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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.
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MRI: In a 2006 article,2 Rona, Carrera and Berardesca described the main noninvasive techniques used in monitoring some of the physical parameters related to the cellulite condition. Thigh circumference is used to monitor edema. Ultrasound monitors
the thickness and the quality of the connective tissue and the edematous component of cellulite. Laser Doppler flowmetry provides information on blood flow and eythema by reporting on skin microcirculation. Thermography is a method for imaging the local skin temperature as a function of blood flow. Skin distensibility, elasticity and hysteresis are among the mechanical properties measured. Plicometery yields data for calculating the percentage of fat in the human body.
Magnetic resonance imaging (MRI) can distinguish structures at a submillimeter scale. It can also describe the physiology of the different skin layers. High spatial resolution MRI can differentiate the different skin departments (epidermis, dermis and hypodermis), â€œgiving new and interesting opportunities for the evaluation of anticellulite treatments,â€ according to these authors.
Measuring dimples: Only last year in presenting an improvement in measuring the dimpling aspect of cellulite, Bielfeldt et al. gave their own "up to now: assessment of anticellulite treatment evaluation methods.7 Those methods included digital photography, visual scoring, circumferential thigh measurements and subjective assessments. Ultrasound imaging and confocal microscopy were used to evaluate structural aspects. Skin elasticity and blood circulation provided some biomechanical data. "The use of such a variety of methods illustrates that science still searches for the one method to classify cellulite by using only one parameter," these authors wrote.
Two areas of innovation by Bielfeldt et al. provided a standardized method for characterizing dimpling of skin. First, improvements made in the set-up (i.e., positioning, illumination, background and camera position) for macrophotography of skin at the thighs enabled standardized photography of the area and reduced the non-treatment-related variations in the images made at different treatment times; a computerized custom-made rating program standardized the rating procedure by using a randomized and blinded presentation of the images. Second, a computerized custom-made analysis program improved the analysis of the ultrasound imaging of the dermis-subcutis border line and allowed the calculation of a modified roughness parameter Ram that characterizes the severity of the adipose protrusions from the subcutis into the dermis; these protrusions correlate positively with dimpling severity. Skin elasticity, blood circulation and thigh circumference were also measured.
"The true improvement in our work is in the visual assessment of cellulite," Stephan Bielfeldt, director of cosmetic research at proDERM Institute for Applied Dermatological Research in Hamburg, Germany, told C&T magazine. "To our knowledge, the degree of standardization of our cellulite photographs was not achieved and published before. All published technical methods like profilometry, elasticity measurement and ultrasound lack in credibility as long as a reliable visual assessment is not available to prove their relevance for the customer. In our work, we added a visual grading tool and with it, we showed the relevance of the technical methods," Bielfeldt said.
Microcirculation: "The first step in cellulite treatment is stimulation of microcirculation and the removal of accumulated fluids and toxic elements," Distante has written.3 "This can improve the interstitial matrix basal regulation, fibroblast activity and decrease interstitial edema, with subsequent increase in lipolysis and a better oxygen and nutrition of the adipose tissue."
In 2006 Distante et al. reported two studies aimed at determining the efficacy of a multifunctional plant complex in the oral treatment of cellulite.3 Of interest here is the variety of instrumental noninvasive evaluations performed.
In the first study, both clinical and instrumental methods were used before starting the treatment, and again after 20 and 60 days of treatment. Color Doppler ultrasound measured the following: morphological characteristics of subcutaneous cellular tissue; distance between skin and muscular fascia; permeability and valve function of deep and superficial venous system; changes in the microvessel caliber at the subcutaneous cellular tissue level. Digital photoplethysmography measured hemodynamic changes in leg sites following tiptoe exercises to determine changes in venous filling time due to bed emptying after exercise. Videocapillaroscopy analyzed the density, area, diameter and perimeter of capillaries.
The second study obtained measurements after 3, 10, 15, 30 and 47 days of treatment on 145 patients. The following data was collected on all patients: height; weight; arterial pressure; oxidative stress; Fat Mass Index; abdominal, thigh and ankle circumference; clinical cellulite evaluation; and self-assessment. The following additional data was collected on half of the patients: blood chemistry (16 factors); videocapillaroscopy (baseline flow and capillary density); Doppler laser flowmetry (resting flow, transcapillar power); ultrasound; pain ultrasonic test; echo color Doppler; light reflection rheography; and thermography.
In the words of these researchers, "The data obtained prove that the mixture of plant extracts contained in the products under investigation are effective in contrasting several physiopathological steps involved in the pathogenesis of cellulite, thus improving all clinical signs and symptoms associated to this condition." Here, at last, is one clear example of objective data proving the efficacy of an anticellulite treatment.