Marked for life?
You don't have to be. Charmaine Mercado gives us the skinny on cellulite and stretch marks.

Treating skin problems such as acne can be relatively easy, what with the many over-the-counter wonders and simple procedures available currently. Not so with cellulite and stretch marks.

The good news is these two problems can be treated and prevented the natural way— you just have to have discipline and patience. Moreover, state-of-the-art procedures are now available to complement the treatment of cellulite and stretch marks.

Shedding light on cellulite
Cellulite is a kind of fat tissue found in the subcutaneous layer of the skin that contains constricting bands of connective tissue, according to Dr. Merck Marcelino, a dermatologist at Medipoint in Manila. This connective tissue varies in thickness and is laced with fat cells. It is held in place by a network of connective fibers that protects our body, cushioning our muscles and organs. A liquid that nourishes and provides an effective waste system surrounds the connective tissue.

When everything works well in the system, waste products are eliminated, resulting in smooth curves. But when fats, toxins and fluids are trapped below the epidural layer, the connective tissue thickens and hardens, giving the skin a rippled appearance, Marcelino explains. With age, the layer of the skin thins, giving rise to cellulite.

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“The term cellulite refers to the popular description of uneven, bumpy ‘orange peel’ or ‘cotton cheese’ appearance in the thighs, buttocks and breasts of post-pubertal women,” says Dr. Eileen Tan, associate consultant, dermatology services of Changi General Hospital in Singapore.

More common in women
Cellulite is more common among women, says Marcelino. Men rarely develop it because their network of fat cells are deep in the skin, their cells being shaped more sharply, thus rarely “poking through” the skin that result to the dimples associated with cellulite. But when men do develop cellulite, this tends to be on the neck and abdomen.

Cellulite starts to appear in girls around the age of 14 and increases as they mature and the sub-cutaneous skin layer thins and redistributes. Post-natal women and those who take birth control pills often develop cellulite because their body is unable to eliminate excess estrogen, causing fat cells to enlarge. This results in water retention, which prevents the body from flushing toxins and resulting in cellulite formation. For the same reason, women taking diet pills, sleeping pills and diuretics are also prone to cellulite. “An excess of estrogen in women is believed to cause weakening of connective tissue, allowing fat in the skin to bulge,” says Marcelino.

Not about being fat
Cellulite is different from fat. The fatty layer functions as an insulator and provides support for the organs whereas cellulite is lumpy and serves no cushioning or padding purpose whatsoever.

A person doesn’t have to be fat or heavy to develop cellulite, Marcelino stresses. Even a person with the thinnest thighs can develop cellulite. It’s because genetics influences the way fat is distributed in the body.

Fight cellulite with healthy living
But heredity isn’t destiny: There are many things you can do to fight cellulite.

It is believed that the key to fighting cellulite is to detoxify the body by eating a healthy diet, exercising regularly, promoting proper circulation and managing stress.

Quit the nicotine habit as smoking damages the connective tissue, which contributes to the dimpling effect of cellulite. Drink plenty of water to flush out toxins from the body. Eat a lot of fresh fruits, vegetables and whole-grain foods. Try the caveman diet by staying away from processed foods as much as possible. Cut down on your intake of sugar, caffeine, alcohol, saturated fat and other problem foods.

According to Marcelino, poor eating habits cause toxins to build up in the body’s circulatory system, thereby promoting cellulite formation. “The body stores dietary toxins in the cells under the skin. These cells swell and reduce blood circulation, which, in turn, result in fat accumulation and stretching of connective tissue fibers. The end result is unsightly cellulite.”

Increasing circulation by massaging the cellulite-prone area is also a good way of fighting cellulite. “Massage and manipulation carried out in salons and spas have been used as a treatment for cellulite,” says Tan.

Some studies suggest that tension and stress cause the connective tissue covering the muscle to seize up, blocking the tissue and preventing proper waste elimination. That’s why stress reduction is recommended. Exercise is an excellent stress buster and a great way to burn fat and improve circulation. Try an aerobic workout like walking, jogging or swimming that work on the thighs, hips and buttocks. Aerobic workouts enhance blood and lymphatic circulation, promote sweating that helps in detoxification and improve muscle tone and overall well-being.

LOTIONS AND CREAMS
Body firming lotions and creams may also help reduce cellulite by plumping up the skin, giving it a sleeker appearance. Tan describes the efficacy of creams and lotions currently being used to combat cellulite: Xanthines: The methylxanthines, which include caffeine, aminophylline and theophyline, exert their effects on lipolysis or fat breakdown. However, continued application of xanthine-containing creams would be necessary to maintain the effect. Retinoids: Topical retinoids have been shown to improve skin texture over a period of years, although large-scale studies on their efficacy have yet to be published. Herbals: Herbal therapy for cellulite has been marketed as the natural way to lose weight or reduce cellulite. A word of caution: The types of herbs contained in the remedy are frequently unknown and many are a complex mixture of several botanical extracts. Some of these extracts have been found to contain xanthine derivatives. Toxicity is a possibility. Moreover, the safety profiles of these botanical extracts have not yet been adequately established.

STRETCH MARKS
Stretch marks (striae) are lines that appear in places where fat are stored: abdomen, upper arms, breasts, thighs and buttocks. "They can occur in both women and men," says Tan. Stretch marks develop in the dermis, the elastic, resilient middle layer responsible for maintaining the skin's shape. They can occur in anyone regardless of age and can be caused by pregnancy, too much exercise and rapid weight change. According to Tan, excessive steroid use and Cushing's syndrome (a disease caused by an excess of cortisol production or by exces-sive use of cortisol or other similar steroid hormones) also cause striae. Stretch marks first appear as red marks then fade into flesh-colored splotches, says Marcelino. Depending on a person's natural skin color, stretch marks may also begin as raised pink, reddish brown or dark brown striations that turn purple or bright violet. They usually become less obvious over time.

SOLUTIONS
Stretch marks should be treated as soon as possible. Once stretch marks begin to flatten and fade, they become more difficult to eliminate. Unfortunately, there is no topical cream that will completely eliminate the marks. For red stretch marks, tretinoin (prescribed by a dermatologist) may provide subtle improvements by causing blood vessels to constrict, thus reducing the redness. "Tretinoin is usually effective in improving the appearance of fresh striae," says Tan. "The use of such topical compounds combined with laser therapy seems to produce better results compared to administering just one of these treatment modalities." However, tretinoin should not be used during pregnancy and when breastfeeding. Laser surgery is being developed for the treatment of stretch marks. However, it does not remove stretch marks; it merely makes them fade. Moreover, the laser only responds to dark colors, thus will only be effective when stretch marks are still darkly colored. According to Tan, non-ablative laser works on stretch marks by stimulating collagen production and deposition. Laser treatment requires multiple sessions, she adds.

PARTNERSHIP
"The treatment of stretch marks involves a partnership between patient and dermatologist," says Tan. "This helps the dermatologist develop a treatment appropriate to the patient's skin type, lifestyle, goals, expectations and budget."