In actuality, we really don’t know what causes cellulite. One theory suggests cellulite arises from swelling within localized fatty areas. This can be accentuated by increases in lymphatic pressure or venous blood pressure. For some, excess fat, loose skin, or a combination of the two additionally contribute to the problem. Stress, trauma, diet, medications, and pregnancy have also been listed as possible contributing factors.
Anything that we can do to decrease the loss of elasticity of the skin and dermal elements will be helpful to keep cellulite in check. Since smoking decreases the elastic fibers, don’t smoke. Radiation decreases the elastic fibers in the skin, and we get more radiation from sun exposure than any other way. This is cumulative over your life. So when you get sun at 20 years of age, you are going to pay for it when you are 60. Having children makes it hard not to gain and lose weight. And we all, as much as we hate it, get older.
The two main causes of cellulite are abnormal skin related due to both fat and swelling which is accentuated by adjacent tight supportive connective tissue of the skin or loose skin causing a traction on this connective tissue. For some patients, both factors come into play.
Where you see cells of fat under very thin skin, so it looks like tissue paper over cottage cheese. Still this is a defect in the thickness of the skin or collagen of the dermis. This is not the most common type of cellulite, and is more a function of having very thin skin. Very thin skin can be genetic or it can be with age. We know that menopause does affect the dermis, and that it thins out quite a bit.
A second type of cellulite comes from losing elasticity from the skin elements. There are little bands of collagen that run from the deeper structures to the skin that hold the subcutaneous fat in a lattice work. These bands are the steel bands that don’t give way over time. As the skin loses its elasticity from getting older, smoking, sun exposure, and weight gain and loss, the skin sags around these steel bands and isn’t as tight. The lattice-work collagen holds onto the skin at spots, making indentations or cellulite.