The Condition: What Causes Cellulite?

It was previously thought that cellulite is simply an indication of excess fat, and so changes to diet and increased exercise would be the surest bet to rid sufferers of this unsightly condition. But as we now know, whilst it is true that cellulite is more prevalent in people who have excess fat, even slim and fit people – including super-fit top athletes – can suffer from cellulite. It is more likely to happen after the age of 25 years, but it can affect younger people as well, including teenagers. It is a statement of fact that around 80% of women will suffer from cellulite; 80-90% at some point after puberty. Few subjects have elicited more debate, yet there is still a lot of ignorance around what causes cellulite and cellulite remedies.

Under the skin

As there is much information out there regarding various surgeries to get rid of fat, and because many people tend to associate cellulite with being overweight, you may have ended up on this website having searched for information on cellulite removal surgery. However, recent studies have determined that the anatomical structures which create the appearance of cellulite are not simply indicative of excess fat.  To understand cellulite more fully, you need to know more about the structures in our dermis (the inner layer of the two main layers of cells that make up our skin) that lead to the appearance of cellulite. It may surprise you to learn that cellulite is not considered a medical condition, but the fact is, millions of people suffer severe anxiety about cellulite.

Roles of fat…

There’s no escaping it. We all have body fat. And that’s a good thing. Crucial, in fact. Our fat serves many important functions; as insulation, as a physical barrier against trauma and a source of energy reserve, but he primary function of fat reserves is as an energy source.

When our bodies require additional energy to that which is immediately available through food digestion, the triglycerides (fat stores) are broken down into glycerol and fatty acids that are metabolised, producing energy.  This is why we lose weight through changes to diet and exercise.  However, the main fat reserves utilised are not the fat lying just under the dermal layer; it is this fat under the skin’s top layer that is one of the factors that cause the lumpy appearance of cellulite.

The short straw

Unfortunately for women, the way the fat is stored in the dermal layer (hypodermis layer) is different to that of men, which is why men generally don’t suffer from cellulite.  Just under our dermis there are very small fat chambers which are separated by walls of connective tissue (septae), perpendicular to our skin.  In males, these structures are crossed at an angle, which prevents the fat bulging (which is what causes cellulite).  As these pockets of fatty tissue fill these tiny compartments, the fat bulges out towards the surface of our skin, giving that orange peel appearance.

Like blood, lymphatic fluid is constantly pumped through our bodies. It maintains fluid balance and plays a role in absorbing fats and fat-soluble nutrients.  In a non-cellulite case, these fluids are at equilibrium. However, under conditions of increased pressure in the hypodermis due to underlying pressure within the fat chambers, the fluid cannot flow as normal.  This leads to a build-up of static lymph fluid which remains in the affected area, further increasing the internal pressure trying to bulge out.  The perfect storm!


The development and severity of cellulite can be broken down into 4 key stages:

– Stage Zero

No appearance of cellulite. The skin both looks smooth and is smooth to the touch, with no signs of wrinkling, even when pinched.

– Stage One

The dermis is beginning to deteriorate. partially due to decreased collagen levels which is a natural part of the aging process.  The resulting loss of elasticity reduces the resistance to subdermal pressures protruding outwards.  Furthermore, as the internal pressure in the immediate area increases, basic integrity of the blood vessels and capillaries start to degrade and in the uppermost surface (dermis) we start to lose some of the capillary network.  The fat cells that are housed in these perpendicular compartments begin to get larger, maybe 2 to 3 times their original size. As they are rigid in their structure, pressure increases leading to a loss of flow for the lymphatic fluid as well as the blood circulation.

– Stage Two

The structures in the dermis degrade even further as the fat cell clusters continue to increase in size.  This results in the blood vessels being pushed further away from the surface.  This pressure within can reach a level where micro-gaps appear in the dermis.  Your body interprets this as damage, invoking an inflammatory response (perfectly normal) in which enzymes create a host pathway for immune cells to migrate to the site of the inflammation.  Fluids gather in this area, further increasing the internal pressure within the dermal structures, leading to what is commonly described as an orange peel-like appearance on the surface of the skin. Specific enzymes such as collagenase and elastase create an available path for immune cells to migrate to the site of inflammation and fluids continue to accumulate. At this stage, the cellulite appears when you are in an upright position, but it is not visible when lying down. You may feel a slight sensitivity when you touch the skin in the affected areas.

– Stages Three

The circulatory system deteriorates further, slowing the metabolism in the cells of the dermis. Protein synthesis (which helps skin and other body tissues regenerate) is compromised, and the repair process is reduced, which leads directly to protein deposits forming around the fat cells in the aforementioned fat ‘chambers’.  As this process increases, the fatty lumps will appear to be much harder as firm nodules form in the affected area.  When the pinch test is applied at this stage the cellulite may show as quite large hard lumps rather than small undulations as seen at the ‘orange peel stage’ (stage two).

So as we have learned, there is no one singular cause of cellulite, and there are different stages,  with combination of factors resulting in different levels of severity.  Studies have shown that as the condition develops through the mild cellulite of stage one to the severe cellulite of stage three, there are different, consistently-observed, molecular and structural changes in the hypodermis, and these structural changes are triggered by a number of factors.


So, to summarise the various factors that lead to cellulite are:

  • Ageing skin starts to lose its elasticity and strength due to a natural drop in collagen and elastin levels in the dermis
  • Fat cells enlarge in the interlobular spaces, increasing the pressure within
  • This pressure leads to the retention of fluids, which adds to the exterior visible swelling
  • Poor circulation of blood and lymphatic flow
  • The toxic waste that these fluids are trying to remove also has a degradation effect on collagen and elastin fibres, further exasperating the problem of thinning skin

The main factor in the formation of cellulite is reported to be the breakdown of the connective tissue caused by aging and the decline in the circulatory system.  Fluid retention does play a part in increasing the appearance of cellulite in the affected area, but the poor circulation of blood and lymphatic flow are key reasons as to why cellulite forms.


So what is the solution?

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