HOW CELLULITE DEVELOPS
STRUCTURE OF THE SKIN AND SUBCUTANEOUS ADIPOSE TISSUE
The skin and the subcutaneous tissue are composed of layers and cellulite is caused by structural changes that take place between these layers. Therefore, a good understanding of the structure of the skin is essential to understand how cellulite develops. The skin and the subcutaneous tissue are composed of different layers (see Figure 1).
The epidermis being the outmost layer of the skin has underlying tissues protected from any external influences. Deep in the epidermis, there arises new skin cells that move toward the outer layer of the skin surface and gradually dry out. Hence, the skin is constantly renewed and remains vital.
The dermis is the thickest layer of the skin. The dermis comprises the collagen and elastin that make the skin elastic and firm. If the skin lacks collagen and elastin, the skin will feel less tight. The dermis also comprises the nerves, blood vessels, glands, and the hair follicles. (For simple understanding, these are shown in Figure 1).
SUB-DERMAL FAT LAYER (SUBCUTANEOUS FAT)
The sub-dermal (subcutaneous) fat layer contains fat cells and provides insulation for the body and gives shape to the body contours. The fat cells are separated by thin, solid bands of connective tissue called the “septa.” They connect the skin to the firm connective tissue membrane, also called deeper fascia. The septa ensures the subcutaneous fat layer remains stable.
The fascia is composed of connective tissue and has underlying muscles. The fascia contains the body fat and makes it water resistant. Blood vessels also pass through the fascia to the skin.
ACTIVE BODY FAT
Among the fascia and other muscles above the layer of fat, one important component helps in storage and burning of fat. This active body serves as a source of energy. The fat increases if you eat foods higher in calories and decreases when you eat foods lower in calories and do more sports.
Figure 1: Structure of a healthy skin and subcutaneous adipose tissue. Healthy skin shows little or no signs of cellulite in the different skin layers.
HOW CELLULITE IS FORMED
The big question is how cellulite develops? Cellulite is formed by changes in the structure of the skin and in the subcutaneous fat layer, which changes the structure of the skin surface.2 An adequate anti-cellulite treatment ensures both the skin and the subcutaneous fat are treated effectively. If the product only deals with the skin or deals only with the subcutaneous fat, there will be a minimal improvement of the cellulite, and fewer results would be visible. There are multiple complex changes in the epidermis (skin), dermis (corium), and the subcutaneous fat that provide the typical characteristics of cellulite skin.3 Several factors play a role.
EARLY STAGE: NO VISIBLE CELLULITE
The process of how cellulite develops is started. The most significant change is the damage that may be caused in the wall of the blood vessels that run into the skin. There are fewer nutrients and water transported to the skin, and this will change the structure of the subcutaneous adipose tissue.4 Due to damage to the vascular wall, there is also a leakage of moisture to the tissues.5 The subcutaneous fat cells are 2-3 times as big and clump together. At this early stage of cellulite, the dermis (corium) and epidermis (cuticle) are still healthy. There is no typical external appearance of orange peel skin. See Figure 2.
Figure 2: Early stage of how cellulite develops. The dermis and epidermis are healthy. The skin surface does not show cellulitis. Changes have occurred in the subcutaneous tissue.
MIDDLE STAGE: LIMITED CELLULITE IS FORMED
The process of how cellulite develops continues. The fat cells swell, causing the blood vessels to be repressed, and there are fewer nutrients and water that can reach the skin. Due to the lack of essential nutrients to the dermis (corium), it becomes thinner.6 The connective tissue undergoes changes (also called “fibrosis”) to give the dermis some firmness. The attenuated dermis can no longer keep the underlying fat in place, because it pushes the coagulated fat into the dermis and epidermis. The skin surface feels stiffer and the cellulite is visible when tensing the muscles. See Figure 3.
Figure 3: Middle stage of how cellulite develops. The dermis becomes thinner and the connective tissue undergoes fibrosis. Coagulated fat is pushed into the dermis and epidermis.
ADVANCED STAGE: CLEARLY VISIBLE CELLULITE IS FORMED
This is the advanced stage of how cellulite develops. The subcutaneous fat cells move into the weakened epidermis. The clumped fat cells are rigid structures, because collagen fibers are surrounding the fat cells.5 In time, there is a huge tangle of rigid collagen and fat created in the skin. The septa in the subcutaneous adipose tissue also undergo changes, which may reduce scarring. This pulls the septa of the skin surface down5,7,8,9 which causes the formation of the typical orange peel skin that is rough and bumpy.10 In this advanced stage, cellulite is evident in both tensed and relaxed muscles. At this stage, pain and a feeling of heaviness may occur in the affected skin areas.11,12,13 See Figure 4.
Figure 4: Advanced stage of how cellulite develops. Rigid collagen and fat are created in the skin and the septa will pull the skin surface down. The typical orange peel skin is formed.
Hopefully, after reading this article you better understand the question ‘how cellulite develops?’. Do you still have a question about cellulite or anti cellulite treatments? Chat with one of our cellulite experts or send us an email.
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- GW Lucasse, WLM Van-der-Sluys et al. The effectiveness of massage treatment on cellulite as monitored by ultrasound imaging. Skin Re Technol 3:154–60, 1997.
- ZD Draelos. Cellulite. 1. Etiology and purported treatment. Dermatol Surg 23:1177–81, 1997.
- GW Lucassen, WLN Van-Der-Sluys et al. The effectiveness of massage treatment on cellulite as monitored by ultrasound imaging. Skin Res Technol 3:154–16, 1997.
- ABR Rossi, AL Vergnanini. Cellulite: a review. J Eur. Acad Dermatol Vener 14:251–62, 2000.
- DM Hexsel, D Gobbato, R Mazzuco, CL Hexsel. Lipodistrofi a ginóide. In: MPV Kede, Sabatovich (eds). Dermatologia Estética. 1st ed. Atheneu: São Paulo; 2003: 350–59.
- LHC Paschoal. Tratamento da “celulite”- lipodistrofi a ginóide (LDG). In: EK Horibe (eds). Estética Clínica e Cirúrgica. Revinter Rio de Janeiro; 2000: 257–60.
- D Hexsel, R Mazzuco. Subcision: Uma alternativa cirúrgica para a lipodistrofi a ginóide (“celulite”) e outras alterações do relevo corporal. An Bras Dermatol 72(1):27–32, 1997.
- PA Bacci, G Leibaschoff . La Cellulite. Medical Books. Gasgón 19:196, 2000.
- M Ronald, Di Salvo. Controlling the appearance of cellulite. Cosmetics and Toiletries 110:50–58, 1995.
- DM Hexsel, NIM De Oliveira. Tratamento da celulite pela subcisão. In: Horibe EK (eds). Estética Clínica e Cirúrgica. Revinter: Rio de Janeiro; 2000: 261–64.
- DM Hexsel. Body repair. In: LC Parish et al. In: Women’s dermatology: Parthenon Publishing: Nova Iorque; 2001: 586–95.
- LB Medeiros. Lipodistrofi a ginóide. Abordagem Terapêutica. In: MP Kede, Sabatovich (eds). Dermatologia Estética, 1st ed Atheneu: Rio de Janeiro; 2003: 337–42.