How is cellulite created and what does it look like? Can it be treated?

How is cellulite created and what does it look like? Can it be treated?
Photo source: Getty images

Cellulite is not just a superficial aesthetic problem. The issue of orange peel, as cellulite is popularly called, affects the deeper layers of the skin. Unevenness, bumps, scratches, deepening of the skin mainly bother women, especially in the buttocks, hips, and thighs.

Most common symptoms

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Cellulite, also referred to as orange peel, is the name for unsightly-looking bumpy skin with numerous depressions and irregularities. It most often occurs in women, but can also affect men.

Orange skin is mostly an aesthetic problem, the basis of which springs in the deeper layers of the skin. Some statistics show that more than  90% of women suffer from it. This dominantly female issue is addressed by experts from several industries.

Cosmetic centers and, in the case of more severe forms, lymphologists, gynecologists, vascular and plastic surgery doctors deal with cellulite. This problem is not modern, cellulite has been here for a long time. It was dealt with by the French in the 20th century, in the 1920s. However, they fully addressed this issue in the 1970s, when interest in beautiful and slim bodies was growing.

The past of cellulite is full of contradictions. Not just for her name. This is mainly because the suffix itis means inflammation in medicine. But cellulite is not inflammatory in nature. Its name has therefore been changed to cellulite. Nevertheless, the name cellulite is widespread and common worldwide.

Doctors and other experts could not agree on whether it was a disease, a symptom or a syndrome. The aesthetic problem for women is appearance, which is solved by cosmetics, of course, the reason is changes in the deeper part of the skin. But it can be multidisciplinary.

So what is an orange peel?

The origin of cellulite should be traced to the subcutaneous tissue. It forms fat lobes that are separated from each other. These lobes are supplied with blood as well as lymphatic vessels. Subcutaneous tissue in women has slightly different properties and abilities than in men.

Of course, in both sexes, fat cells isolate heat in the body and also have a protective function. A woman has twice the number of fat cells and they can increase their volume up to two hundred times. This is aided by a vertically arranged fibrous fiber.

TIP: Information about orange peel in the symptoms section.

In men, the deposition of this fiber is reticulated, ie in a grid. Women's skin is thus more elastic and has a better ability to stretch. This property of the skin is important in women, especially during pregnancy.

Impaired blood and lymph circulation contribute to orange peel skin. This is due to the excessive filling of fat cells with fat. This results in swelling, reduced oxygenation, and permanent damage to the subcutaneous tissue. 

This is manifested by bumpy skin, especially in the predilection (susceptible) area:

  • back
  • butt
  • thighs
  • belly
  • arms

The cause of cellulite is related to the level of hormones, especially the female hormone estrogen. Which disrupts the function and absorption of vitamin E and vitamin B6. The first promotes blood circulation and the second removes fluid retention in the tissues. It is during the change in the production and secretion of hormones that cellulite appears the most.


Thus, the cause of cellulite is changing in the subcutaneous tissue. Accumulation of fat in fat cells (adipocytes) and disruption of blood and lymph microcirculation. This results in swelling, water retention, and impaired oxygenation. The result is a chronic process that results in an orange appearance of the skin.

Several external and internal factors are involved in the development of cellulite.

Risk factors that contribute to cellulite in the table

Risk factor Description
Hormones estrogens (female hormones) support fat storage and water retention, especially during puberty, but also in the case of the use of hormonal preparations, ie hormonal contraception
Inheritance affects the properties and quality of the skin and predisposition to cellulite
Overweight unnecessary supply of nutrients contributes to the storage of fat stores in the subcutaneous tissue, fat is stored unevenly
Eating habits excessive intake of fats and sugars, in the form of white bread, fatty foods, a mistake is also a lack of vitamins and minerals, ie reduced intake of vegetables and fruits the problem is a low drinking regime and lack of water
Lack of exercise contributes to fat storage, energy is underused, muscles are weakened, blood flow is reduced and lymph circulation is reduced
Unsuitable footwear and tight clothing and underwear worsen lymphatic drainage
Long-term standing but also long-term sitting and a sedentary lifestyle worsen the blood supply to the body
Varieties arise and worsen blood circulation, resulting in swelling of the lower limbs
Other factors also have a negative effect:
  • stress
  • smoking
  • alcohol
  • coffee
  • excess salt

As is clear from the table, it is not just overweight or obesity that is behind the development of cellulite. Slim women can also have orange peel. In men, it can occur mainly in places where the skin is exposed to long-term stress.

