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Abstract

Cellulite is characterized by alterations to the skin surface, presenting as dimpled or puckered skin of the buttocks and posterior and lateral thighs. It mainly affects women. Cellulite occurrence is believed to be due to structural, inflammatory, morphological and biochemical alterations of the subcutaneous tissue. However, its pathogenesis is not completely understood. Topical treatments for cellulite include many agents, such those that increase the microcirculation flow, agents that reduce lipogenesis and promote lipolysis, agents that restore the normal structure of dermis and subcutaneous tissue, and agents that scavenge free radicals or prevent their formation. There are many cosmetic and medical treatments for cellulite. However, there is little clinical evidence of an improvement in cellulite, and none have been shown to lead to its resolution. The successful treatment of cellulite will ultimately depend upon our understanding of the physiopathology of cellulite adipose tissue.

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... A variety of therapies have been proposed for the cellulite treatment, including weight loss, exercises, massage, and various topical agents, as well as oral supplements and functional foods. 2,6,7 However, there are few scientifically reported studies examining the extent to which they improve the condition. Successful treatment of cellulite will ultimately depend on an improvement in the understanding of the pathophysiology of cellulite adipose tissue. ...
... Successful treatment of cellulite will ultimately depend on an improvement in the understanding of the pathophysiology of cellulite adipose tissue. 6 It is commonly accepted that dermal and subcutaneous connective tissue, which has been weakened by altered and disordered extracellular matrix, plays a key role in the pathophysiology of cellulite and contributes to the irregular and dimpled appearance of cellulite-affected skin. Consequently, therapies aiming to restore the normal structure of the dermis and subcutaneous tissue can be a meaningful approach to improving the cellulite condition. ...
... Consequently, therapies aiming to restore the normal structure of the dermis and subcutaneous tissue can be a meaningful approach to improving the cellulite condition. 2,3,6,7 Dietary supplementation with collagen peptides has demonstrated a notably stimulatory effect on dermal cellular metabolism, improving the biosynthesis of extracellular matrix proteins and, consequently, restoring dermal structure. ...
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One of the critical features of Alzheimer's disease is cognitive dysfunction, which is, in part, due to decreases in acetylcholine (ACh). The ethanol extract of Perilla frutescens was selected for isolating the acetylcholinesterase (AChE) inhibitor based on preliminary screening. In vivo behavioral tests were performed to examine the effects of the P. frutescens extract on trimethyltin chloride-induced impairment of learning and memory in mice. A diet containing P. frutescens extract effectively reversed learning and memory impairment on the Y-maze and passive avoidance tests. To isolate the active compound from the P. frutescens extract, solvent partitioning, silica gel open column chromatography, thin-layer chromatography, and high-performance liquid chromatography were used. The AChE inhibitor was identified as rosmarinic acid.
... 1,31,36 Formulações de uso tópico empregadas no tratamento da celulite e da gordura localizada, geralmente, apresentam efeitos tais como a lipólise no tecido adiposo subcutâneo, estimulam a drenagem linfática de substâncias tóxicas, melhoram a microcirculação periférica, reduzem o edema e estimulam a produção de colágeno. 11,36 Alguns ativos lipolíticos prometem o tratamento estético para a celulite e a gordura localizada; no entanto, há pouca informação científica disponível a respeito dos mecanismos de ação, dos efeitos fisiológicos, das restrições ou contraindicações dessas substâncias 5,6 . Esta falta de informações científicas dificulta o trabalho dos profissionais da estética que buscam avaliar cuidadosamente cada produto de modo a optar pelo uso daqueles que, além de mais eficientes, também representem menor risco à saúde 6 . ...
... Tal mecanismo pode explicar parcialmente a maior prevalência dessa condição nas mulheres. Outra evidência dessa influência hormonal é o aparecimento da LG na puberdade e sua exacerbação durante a gravidez e amamentação, além da relação com o uso de contraceptivos orais 11,12 . ...
