What really works for cellulite?

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The dreaded dimples

As the last lap of summer comes into focus, so do those clumped, dimpled thighs, hips and bottoms. Cellulite can affect both genders, yet it's much more common in women than men, says Dr. Bruce Katz, director of the JUVA Skin & Laser Center in New York City and spokesman for the American Academy of Dermatology. "It's not 100 percent clear what causes it," he says. "There are some theories about possible hormonal effects." No matter the cause of the lifelong lumps, one thing is certain: Everybody is looking to get rid of it. Here's some advice from the experts.

The skinny on cellulite

The lumps and dimples, which often don't appear in women until puberty, develop when an abundance of fat pushes up against the skin while strong connective tissues pull down, creating an uneven surface or dimpling. "Even thin women have cellulite, although the more weight you have, the greater your cellulite problems can be," says Dr. Karyn Grossman of Grossman Dermatology and spokeswoman for the AAD, who practices in Santa Monica, California, and New York City.

Types of treatments

While some say nothing will solve this age-old issue, Dr. Lisa Donofrio, a dermatologist and cosmetic surgeon practicing in New Haven, Connecticut, New York and New Orleans, says treatments work, and they come in three forms: those aimed at thickening or tightening the overlaying skin; those that that focus on decreasing the pull or dimpling; and those geared toward getting rid of fat. "Treatments designed at severing or lessening the thickness of the septal bands are the newest and most promising for long-term changes in the architecture," Donofrio says, referring to tight connective bands that cause dimpling. Here's a rundown on your options:

Creams

Donofrio says topical creams that encourage skin thickening by improving collagen production will be marked as containing tretinoin, retinoids or glycolic acids. Most over-the-counter cellulite lotions claim to firm and moisturize the skin. However, Katz warns there's no scientific evidence that cellulite creams containing aminophylline, a prescription drug approved for the treatment of asthma, have any effect on cellulite. What's more, the Mayo Clinic says aminophylline creams can cause allergic reactions in some people. These over-the-counter creams can range in price from $8 to more than $45 for just a few ounces, and there's no guarantee they'll provide lasting effects.

Endermologie

This is a combination of a suction and rolling machine believed to break up the fat cells that cause cellulite dimples. "It's a little old-fashioned, but it works well for those who like it," Grossman says. It requires a series of 10 to 15 treatments at a dermatology office plus monthly maintenance, which requires return visits. "If you have an improvement, you'll need to do it intermittently to see if it makes more sense to continue," she adds. Each session costs about $100.

Subcision

This procedure is not for the faint of heart, and will require some local anesthesia. The doctor will use a fine needle with a hook to cut the hard connective tissue that's responsible for the lumpy appearance of cellulite. "That works for discrete, little dimples in skin but it's not really for tightening skin or evening out the fatty layers," Katz says. This invasive procedure can run you as much as $4,000, but there are other, less-aggressive subcision treatments.

Cellulaze

This Food and Drug Administration-approved laser procedure treats the fibrous bands beneath the skin that cause lumping, while thickening and adding elasticity to the skin. However, Grossman warns it's a bigger commitment than other treatments. "Expect swelling or bruising for four to six weeks, and some people can even go out to six to eight weeks," she says. The best results are not noticeable until six to eight months after the procedure, she adds. Donofrio also says the procedure is painful, has a long recovery time and offers mild improvement. It costs about $2,500 for a small area and $5,000 for larger areas.

Cellfina

This FDA-approved treatment "is a form of subcision connecting to a surgical knife that goes under the skin and cuts the bands" responsible for cellulite lumps, Katz says. "But it doesn't address the rolling changes of cellulite. It just addresses dimples and fibrous bands that pulls down on them." This is another procedure that occurs in your specialist's office, and it carries a price tag of $3,000 to $6,000. Note that Cellfina is a short-term treatment that only reduces the appearance of cellulite for about one year.

Exercise

Diet and exercise are good for you whether or not cellulite is a problem, but they won't necessarily cure you of the clumps. "I had one woman who did the Ironman Triathlon in Hawaii seven times and still has cellulite," Katz says. However, he adds, those who are considered overweight or obese may find that their cellulite improves with weight loss.

Copyright 2015 U.S. News & World Report

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