Though diet and exercise do help to improve skin tone, many women are still affected by the appearance of dimpled, bumpy fat on the thighs and buttocks known as cellulite. Our bodies need fat (it’s an energy source and an insulator, surrounding and protecting the organs, and it helps us absorb vitamins A, D, E, and K), but too much can be a problem. In women, excess fat is stored in the buttocks, hips and thighs, where most cellulite forms.
“No one definitively knows what causes cellulite,” says Dr. Andrew Kornstein, a New York City plastic surgeon. “There are many theories and many causes, probably working in combination.”
A high-fat diet and a sedentary lifestyle seem to take a lot of the blame. However,recent studies indicate that cellulite has little or nothing to do with the metabolism of fat.
So why do women get cellulite? “Women tend to accumulate fat in their waist, hips and thighs,” says Dr. Katie Rodan, assistant professor of clinical dermatology at Stanford University in California. “That is genetic. In women, these areas of the body are resistant to starvation. The evolutionary reason is that it helps us nurse our children.”
Surprisingly, new research indicates that cellulite may have more to do with the male hormone androgen than with the female hormones. “Cellulite is driven by being female, but there is no evidence that changes in hormones associated with pregnancy, breastfeeding, birth-control pills or menopause directly affect it,” says Dr. David MeDaniel, director of the Laser Center of Virginia in Virginia Beach. Interestingly, women with high levels of androgen often do not have cellulite, according to obesity researcher Dr. Michael Rosenbaum, associate professor of clinical pediatrics and clinical medicine at New York’s Columbia Presbyterian Hospital. In studies conducted by Dr. F. Nurnberg in the late seventies, men who had some cellulite also had low levels of the male hormone.
It is now believed that enlarged, bulging fat cells play a role, as does poor circulation of fluids in the area. Skin type is also suspect: Loose or thin skin may reveal cellulite more easily. In addition, poorly hydrated skin from low water intake can look doughy, exacerbating the appearance of cellulite.
Another culprit: the fibrous bands between the pockets of fat in cellulite areas. As the skin sags and bulges with excess fat, the inflexible bands pull on the skin and create dimples. “Women have underlying connective tissue in the thigh that predisposes them to show dimpling,” says Rosenbaum. “The fat sits in pockets that look like a honeycomb.” In men, the connective tissue forms a criss-cross pattern and gives more support. “The connective tissues tissues thicken with age,” says Rodan, making cellulite more difficult to get rid of the older you get.