Cellulite describes a condition that occurs in men and women (although much more common in women) where the skin of the lower limbs, abdomen, and pelvic region becomes dimpled after puberty.Ana Beatris R Rossi, André Luiz Vergnanini; Cellulite: a review, Journal of the European Academy of Dermatology and Venereology; 14 (4), 251–262,(2000). The term was first used in the 1920s and began appearing in English language publications in the late 1960s, the earliest reference in Vogue magazine, "Like a swift migrating fish the word cellulite has suddenly crossed the Atlantic."

Descriptive names for cellulite include orange peel syndrome, cottage cheese skin, the mattress phenomenon, and hail damage. Synonyms include: adiposis edematosa, dermopanniculosis deformans, status protrusus cutis, and gynoid lipodystrophy. Cellulite is unrelated to cellulitis, which is infection of the skin and its underlying connective tissue.

Occurrence

It is common for post-pubescent females to display some degree of cellulite. There appears to be a hormonal component to its presentation. It is rarely seen in males. It is seen more commonly in males with androgen-deficient states such as Klinefelter's syndrome, hypogonadism, post-castration states and in those patients receiving oestrogen therapy for prostate cancer. The cellulite becomes more severe as the androgen deficiency worsens in these males.

Cellulite is not related to being overweight; average and underweight people also get cellulite. However, diet factors (see below) that contribute to cellulite can also contribute to becoming overweight.

Causes

One plausible explanation - which also explains why very few men suffer from cellulite - is based on the composition and behavior of women's fat cells and the connective tissue that holds them in place. Very simply, a woman's connective tissue is very inflexible, so as females gain weight their fat cells expand, and tend to bulge upwards towards the surface of the skin, giving the classic orange-peel appearance of cellulite. In men, not only is there generally less fat on the thighs, but also the outer skin is thicker and thus obscures what is happening to any surplus fat below.

The causes are poorly understood, and several changes in metabolism and physiology may cause cellulite or contribute to cellulite. Among these are a disorder of water metabolism, abnormal hyperpolymerization of the connective tissue, and chronic venous insufficiency.

Hormonal factors

Hormones play a dominant role in the formation of cellulite. Estrogen is the most important hormone. It seems to initiate, and aggravate cellulite. Other hormones including insulin, the catecholamines adrenaline and noradrenaline, thyroid hormones, and prolactin have all been shown to participate in the development of cellulite.