Poor quality of the ligament in the subcutaneous tissue, its collagen properties, insufficient blood, and lymphatic circulation mainly contribute to cellulite in women. The second-largest component is the action of hormones. Estrogens contribute to the storage of fats in the subcutaneous tissue, but also to the retention of water in the body.

Consequently, they also affect the quality of the skin due to the negative impact on collagen. They reduce its creation, and therefore its renewal. Hormonal treatment, contraception, but also the life span of a woman contribute to the increased level of estrogens. Such as puberty or pregnancy.

Adipose tissue itself has a large share in the production, which to a certain extent produces, but also captures estrogen. For example, from hormonal preparations. As a rule, the more fat, the more estrogen, even in the male sex.

Elevated levels of hormones, and thus so-called exogenous estrogens (xenoestrogens), are found in the form of synthetic substances in various products. It can also be indirectly affected by some medicines and drugs (caffeine, alcohol, heroin, marijuana).


The symptoms of cellulite are mainly aesthetic. Women take it as unsightly skin, it bothers them individually. For some, it is mild, almost imperceptible and for others, it is significant at first sight, even from a distance. In addition to visible changes, the skin on the surface may be cooler and paler.

The skin is uneven, bumpy, with depressions and scratches. It can be sensitive but also painful to the touch. The most common cellulite is in localities such as:

  • back
  • thighs
  • arms
  • belly
  • butt

Cellulite is divided into four stages, depending on the appearance of the skin. Based on this classification, its diagnosis is also performed. The skin is compressed with both hands, forming a skin fold. This method is called a splitting test, it is performed on the skin of the front of the thigh.

Cellulite classification table

Degree Description
I. degree  is mild cellulite that is visible only on the sides and is detected in a splitting test
II. degree  cellulite is visible when standing and sitting, especially in bright light and when the muscles are contracted in the supine position, unevenness on the skin is not visible treatment is easy and the changes are reversible
III. degree  skin changes are visible even when lying down, distinct bumps and depressions, the skin is colder and paler this condition requires comprehensive treatment and is sometimes unsuccessful
IV. degree  distinct, marked irregularities, the skin is firm, tight, sensitive, and painful to the touch 


In some cases, cellulite is mild and less visible. In other cases, it is visible from a distance. When evaluating cellulite it is mainly used so-called cutting test (pinch test). This test is performed on the front of the thigh. 

TIP: A  magazine article on childhood obesity provides information on BMI .

The height and weight data needed to determine the BMI are added. In addition to height and weight, the width of the belt and hips and their common index WHR are also evaluated. The index evaluates the approximate distribution of fat with respect to overweight and obesity. The circumference of the thighs and calves is also measured.

Important tests include bioelectrical impedance (BIA), which determines body composition. It uses a different propagation of low-intensity electric current (approximately 800 μA with a frequency of 50 kHz). Thermography is another method that proves the temperature difference on the surface of the skin. The skin affected by cellulite is colder on the surface.


The onset of hormonal changes in young girls during puberty is thought to be the main trigger for change. Pregnancy is another and significant period when hormone levels change significantly. Every other pregnancy contributes to the occurrence of cellulite.

The course of cellulite can be divided according to its classification. And so the first degree would prove itself in almost every woman. It does not indicate pathological changes in the skin and does not need to be treated. It is different in the case of the second degree.

In the second stage, there are changes in the skin, which are highlighted in the splitting test. Uneven skin and deepening are visible. The same is true if the skin is directly lit and with tense muscles. At this time, cellulite is reversible, ie reversible.

This degree is well treated. In most cases, lifestyle adjustments and regime measures are sufficient. Increased physical activity. If cellulite develops further, changes are noticeable even while standing, lying down. This condition requires treatment.

The last stage is characterized by distinct skin changes. There are rough irregularities, depressions, scratches. The skin is cooler, paler. It is characterized by difficult treatment for irreversible changes.

It occurs mainly in people with pear-shaped figure. Overweight to obesity is present. And treatment requires the intervention of several specialists. Hormonal changes during menopause do not have such an effect on cellulite, as estrogen levels are reduced.

How it is treated: Cellulite

Cellulite treatment: medication, exercise, diet and more

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How to get rid of cellulite?

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Interesting resources

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  • Pinna, K. (2007). Nutrition and diet therapy. Belmont, CA: Wadsworth. p. 178.
  • Avram, Mathew M (2004). "Cellulite: A review of its physiology and treatment". Journal of Cosmetic and Laser Therapy6 (4): 181–5. CiteSeerX 
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