Cellulite

In 2005, investigators conducted a double-blind, randomized study in which 40 women with moderate cellulite were instructed to apply an anticellulite cream nightly for 4 weeks. This cream contained caffeine, green tea, black pepper, orange, and cinnamon bark extract. The active cream was applied on the right or left leg, and the placebo cream to the other leg. Participants were instructed to wear bioceramic-coated neoprene shorts to promote penetration of the active agent. Five blinded, independent physicians evaluated photos taken before treatment and after 4 weeks for improvement. Subject questionnaires were completed to assess tolerability and efficacy. A total of 34 subjects completed the study, of whom 21 reported overall improvement in their cellulite; 13 of the 21 reported greater improvement in the thigh receiving the active agent. The physician evaluators found that thighs treated with the active formulation showed greater improvement in 68% of subjects. No adverse effects were reported (J. Cosmet. Dermatol. 2005;4:93-102).

The investigators in this study had previously performed a double-blind, randomized study of 20 women who applied an anticellulite cream to affected sites nightly for 4 weeks. In that trial, the efficacy of the topical agent when used alone was compared with its efficacy when used in combination with an occlusive bioceramic-coated neoprene garment. Seventeen women completed the trial.

Responses to questionnaires showed that 76% of the participants identified overall improvement, with 54% indicating that the thigh treated with the topical agent and garment occlusion exhibited greater improvement. Measurements indicated a slightly greater reduction in thigh circumference in the occlusion group (1.3 cm vs. 1.1 cm).

Dermatologists evaluating the subjects reported improvement in 65% of thighs treated with occlusion and 59% of thighs treated only with the topical cream. They also observed greater improvement in occluded thighs than nonoccluded thighs in 65% of the participants. The investigators concluded that the occlusion achieved with the bioceramic-coated neoprene garment potentiates the activity of anticellulite cream (J. Drugs Dermatol. 2004;3:417-25).

Recently, investigators conducted a double-blind, randomized, controlled study of nine healthy women with grade II-III cellulite to assess a new anticellulite gel combined with a light-emitting diode (LED) array. The volunteers were randomly treated twice daily with an active phosphatidylcholine-based, cosmeceutical gel on one thigh and a placebo gel on the control thigh for 3 months. Each thigh also was exposed, twice weekly for 15 minutes, to LED light at red (660 nm) and near-infrared (950 nm) wavelengths. Height, weight, and body mass were measured and digital photographic images were taken at 0, 6, and 12 weeks, and then 18 months after the first treatment.

At 3 months, investigators found that eight of nine thighs treated with combination therapy improved, warranting a downgrading of the cellulite level. At 18 months, five of the eight responsive thighs regressed to the cellulite grade noted at the beginning of the study (J. Cosmet. Laser Ther. 2007;9:87-96).

At the Store

A group of investigators recently conducted a literature review of the botanical extracts used as active ingredients for treating cellulite and, given the dearth of published findings, also contacted the manufacturers of such products for information on their efficacy. The authors suggested that a product's capacity to reduce fat deposits through frequent topical use relies on the concentration of the active ingredient and its availability at the treatment site (Dermatol. Surg. 2005;31:866-72).

Conclusions

Although cellulite is physically harmless, the pervasiveness of this unaesthetic condition has provided the impetus for much research and the development of numerous treatment options, some of which can be rather expensive. Despite the relatively poor track record of most treatment options, therapy approaches continue to proliferate. In some instances, weight control may improve the appearance of cellulite.

Topical formulations containing a range of ingredients, including botanicals, have shown some promise, particularly those containing caffeine and theophylline, but with fleeting benefits most often observed in combination with another treatment modality. Lasers are being developed to treat cellulite. At this point there is no mechanical, surgical, laser, light, or topical therapy that has proven to be consistently efficacious. There is much research going on that may lead to advances in this area in the future.