How is cellulite treated?

Treatment of Cellulite

The most effective treatments for cellulite include a combination of energy-based devices (radiofrequency, laser therapy), subcision techniques, and injectable treatments, which should be selected based on cellulite severity and individual patient factors. 1, 2

Understanding Cellulite

• Cellulite is characterized by skin dimpling resembling an "orange peel" appearance due to superficial cutaneous edema surrounding hair follicles and tethering of hair follicles to the underlying dermis 3
• It affects up to 90% of post-pubertal females and is now considered a pathological entity with systemic associations and negative psychological impact 4

Treatment Approach Based on Severity

Mild Cellulite

• Implement lifestyle modifications including healthy diet, proper hydration, and regular exercise as first-line treatment 2
• Use topical agents as adjuncts to lifestyle modifications, though evidence for their efficacy is inconsistent 2
• Consider topical creams containing xanthines, botanicals, and retinoid receptor ligands which may provide some benefit 5

Moderate Cellulite

• Apply non-invasive energy-based treatments as primary interventions 2
• Radiofrequency demonstrates the strongest efficacy among non-invasive options in current peer-reviewed literature 2
• Laser therapy and ultrasound treatments are also effective options with good safety profiles 4
• Acoustic wave therapy shows benefit in cellulite reduction 4

Severe Cellulite

• Employ minimally invasive approaches such as subcision techniques 2
• Consider injectable treatments including biostimulators 1
• 1440-nm Nd:YAG minimally invasive laser shows beneficial results in severe cases 4

Advanced Combination Approaches

• Platelet-rich fibrin (PRF) with nanofat demonstrates superior results with >90% satisfaction rate and significant improvements in skin texture 3
• Cellular Matrix (combining PRP and hyaluronic acid) shows statistically significant improvement in overall appearance compared to either treatment alone 3
• Microneedling with PRP produces significant neocollagenosis and increased collagen bundle deposition 3
• Multimodal methods are typically required to address the various factors underlying cellulite appearance 1

Important Considerations

• Treatment should be tailored based on the patient's specific presentation and cellulite severity 4
• Combination therapies are often required for optimal results 6
• Methodological differences in clinical trials make direct comparison between treatment modalities difficult 4
• Advanced interventions like physical and acoustic subcision, radiofrequency, and injectable biostimulators show accumulating evidence of efficacy and patient satisfaction 1

Treatment Safety

• PRF treatments are generally well-tolerated with only minor, self-limited adverse events 3
• Combined PRP and hyaluronic acid treatments have no reported serious adverse events 3
• Energy-based devices like laser and radiofrequency have good safety profiles 4