Cellulite-Dermatosclerosis derm panniculopathy
Whatever you call it, you don't have to live with it.
Cellulite treatments range from 8 to 12 sessions that offer dramatic results.
There is a controversy surrounding the definition, the pathophisiology and the very existence of edematosclerosis dermopanniculopathy or "cellulite".
"Cellulite" is the French spelling of "cellulitis". The term was first used to mean "lumpy fat deposits" by Hogner in 1891, and this meaning of the term has achieved general use in Europe since about 1920. However this terminology is actually incorrect. The term cellulitis, suggests an inflammatory state of the cells. In fact there is a correct medical use for "cellulitis": an inflammation which spreads throughout the dermal connective or cellular tissue. It is an acute infection usually caused by a group a betahemolytic streptococci with inflammation, usually systemic symptoms and fever. Lymphangitis, bacteremia and seticemia may eventually follow. It is commonly seen in complicated lymphedema.
This meaning of cellulitis however is very different from the cosmetic condition we shall discuss here. It has been suggested that better terms for this condition would be "panniculitis" (Binazzi), "edematosclerosis dermopanniculopathy" (though these too imply inflammation), "liposclerosis" (Curtis), or the unwieldy but accurate "edemato-fibro-schelortic dermopanniculopathy."
Physiology of Cellulite
Cellulite is a conjunctive and microvascular condition.
The walls of the blood vessels undergo a change and their permeability increases,
causing a micro-edema. Lymphatics are normal, but there is a veno-lymphatic
stagnation.
Curri describes four phases of "cellulite" (1987)
Phase 1 and 2 are characterized by:
Disappearance of glycosaminoglycans (or acid
mucopolysaccharides) from blood vessel walls
Local micro-edema with pericaoillary transudation of plasma (filtration
of plasma through the capillary wall)
Restructuring of fatty lobules
Increase in the size of fat cells
Phase 3 and 4 are characterized by:
Anarchic proliferation of conjunctive tissue
Formation of micro- and macro-nodule
Guidelines for the treatment of Cellulite
LDT may help alleviate the clinical manifestation
of cellulite. Some specific techniques will often need to be applied before
regular lymphatic drainage will have much effect on its own. Essentially,
the stagnation of the veno-lymphatic circulation may be released by specific
maneuvers that work on conjunctive tissue fibers are very simple and changes
are quick and usually noticeable from one session to the next. Sessions
can range from 8-12 depending on the individual and their willing commitment
to change dietary habits and increase exercise,
The most effective bodywork treatment of cellulite consists of a combination of connective tissue massage or myofascial release to break down adhesions in the superficial tissues and increase nutrition to the tissues, followed by gentle lymphatic massage to remove inflammation and remove metabolic waste, microscopic organisms and microscopic particles. Phytotherapy is also needed to help stimulate the lymph, detox the superficial layers, and tone the skin. Exfoliation of dead skin cells helps to stimulate circulation and the lymphatic vessels. Home treatment is essential between visits.
More on Cellulite
Cellulite (cell-u-leet) is an unscientific descriptive
term. It was first used in Sweden at the end of the 19th century and was
adopted by French salons to refer to the dimpled, rippling subcutaneous
deposits of fat, body fluids and waste materials that form on the bodies
of many women and some men. Another term for the condition is lipedema.
This can be misleading, because lipedema is not a true edema, consisting
as it does of mostly fat cells and connective tissue. However, chronic lipedema
can eventually develop true edema along with chronic inflammation resulting
in changes in the skin, making it thicker, coarse, less flexible red and
dry.
Cellulite can appear on the hips and thighs (most commonly) and upper arms. On older women it may also appear across the upper back, across the abdomen and even on the calves. To the touch, the texture of cellulite is lumpy and discontinuous and when squeezed or palpated cellulite comes to the hand in lumps and masses. The appearance of cellulite is unfortunate at the least and positively disfiguring in severe cases. The tendency toward cellulite can be inherited, although lifestyle and diet play a major role in its formation.
Cellulite is distributed mainly in the well-known "saddlebag" area, over the hips, abdomen, and thighs. Other areas of the body are normal in size and appearance. So cellulite has two components: an unattractive distribution of fat cells below the waist and disturbance of the connective tissue which causes scarring and distortion of the superficial fascia. It can also include true edema, which is an abnormal accumulation of fluid in these regions. Manual therapies are effective in treating the scarring of the connective tissue and the edema. Manual therapies cannot remove or redistribute fat cells. In fact, the only therapy that can actually remove fat cells is liposuction! However, massage can smooth the rippled appearance of the skin, improve the nutrition to the skin and hasten the removal of metabolic waste, microorganisms, and microscopic particles from the area.
Cellulite forms in the superficial fascia, a layer of connective tissue below the skin that contains fat cells. Superficial fascia is fibrous and due to inactivity, injuries, and improper exercise, adhesions (scar tissue) in the fascia can form contributing to the bunched-up or rippled look of the skin. Not only does the superficial fascia become more fibrous, thickened and coarse, less flexible, but it can also adhere to underlying structures that it normally slides over.
Improper exercise is also a factor in cellulite. Lack of exercise causes one set of problems, including flaccid, weak muscles and poor skin tone, sluggish lymph circulation and weight gain. Over-exercise causes another set of problems: tense, overworked muscles contributing to fatigue and the build-up of the by-products of the combustion of energy. Overworked, fatigued muscles are easily injured, leading to tears in the connective tissue that in turn lead to the development of scar tissue and adhesions. Excessive exercise combined with very strict dieting can lead to malnutrition, which adversely affects the appearance and texture of the skin.
Overweight, sun, gravity, and even exposure to cold can cause changes in the skin ranging from atrophy to hypertrophy. If the collagen of the skin is damaged, changes take place including accumulations of fat cells and thickened skin. Fat cells can change in size depending on exercise and diet. All of these conditions contribute to the appearance of cellulite.
In a nutshell, cellulite (lipedema) is a condition
of stagnation, whatever the cause. The ultimate remedy is to enhance the
body's circulation, improve nutrition, increase metabolism, and reduce scar
tissue and adhesions in the superficial fascia. Treatment of cellulite requires
more than just lymph drainage massage. A successful program has to include
changes in diet and lifestyle.
French, R.M., (2003) Milady's Guide to Lymph Drainage Massage, Thompson Learning
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