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Anticellulite Products: Ingredients and Efficacy Testing
By: Bud Brewster, Cosmetics & Toiletries
Posted: December 23, 2008, from the January 2009 issue of Cosmetics & Toiletries.
In August of last year, the Wall Street Journal Health Blog reported that there was "not much high-quality evidence" for the effectiveness of cellulite treatments;1 for example, massage treatments produce swelling that reduces dimpling, but the dimpling reduction is only temporary. In addition, lasers or energy sources that are claimed to affect the fat cells under the skin have not been proven to have any long-term effect, according to the report. "There's nothing that has been shown in any objective way to create improvement for cellulite," Robert A. Weiss, then president-elect of the American Society for Dermatologic Surgery, told the Wall Street Journal.
What was he thinking? Where was the discussion of the huge range2 of anticellulite products and professional methods available to treat cellulite--from topical products and oral regimens, to garments? How could he ignore the body of technical knowledge generated by the suppliers of anticellulite ingredients, and the manufacturers of anticellulite products?
Nevertheless, Weiss gets some support from Enzo Berardesca at the San Gallicano Dermatological Institute in Rome. In 2006, Berardesca admitted that the efficacy of cellulite treatments is often debated. He wrote, "The evaluation of cellulite is based principally on clinical observation, thigh circumference measurements, body mass index and thermography, but for testing anticellulite products, more objective and noninvasive methods of evaluation are requested."2
Both Weiss and Berardesca are asking for objective proof that anticellulite products work. This "Bench & Beyond" column examines selected patents, journal articles, product promotion pieces and one dissertation--all from the last six years--for signs indicating that objective proof is on the way.
"Cellulite is currently considered to be â€œan endocrine metabolic microcirculatory disorder that causes interstitial matrix alterations and structural changes in subcutaneous adipose tissue," according to Distante et al.,3 who then go on to describe four competing theories for how that disorder originates: a circulatory defect, hypertrophy of the fat lobule, a physiological event, and numerous biochemical and metabolic alterations. The cause of cellulite is still a matter of debate.
Normally, the vascular supply to the adipose tissue is characterized by a fine and regular mesh of blood and lymph vessels that provides oxygen and the necessary nutrition and allows the removal of toxic substances. The onset of cellulite formation brings numerous histological changes, as described in the following stages.3,4
1. Even before any cosmetic problems are seen, capillary networks are lost in the dermal region as a result of a breakdown in blood vessel integrity (lipoedema), which swells the adipose tissue. Fluid retention (lipolymphoedema) and clumping of engorged fat cells occur in the subcutaneous tissue.
2. Minimal visual signs (i.e., slight skin surface lumpiness) appear on the thighs. Heterogeneity of blood vessels affects microcirculation. The aggregation of adipose cells and the growth of collagen fibrils hamper blood circulation, leading to circulatory stasis.
3. Pinching of the skin exacerbates the visual appearance of cellulite. Dermal metabolism is reduced due to vascular deterioration. Dermal thinning occurs in response to minimized protein synthesis and deterioration. Adipose cells isolated from nutrition and waste removal swell into micronodules surrounded by a stiff collagen layer (fibrosis).