophoresis to describe 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 state 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. Accept is as true nor not, it took until 1996, for Dr. Neil Solomon in the Johns Hopkins University to appear more closely at the phenomena of cellulite. In a paper of this period, this doctor figured under the microscope cellulite looked just like ordinary fat. In 1998, some researchers in the Rockefeller Institute examined the problem more closely plus they concluded that there was no significant difference between your appearance or purpose of fatty tissue or even the regional blood flow between individuals who had cellulite and people who did not. Additionally they stated that there was some characteristic within female skin that built them into more prone to developing the condition.
Meanwhile, as 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 one company even produced a tablet that promised to consider away cellulite as the patient slept. Things went from the sublime towards the surreal as the second company promised to remove the cellulitic condition by wrapping their clients in a type of snap wrap that caused water loss by perspiration and compression of the swollen tissues. The product was marketed through television and it caused the U.S. Federal Fda (FDA) and the Federal Trade Commission (FTC) to consider notice and produce regulations and guidelines for the advertising of cellulitic products. The quickly realised that they needed to be more scientific within their approach plus they quickly produced literature proclaiming 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 to the subcutaneous fat layer and help stimulate the release of stored fat. Into this modern of scientific enlightenment came other prophets who claimed that horse chestnut contained a chemical called aescin, that could reinforce the effectiveness of veins, support circulation and prevent swelling. Regardless of the rash of scientific opportunism, there was little available on the market that could really lessen the cellulitic condition. It didn't take a genius to realise that it would require a lot more than tablets to remove those stubborn fibrous bands of tissue.
Around this time, another technology entered the market. It had started its earlier life in France like a deep tissue massage for horses until a company called LPG systems chose to try its impact on cellulite. The company called the procedure, Endermologie(r) and claimed it could increase circulation by 200%, by expelling toxins and water develop while the underlying connective fibres were stretched. The product was again heavily marketed in magazines and on the TC networks. Despite many numerous studies, the clinical evidence of the procedural effect remains ambiguous. One study performed in 1998, showed a mean index decrease in body circumference which is between 1.34 and 1.83cms. It had been the same year that President Bill Clinton risked impeachment over his affair with Monica Lewinsky. Despite this evidence, another clinically controlled trial by Collins and 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 their cellulite appearance had actually improved. The authors figured neither of these two treatments was good at improving the appearance of cellulite. Despite these findings, the Endomologie (r) procedure remains widely marketed and also the process has gained popularity in some quarters. My very own impression in the experience of many colleagues would be that the procedure usually 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 more often observed in women because of hormonal reasons. The scientific rationale behind this has not been fully evaluated and a cynic would state that this conclusion isn't particularly difficult to make. We know that cellulitic fat is arranged in large chambers of macromolecules which 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 surface dimply appearance of cellulite. Scientists also know that the 'dimpling' is made worse because of underlying bloating and fibrosis brought on by impaired circulation and destruction from the tissues in this area. This is the main reason that many treatments can give a temporary solution to the problem. The effect is only temporary because in effect, cellulite is localised fat 'caught in a jail' of surrounding scar tissue and these fibrotic walls must 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 straight into subcutaneous fat in order to dissolve it. It is not surprising that this method could 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 this pharmaceutical within the treatment of cellulite. The injections are quite painful and in my experience not always successful in treating the resilient condition. It takes multiple treatments to determine any decrease in size and also the dimpling effect often remains. We have treated nearly 500 patients with this particular compound in differing areas to date and our results will soon undergo scientific evaluation included in a European trial.
This year, a new medical device arrived, which offers to be the most fascinating development up to now in the battle against cellulite. The product is called the VelaSmooth (r) and also the machine has already undergone rigorous medical testing in the United States. The products functions by using a combination of bipolar Rf, Infrared light, and suction in order to safely and effectively re-contour the skin surface. In numerous studies in both Israel and the United States, it looks the most effective treatment available to date. The unit apparently works by allowing radiofrequency to heat fat tissue to some depth of 10mm and also the makers claim this process increases oxygen intracellular diffusion. The infrared light area of the product heats subcutaneous fat to a degree of 3mm and increases skin elasticity.
The suction system is similar to Endomologie (r), in that it can manipulate and smooth out the skin. The procedure requires two treatments a week for 5 to 6 weeks and also the effects last about 6 months before requiring a high up treatment. The overall cost is about e750 for the complete package. Our clinic was selected to trial the brand new technology for the European market and that we shall start evaluating our results in a few months.
Where does that leave us? I feel it will take a combination of the above treatments to eventually solve the issue of cellulite. Like the old spaghetti westerns, we will need technology like Velasmooth (r) to collapse the walls of 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 slowly but surely patients are beginning to see medicine and doctors at last becoming interesting in dealing with this tenacious condition.
