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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 is there any treatment available 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 concerning the etiology of the condition. Many people claim that French and Italian doctors used the word cellulitis over one hundred years ago to describe a condition of fats located under women's skin, that provide a dimpled or peau d'orange appearance. The condition was extremely common and many physicians from the period considered so that it is normal and were interested in the fact that Felix Hoffman had just invented Aspirin. The decades passed, the world went to war twice and traditional medicine was not thinking about treating an ailment, which did not reflect an underlying illness.
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Even just in the early seventies, when Martin Luther King cleared his throat and addressed one fourth of a million people by the Lincoln Memorial, the problem was still largely unheard of. However, all that was about to alter in 1973, when Ny beauty salon owner Nicole Ronsard wrote her book 'Cellulite, Those Lumps, Bumps and Bulges you could not lose before'. For the reason that year, fat must have began to bug the conscience of coastal America since the New York Times best seller non-fiction list best seller for your month was Dr. Atkins' Diet Revolution.
In that year, Ireland joined the Common 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 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. Of course, 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 mention that the machine also was responsible for inducing hernias, creating abnormal cardiac rhythms, and inducing miscarriages. The machine 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 from the big pond and no-one seems to question them 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 personal computer to someone using Pascal or Babbage terminology. It is fair to say most people would immediately recognise the spoof!
However, it was not the case with cellulite because nobody had bothered to scientifically evaluate just what 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 in the phenomena of cellulite. In a paper of this period, this doctor concluded that under the microscope cellulite looked just like ordinary fat. In 1998, some researchers in the Rockefeller Institute examined the problem more closely and they concluded that there wasn't any significant difference between the appearance or purpose of fatty tissue or even the regional blood flow between individuals who had cellulite and those who did not. They also stated that there was some characteristic within female skin that made them 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, 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 kind of snap wrap that caused water loss by perspiration and compression of the swollen tissues. The merchandise was marketed through television and it caused the U.S. Federal Fda (FDA) and the Ftc (FTC) to take notice and produce regulations and guidelines for that advertising of cellulitic products. The industry quickly realised 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. Because the pace quickened, others claimed that an alkaloid in cocoa called theobromine could penetrate towards the subcutaneous fat layer and help stimulate the release of body 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 stop swelling. Despite the rash of scientific opportunism, there was little on the market that could really lessen the cellulitic condition. It didn't take a genius to understand that it would require 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 as a deep tissue massage for horses until a company called LPG systems chose to try its impact 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 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 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 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 study found no objective difference in the thigh girth or thigh fat depth of 52 ladies who were measured by ultrasound. It further demonstrated 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 effective in improving the appearance of cellulite. Despite these bits of information, the Endomologie (r) procedure continues to be widely marketed and also the process has became popular in some quarters. My own impression in the experience of many colleagues would be that the procedure usually takes 10 to 20 treatments to see any results and also the patient has to do a couple of maintenance treatments per month to maintain any beneficial effect.
Therefore, where does that leave us concerning the scientific evaluation of cellulite? It is obvious; most doctors now agree that cellulite is more often seen in women due to hormonal reasons. The scientific rationale behind it has not been fully evaluated and a cynic would state that this conclusion isn't particularly hard to make. We know that cellulitic fat is arranged in large chambers of macromolecules which are separated by columns of collagen fibres. It doesn't take a University qualification to figure out that whenever extra fat is stuffed in to these fibrotic compartments, it will cause them to bulge out, giving the surface dimply appearance of cellulite. Scientists also realize that the 'dimpling' is made worse due to underlying water retention and fibrosis caused by impaired circulation and destruction from the tissues in this region. This is the major reason that many treatments can give a temporary means to fix the problem. The result is only temporary because in effect, cellulite is localised fat 'caught inside a jail' of surrounding scarring and these fibrotic walls must be broken down before we are able to see a more long-term solution to the problem.
Recently, there has been two substantial changes in the continuing war against those offending dimples. In 2003, the Lipodissolve (r) procedure was brought to the Irish market. In this procedure, phosphotidyl choline is injected straight into subcutaneous fat in an effort to dissolve it. It is not surprising that this method could be evaluated in order to see its effect 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 very painful and in my experience not necessarily successful in treating the resilient condition. It takes multiple treatments to determine any reduction in size and the dimpling effect often remains. We have treated nearly 500 patients with this particular compound in differing areas up to now and our results will quickly undergo scientific evaluation as part of a European trial.
This year, a new medical device arrived, which promises 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 undergone rigorous medical testing in the usa. The products works by using a mixture of bipolar Rf, Infrared light, and suction in an effort to safely and effectively re-contour the skin surface. In numerous studies in both Israel and also the United States, it looks the most effective treatment open to date. The unit apparently functions by allowing radiofrequency to heat fat tissue to some depth of 10mm and the makers claim this process increases oxygen intracellular diffusion. The infrared light part 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 process requires two treatments per week for 5 to 6 weeks and also the effects last about six months before requiring a high up treatment. The total 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 produces a few months.
Where does that leave us? Personally i think it will take a combination of the above treatments to eventually solve the problem of cellulite. Such as the old spaghetti westerns, we'll need technology like Velasmooth (r) to break down 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 previously begun in Canada and Italy and slowly but surely patients are realizing medicine and doctors finally becoming interesting in dealing with this tenacious condition.
