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A New Look at Cellulite, Part II

By: Peter T. Pugliese, MD
Posted: July 23, 2008, from the August 2008 issue of Skin Inc. magazine.
Woman doing yoga with apple in foreground


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Many of these ingredients are new, but by the time this article reaches you, there will be some products on the market that contain them. The estrogen blocking agent, genistein, is a soy derivative. Look for this on the label of ingredients—if it is not there, don’t use the product. This a phytoestrogen, which is 1,000 times less potent than estradiol, one of your body’s natural estrogens. It works by getting into the estrogen receptors on the fibroblasts and blocking the natural estrogen from getting to them. Placed on your thighs and buttocks, it will not interfere with your periods.

Oligomeric proanthocyanidins are a group of highly effective antioxidants, as well as MMP inhibitors. They appear to combine with collagen, and thereby prevent the MMPs from attaching to their binding sites. This action makes them a key ingredient in the battle against cellulite. There are many sources, both topical and oral. Take 100–200 mg per day orally, depending on your weight. In a topical form, it should be no less than 0.5% and even as high as 1.5%. Sources are pine bark, grape seeds and sea buckthorn oil. Be sure that you are using a reliable source. Preventing the destructive action of MMP-1 is a critical step in treating cellulite.

Rebuilding collagen is the next step. Collagen is made in the dermis by fibroblasts, which are under the control of many hormones and other second messengers, as well as by physical forces from both inside and outside the skin. A major stimulator of collagen is asiatic acid, a complex triterpene that stimulates the fibroblasts to produce collagen.j It is also an anti-inflammatory and wound-healing agent. Asiatic acid is an expensive agent, and you may see it substituted with ursolic acid, which is also effective, but not as potent. It is always best to use asiatic acid with vitamin C (ascorbic acid) since the two ingredients maximize collagen production.

At this stage, the damage has been stopped and the tissue needs to be repaired. A good portion of the area’s fat needs to be cleaned up and returned back to good shape. With the proper compression and the addition of the above therapeutic agents, the fat will go back to its original configuration. To start this process, some of the displaced fat needs to be utilized. Keep in mind that fat is stored energy, so you need to pull that energy out of storage to reduce it. Fat contains nine kilocalories per gram, so it has quite a bit of energy, but, fortunately, you can use this fat without strenuous exercise. The key is to direct the body to use the fat on your thighs and buttocks by applying specific ingredients. You may recall from the first article about cellulite that fat is metabolized in a certain way. Figure 5 outlines that pathway, but we are adding a new activator—resveratrol—an ingredient found in red wine and many other natural substances that helps to prevent new fat cells from forming and helps to mobilize exiting fat cells.1

The following additional ingredients also should be present.

  • Coleus forskolii extract, which stimulates lipolysis
  • Theophylline, or theophylline acetate, which prevents enzyme phosphodiesterase from destroying cyclic adenosine monophosphate (AMP), a key stimulant of the beta receptor on the fat cell.
  • Carnitine, or acetyl carnitine, is needed to burn up more fatty acid because it is produced in the adipocytes. The carnitine will shuttle the fatty acids into the mitochondria where they are converted to carbon dioxide, water and energy. You need to understand this process well because it is essential to re-establish this fat in a normal manner. The only reason the body will pull this fat from the thighs and buttocks is because the area is being specifically targeted and stimulated with the correct ingredients. Once fatty acids are in the bloodstream at night, the body doesn’t really care where they are coming from.

Physical measures