Cellulite (dermatoliposclerosis) is an aesthetic problem caused by the accumulation of subcutaneous adipose tissue at the level of the thighs, hips and buttocks, and can be found in both women and men. Infectious cellulitis is a medical condition with a risk of unfavorable evolution caused by a bacterial infection of the skin. This form of cellulitis is a health problem that requires adequate drug treatment to prevent the patient’s unfavorable evolution through the appearance of septicemic complications.
The 2 types of cellulite mentioned are distinct entities that require a different approach and management depending on the etiology.
Infectious cellulitis risk factors
Health risks of infectious cellulitis
What is aesthetic cellulite?
Aesthetic cellulite or localized hydrolipodystrophy is determined by the accumulation of subcutaneous fat that affects between 80-90% of women and manifests itself in the form of bumps or “dimples” with an orange peel appearance on the skin of the thighs, hips and the buttocks. From a medical point of view, cellulite is a degenerative process of subcutaneous adipocytes, accompanied by poor local blood circulation.
Depending on the degree of damage to the aesthetic aspect, cellulite can be classified into 3 distinct categories as follows:
- Cellulitis of the first degree or mild cellulite causes the appearance of an “orange peel” appearance of the skin with 1-4 superficial depressions
- Grade II cellulite or moderate cellulite is recognized by the characteristic appearance of the skin in the form of “cow cheese”
- Grade III severe cellulite manifests itself by altering the aesthetic appearance of the skin, which is similar to a “padded mattress”
- Aesthetic cellulite can be located superficially or deeply, localized or diffuse depending on the disposition and extent of subcutaneous fat accumulations
Causes of aesthetic cellulite
Dermatoliposclerosis is mainly due to the arrangement of fat cells in the hypodermis in relation to connective tissue fibers.
The exact causes that lead to the unsightly appearance of subcutaneous fat deposits are not fully known, but a series of risk factors involved in adipogenesis processes have been identified:
- Gender – women are more often faced with aesthetic cellulite due to a vertical arrangement (different from men’s) of connective tissue fibers at the subcutaneous level. The increase in size of the adipocytes in the spaces delimited by the fibrous connective tissue push the skin up and create the characteristic “orange peel” or “quilted mattress” appearance.
- Hormonal factors – estrogen, insulin, noradrenaline, thyroid hormones and prolactin have a modulating effect on the firmness of subcutaneous collagen fibers and contribute to the appearance of the unaesthetic appearance due to cellulite.
- Age – with advancing age, the incidence of cellulite increases in both women and men, being favored by the physiological loss of skin elasticity.
- Body weight – dermatoliposclerosis is more common in overweight people of both sexes, but it can also be found in normal-weight women.
- Diet and lifestyle – the lack of regular physical exercises and an unbalanced diet favor the growth of subcutaneous fat cells with the appearance of the unaesthetic appearance associated with cellulite.
Is cellulite “inherited”?
The hereditary character of dermatoliposclerosis can be explained by the transmission from one generation to the next of the phenotypic features that involve the distribution of fat at the subcutaneous level and the quality of the collagen fibers that make up the supporting connective tissue.
Types of cellulite
Dermatoliposclerosis can be classified into several categories depending on the pathological mechanisms that determine the appearance of aesthetic changes, namely:
- Adipose cellulite is frequently a consequence of an inadequate diet that contains high amounts of sweets, fats and alcohol and a sedentary lifestyle.
- Oedematous or watery cellulite is due to an accumulation of liquid at the interstitial level and is more commonly found in women under hormonal contraceptive treatments or in the case of those suffering from certain hormonal imbalances.
- Fibrous cellulite can cause painful discomfort due to the inflammatory component it associates.
Infectious cellulitis
Infectious cellulitis is caused by an infection of the subcutaneous tissue with streptococci or staphylococci found on the surface of the skin. Bacterial cellulitis frequently affects the lower limbs, but it can also be found on the upper limbs or the face, depending on the location of the cutaneous continuity solution that facilitates the penetration of bacteria deep into the skin.
The main manifestations that make up the evolutionary clinical picture of bacterial cellulitis are represented by: skin inflammation, pain, local heat, blisters (skin lesions with liquid content), fever, chills and altered general condition.
