Cellulite: causes of origin and evolution

By Dr. Davide Cacciola

Edematous-fibro-sclerotic panniculopathy, better known as cellulitis, is a pathology that indicates an altered condition of the hypodermis, a subcutaneous tissue present underneath the skin, consisting mainly of fat cells.

Ipoderma is an active tissue because its metabolism is linked to the caloric balance.

It has two main functions:

  • Lipolysis: dissolves fats when the caloric balance is negative
  • Liposynthesis: deposits fat when the caloric balance is positive.

It is therefore the body's energy reserve

The abundance of the adipose panniculus in the hypodermis depends on the constitution of the subject, on its hormonal balance, on its eating habits, on sex and on age. In women, it is distributed mainly in the lower part of the body, to the hips and to the buttocks, these areas having greater sensitivity to the action of the female hormones estrogen and progesterone.

The metabolic activity of the Ipoderma works at "regime" when a good microcirculation of the adipose mass and a regular diffusion of the fat molecules, the triglycerides, is maintained.

The factors that negatively affect the microcirculation of the adipose tissue cause functional alterations of the blood vessels, causing dysfunctions against the hypodermis and overlying tissue, the dermis.

Cellulite starts to manifest itself with the degeneration of the microcirculation of the adipose tissue, with consequent alteration of its metabolic functions.

Causes of cellulite

At the origin of cellulite there is a combination of genetic, hormonal and vascular causes aggravated by a sedentary lifestyle, stress and bad eating and behavioral habits.

  • GENETIC CAUSES: at the origin of cellulite there is a genetic predisposition linked to factors such as increased hormonal activity, capillary fragility and poor circulation.//
  • HORMONAL PROFILE: Excessive estrogen activity leads to water retention,
  • ALTERATIONS TO THE CIRCULATION: The venous circulation brings blood to the heart. At the level of the lower limbs some factors facilitate this transport: muscle compression, the elasticity of the vessels and the presence of valves - along the course of the vessels - which prevent blood reflux. When conditions occur that interfere with the functioning of this series of factors, there is a slowing of the blood circulation, a stasis that favors the onset of cellulite
  • STRESS: Frantic life, excessive physical and mental fatigue, and poor night rest are all conditions which, combined with other factors, contribute to determining the onset of cellulite.
  • BAD HABITS: Unsuitable shoes, such as those with high heels and narrow toes, and clothes that are too tight, alter the posture and hinder blood and lymphatic circulation.

Cellulite evolution

Under normal conditions the adipose tissue is well supplied by blood and the capillaries, running near the adipocyte membrane, allow correct metabolic exchanges.

The stages of evolution of cellulite are four and go from the first to the last in order of gravity

  • Stage 1: An initial alteration of blood microcirculation occurs. The vessels present an abnormal permeability of the wall and this causes plasma transudation, with stagnation and accumulation in the interstitial spaces. It is characterized by edema and can be considered a reversible state
  • Stage 2: The phenomena that characterize the first increase. Trade is further reduced and toxins are also present.

    The skin becomes pale, hypodermic and pasty

  • Stage 3: Micronodules are formed which further hinder metabolic exchanges, causing a slow and progressive destruction of the connective tissue of the dermis. The skin has the classic orange peel appearance.
  • Stage 4: The micronodules become macronodules, easily recognizable on palpation. A fibrosis of the connective tissue occurs, that is an increase of the fibrous tissue as a response to the inflammation of the surrounding tissue. The orange-peel aspect of the skin becomes very marked, the skin is pale and hypothermic, and painful. This stage can be considered irreversible.

Types of Cellulite

  • Compact Cellulite: it mainly affects people in good physical shape with a poorly mobile tonic muscle. It is hard and painful on palpation, it is localized on the knees, thighs and buttocks.
  • Soft or flaccid cellulite: It usually affects individuals with hypotonic tissue, so people of middle age or weight change too quickly or in an unbalanced way. It is located inside the thighs and arms. In the affected tissues we note the fluctuation of the part during walking or passing from the extended station to the upright one.
  • Edematous cellulite: It is often associated with the compact one. It is characterized by the presence of liquid stagnation of the buttocks and pelvis, which gives the tissues a swollen and spongy appearance and causes pain to the touch. It is often associated with the compact one. It is always associated with poor venous and lymphatic circulation in the lower limbs. It is very painful to the touch.

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