Leidy Ceron

By: Leidy Cerón

Graduate of Nursing

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Cellulite called etiopathogenically PEFE (fibroosclerotic edematous paniculopathy) is a mainly aesthetic problem that occurs to 90% of women. It is an alteration microcirculation and subsequently of the components of subcutaneous adipose tissue resulting in an overload of liquid, toxins, fats and sclerated fibers, which alters the harmony of the dermis.

It takes place in the surface or areolar layer of subcutaneous adipose tissue that is located between the dermis and the fascia superficialis; and it’s made up of adipocytes.

Adipocytes are fat energy cells that in this layer are divided by connective fibers forming cells and creating what is determined as current fat or easily mobilized fat.

In women these connective fibers are distributed vertically and in men are diagonally creating mini hexagons. This fact is relevant when it comes to understanding why men don’t usually have cellulite and women do.

In the case of women having vertical fibers allows a fat accumulation to be able to push the dermis thus altering the harmony of the skin, however, in men being distributed diagonally crossing each other, they prevent this fact.

In men are diagonally creating mini hexagons. This fact is relevant when it comes to understanding why men don’t usually have cellulite and women do.

Frequent locations:

In women, cellulite is usually located in the thighs, buttocks, upper arms, and abdomen.

In men, although it is much less common because of what we have described above and its onset is usually related to obesity; It would be located in the upper arms, abdomen and lateral area.

Cellulite formation goes through 4 stages

In stage I there is a venous stasis and an increase in capillary permeability that causes fluids to pass into the tissue interstitial creating interstitial edema and lymphatic overload.

Clinically this stage is characterized by an increase in skin pasture with decreased elasticity and slight hypothermia.

At this stage there is no external impact person may have signs of tiredness, heaviness or fatigue.

In stage II there is an increase in edema that causes: on the one hand, a hypertrophy of adipocytes that fuse in block, on the other, compresses microcirculation and nerve fibers and on the other hand stimulates a disorganized proliferation of connective fibrins by compacting and enveloping adipocytes. Creating micro nodules (hypertrophied adipocytes wrapped in compact conjunctive fibrins)

At this stage we will see a zonally pale skin and an increase in the previous signs (more pasty, more hypothermic and less elastic)

Here cellulite is not yet visible and requires a pinch to be seen, without the presence of pain.

In stage III this disorganization leads to: On the one hand, an increase of micronodules that push the dermis and on the other the connective fibers that form the cells are also compacted creating an anchor of the skin.

At this stage what we know as “orange skin” becomes visible, with a palpatory sensation of micronodules on deep planes and there is no presence of spontaneous pain.

It may be accompanied by micro varicose veins and skin striations.

In stage IV if this process increases the micronodules become macro nodules which makes cellulite more visible and where the circulatory picture is aggravated.

Clinically the skin is wavy, like a mattress, pale and zonal hypothermic, flaccid with the presence of painful nodules to punctual digital palpation and spontaneous pain may appear.

It is usually related to more pathological circulatory disorders that require medical follow-up.

PEFE can also be classified according to the degree of sagging skin: In compact, soft and edematous

COMPACT: Grain to the touch and hard, with adhesion to the deep planes. It is not modified with the change of position and painless. It is located in the upper thigh area.

 It usually occurs in young women with firm tissues, it is typical of athletes

EDEMATOSE: It has a pasty consistency. Pain appears at deep palpation. It is associated with circulatory insufficiency, varicose veins, telangiectasias, capillary fragility, edema, cramp, tingling and heaviness.

It is located mainly in the lower limbs that it invades in its entirety

FLACIDS: To the touch, roll between your fingers and change depending on the position. The skin loses its continent capacity and decreases its elasticity. It’s not painful.

It is typical of sedentary people, or those who have done a lot of sport and stopped doing it or in those who have gained weight very quickly.

Varicose veins are common, as well as soft edema or swellings with a lot of fluid retention.

To make proper treatment of cellulite we need to control the risk factors that favor its appearance as:

  • Dry fruit such us peanuts or cashews
  • Potato and cassava
  • Milk or derivatives such as margarine, cheese…
  • Consumption of products containing refined sugars and saturated fats very present in industrial pastries and sweets.
  • Abuse of alcohol and fizzy drinks.
  • Coffee
  • Tobacco
  • The use of tight clothing and high heels that make it difficult to circulate.
  • Stress and insufficient rest

 On the other hand, enhance in the diet the foods that will help to alleviate it such as:

  • Green tea:  Speeds metabolism and stimulates the release of stored fat
  • Water 1.5 or 2 liters each day
  • Whole grains
  • Fruits and vegetables rich in vitamin C

No less important is to keep in mind that to obtain better results, it is better to approach it from different areas with multi-therapy including a healthy diet and physical activity.