Cellulite is a disorder that affects the hypodermis and is caused by the degeneration of the microcirculation in adipose tissues, with consequent alteration of its most important metabolic functions. It is a condition that almost exclusively affects women, compromising the figure of so many. The clinical term that identifies the problem is Edematous-Fibro-Sclerotic Pannicolopathy (EFSP).

During the last few years, three main hypotheses have been drawn up on the etiopathogenesis of cellulite, with alternating aspects that indicate, as the cause of this imperfection, respectively: oedema due to excessive hydrophilicity of the intercellular matrix; microcirculatory alteration; a different anatomical conformation of the subcutaneous layer in women compared to men. In any case, at the origin of cellulite there are hormonal imbalances especially the action of the oestrogens that can have a huge impact on the anatomical conditions and metabolism of adipose tissue in women. In fact, this disorder is clinically more evident in females, especially during puberty in the gluteal-posterior femoral regions. Other predisposing causes are pregnancy and pre-menopause.

Basic diagnostic criteria: ultrasound tests (trans-dermal ultrasound) are important for the arrangement and density of the connective tissue septa in the early stages and to assess the presence of oedema. Where appropriate the RMN can be used in cases where the BMI is above thirty. Along with an in-depth postural assessment during the first check-up. Especially in order to determine the degree of severity according to the classification endorsed by Curri (1st-4th).

Stage I

Rupture of individual adipocytes, plasma exudation, slight diapedetic haemorrhages. Anisopoikilocytosis.

Scarcely appreciable during palpation, pale skin and increased softness at certain points, no tenderness.

Stage II

Ectasia of the small vessels, hypovolemia and zonal hypoxia, onset of regressive adipocyte. Fibrillo poiesis.

Hypothermia, hypoelasticity of skin. Possible moderate tenderness.

Stage III

Reduction of capillary flow. Disorganised connectivity phenomena and tendency towards the formation of capsules.

Orange peel skin. Hyperkeratosis. Appearance of minute nodules, tenderness when pinched.

Stage IV

Onset of “cellulite” micronodules surrounded by sclero-jalinosis fibres containing degenerated adipocyte residues. More micronodules, local dystrophic phenomena.

Appreciable amount of characteristic “cellulite” nodules, which can be move between layers, painful when touched. The overlying skin may show modest atrophic and retraction (stretch lines) signs.

Therapies: Manual lymphatic drainage, Mesotherapy; Active ingredients with medical prescription.