... Os princípios ativos lipolíticos, os quais são classificados como cosméticos, têm como compromisso estimular a lipólise do tecido adiposo; ou seja, a degradação dos lipídeos em ácidos graxos e glicerol a fim de serem introduzidos na corrente sanguínea. Na estética a aplicação dos cosméticos/fármacos tem revelado resultados satisfatórios em diversas alterações da pele 1,11 . ...
Article
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Resumo A lipodistrofia ginoide (celulite) e a adiposidade localizada são tipos de imperfeições estéticas consideradas as principais causas de insatisfação corporal em mulheres. Devido as alterações cutâneas provocadas por estas afecções, bem como, a preocupação atual do ser humano com a imagem corporal, muitas pessoas têm buscado a realização de procedimentos estéticos e cosméticos para manter uma melhor aparência corporal e saúde. Tanto a gordura localizada quanto a celulite apresentam impacto não apenas estético, assim como na qualidade de vida do indivíduo. Descrever os principais mecanismos de ação e efeitos biológicos dos ativos lipolíticos mais utilizados no tratamento da lipodistrofia ginoide e da gordura corporal localizada. Este estudo consiste em uma revisão bibliográfica narrativa. Dentre os tratamentos estéticos satisfatórios para estas afecções destaca-se a aplicação de ativos lipolíticos como as Metilxantinas (cafeína, teofilina, aminofilina, etc.), Isoproterenol, Ioimbina e L-carnitina, os quais ativam vias lipolíticas nas células adiposas do tecido subcutâneo induzindo a redução dos depósitos de gordura cutâneos e melhorando a aparência da pele. Embora algumas substâncias lipolíticas, como o ácido desoxicólico, sejam benéficos para a lise de adipócitos subcutâneos, os profissionais devem estar cientes dos efeitos adversos e riscos envolvidos com o uso das substâncias lipolíticas em tratamentos estéticos para celulite e gordura localizada. O conhecimento da anatomia corporal local, propriedades e efeitos adversos são fundamentais para o tratamento eficiente com agentes lipolíticos. Palavras-Chave: Ativos lipolíticos; Cosméticos; Celulite; Lipodistrofia ginoide; Adiposidade localizada. Abstract Ginoid Lipodystrophy (cellulite) and localized body fat are types of aesthetic imperfections considered the main causes of body dissatisfaction in women. Due to the skin changes caused by these conditions, as well as the current concern of the human being with body image, many people have sought to perform aesthetic and cosmetic procedures to maintain a better body appearance and health. Both localized fat and cellulite have an impact not only aesthetic, but also on the individual's quality of life. To describe the main mechanisms of action and biological eff ects of the lipolytic actives most used in the treatment of gynoid lipodystrophy and localized adiposity. This study consists of a narrative literature review. Among the satisfactory aesthetic treatments for these conditions, the application of lipolytic actives such as Methylxanthines (caff eine, theophylline, aminophylline, etc.), Isoproterenol, Yohimbine and L-carnitine, which activate lipolytic pathways in the subcutaneous fat cells, inducing reduction of cutaneous fat deposits, improving the appearance of the skin. lthough some lipolytic substances, such as deoxycholic acid, are benefi cial for the lysis of subcutaneous adipocytes, professionals should be aware of the adverse eff ects and risks involved with the use of lipolytic substances in aesthetic treatments for cellulite and localized fat. Knowledge of local body anatomy, properties and adverse eff ects is essential for effi cient treatment with lipolytic agents.
... A variety of therapies have been proposed for the cellulite treatment, including weight loss, exercises, massage, and various topical agents, as well as oral supplements and functional foods. 2,6,7 However, there are few scientifically reported studies examining the extent to which they improve the condition. Successful treatment of cellulite will ultimately depend on an improvement in the understanding of the pathophysiology of cellulite adipose tissue. ...
... Successful treatment of cellulite will ultimately depend on an improvement in the understanding of the pathophysiology of cellulite adipose tissue. 6 It is commonly accepted that dermal and subcutaneous connective tissue, which has been weakened by altered and disordered extracellular matrix, plays a key role in the pathophysiology of cellulite and contributes to the irregular and dimpled appearance of cellulite-affected skin. Consequently, therapies aiming to restore the normal structure of the dermis and subcutaneous tissue can be a meaningful approach to improving the cellulite condition. ...