Infectious cellulitis risk factors
The risk factors of infectious cellulitis are frequently represented by:
- The existence of a continuity solution at the integumentary level caused by a burn, fractures, abrasions or accidental lacerations
- The existence of a pathology that causes a decrease in the functioning of the immune system, such as diabetes, leukemia or HIV
- The association of skin pathologies such as atopic dermatitis, athlete’s foot or infection with the varicella-zoster virus affects the integrity of the skin and creates continuity solutions at its level, which favors the penetration of pathogenic germs in depth
- Lymphedema of the upper or lower limbs
- Personal history of bacterial cellulitis
- Obesity
Health risks of infectious cellulitis
Bacterial cellulitis is a severe condition that, untreated, can develop with the appearance of secondary complications represented by:
- Septicemia
- Endocarditis
- Osteomyelitis
- Necrotizing fasciitis
Cellulite treatment
The treatment of infectious cellulitis is etiological and is based on the administration of antibiotics according to the sensitivities of the germ that triggered the appearance of the pathological process. The duration of the antibiotic treatment is between 5 and 10 days, depending on the severity and the particularities of each case. In cases of severe evolution of infectious cellulitis, it may be necessary to hospitalize the patient for careful monitoring and administration of parenteral antibiotic treatment.
The treatment of aesthetic cellulite involves the adoption of a series of measures that include lifestyle changes along with:
- Endermological massage for mobilizing adipose tissue, improving blood circulation and skin elasticity. The technique involves the use of a non-surgical process to detach the adipose tissue by means of a suction force and light pressure exerted with the help of a special device.
- Vacuum treatment
- Radiofrequency treatment
- Cryolipolysis
- Lymphatic drainage to improve lymphatic circulation and eliminate water retention
- Electrostimulation or neuromuscular electrical stimulation for toning the areas affected by cellulite
- Thermotherapy
- Ozone
- Wrapping with paraffin
The minimally invasive treatments that can be applied to improve the unaesthetic aspect of cellulite are represented by:
- Mesotherapy involves the subcutaneous injection of a mixture of vitamins, amino acids, minerals, trace elements and hyaluronic acid
- Treatment with X-wave shock waves that produce vibrations of increased intensity
- Carboxytherapy
- Liposuction or liposuction is not a treatment method for cellulite, but it has the effect of reducing the amount of subcutaneous adipose tissue, improving the aesthetic appearance
- The surgical correction of the unsightly appearance of cellulite or lipo-shifting involves the sectioning of the fibrous bundles under the skin with the help of a special needle after total anesthesia of the patient. This procedure is ideal for cellulite on the buttocks, the complete healing time after this procedure being several weeks
Can cellulite be prevented?
A balanced diet and an active lifestyle represent prophylactic methods used successfully to prevent the formation of unsightly fat deposits at the subcutaneous level, along with the administration of food supplements based on vitamins A, C and B, calcium, potassium, magnesium and antioxidants.
Foods recommended for people who want to improve the unsightly appearance of cellulite are represented by kiwi, bananas, watermelon, pineapple, berries, avocado, oat grains, fish oil, flax seeds and lean meat. Detoxification belts with natural juices to combat and remedy cellulite can be obtained from celery, lemon or grapefruit, while herbal infusions with anti-cellulite properties can be made from green tea leaves, ivy, dandelion, mouse tail, sage and rosemary.
References:
- Cellulite and its treatment, A. V. Rawlings – https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-2494.2006.00318.x
- Cellulite: a review, Ana Beatris R Rossi, André Luiz Vergnanini – https://onlinelibrary.wiley.com/doi/full/10.1046/j.1468-3083.2000.00016.x
- Treatment of cellulite: Part I. Pathophysiology, Misbah H. Khan, Frank Victor, Babar Rao, Neil S. Sadick, Science Direct – https://www.sciencedirect.com/science/article/abs/pii/S0190962209014492
- Treatment of cellulite: Part II. Advances and controversies, Misbah H. Khan, Frank Victor, Babar Rao, Neil S. Sadick, Science Direct – https://www.sciencedirect.com/science/article/abs/pii/S0190962209014480