... Consequently, therapies aiming to restore the normal structure of the dermis and subcutaneous tissue can be a meaningful approach to improving the cellulite condition. 2,3,6,7 Dietary supplementation with collagen peptides has demonstrated a notably stimulatory effect on dermal cellular metabolism, improving the biosynthesis of extracellular matrix proteins and, consequently, restoring dermal structure. ...
Article
Full-text available
In this double-blind, placebo-controlled clinical study, we investigated the efficacy of specific bioactive collagen peptides (BCP) on the cellulite treatment of normal and overweight women. In total, 105 women aged 24-50 years with moderate cellulite were randomized to orally receive a daily dosage of 2.5 g BCP or a placebo over 6 months. The degree of cellulite was evaluated before starting the treatment and after 3 and 6 months of intake. In addition, skin waviness, dermal density, and the length of subcutaneous borderline were assessed. BCP treatment led to a statistically significant decrease in the degree of cellulite and a reduced skin waviness on thighs (P < 0.05) in normal weight women. Moreover, dermal density was significantly improved (P < 0.05) compared to placebo. The subcutaneous borderline showed a significant shortening after BCP intake compared to the beginning of the study, indicating cellulite improvement, but the data failed to reach statistical significance compared to placebo. The efficacy of BCP treatment was also confirmed in overweight women, although the impact was less pronounced in comparison with women of normal body weight. The results of the study demonstrated that a regular ingestion of BCP over a period of 6 months led to a clear improvement of the skin appearance in women suffering from moderate cellulite. Based on the current data, it can be concluded that a long-term therapy with orally administered BCP leads to an improvement of cellulite and has a positive impact on skin health.
... 1,3,4 The etiology of cellulite is believed to be attributed primarily to the subcutaneous tissue structure in women and to fat cell volume secondarily. 5,6 Based on magnetic resonance imaging study results in women, cellulite depressions are associated with underlying thick fibrous septae, 5,6 generally running perpendicular to the skin. 4 The fibrous septae tether the dermis to underlying fascia resulting in dermal depressions and a dimpled appearance of the skin where the tethers are attached, 6 as depicted in Figure 1. ...
... 1,3,4 The etiology of cellulite is believed to be attributed primarily to the subcutaneous tissue structure in women and to fat cell volume secondarily. 5,6 Based on magnetic resonance imaging study results in women, cellulite depressions are associated with underlying thick fibrous septae, 5,6 generally running perpendicular to the skin. 4 The fibrous septae tether the dermis to underlying fascia resulting in dermal depressions and a dimpled appearance of the skin where the tethers are attached, 6 as depicted in Figure 1. ...
... 5,6 Based on magnetic resonance imaging study results in women, cellulite depressions are associated with underlying thick fibrous septae, 5,6 generally running perpendicular to the skin. 4 The fibrous septae tether the dermis to underlying fascia resulting in dermal depressions and a dimpled appearance of the skin where the tethers are attached, 6 as depicted in Figure 1. Evidence also exists suggesting that skin laxity contributes to the appearance of cellulite, and may provide support to the tenet that cellulite worsens with age. 5 A novel tissue stabilized-guided subsicion (TS-GS) system (Cellfina System; Merz North America, Inc., Raleigh, NC) has been shown to reduce the appearance of cellulite safely and effectively, 1 and is Food and Drug Administration (FDA)-cleared for long-term improvement in the appearance of cellulite in the buttocks and thigh areas of adult females (reference IFU). ...
Article
Background: Cellulite is a common female cosmetic concern for which no single treatment option had been proven effective over the long term. A novel tissue stabilized-guided subsicion system (TS-GS system) has demonstrated significant reduction in the appearance of cellulite after treatment. Objective: The objective of this extended follow-up period was to assess the effectiveness of TS-GS out to 3 years after initial treatment. Patients and methods: After completing an open-label, multicenter, pivotal study, 45 subjects were followed for an extended period of up to 3 years after receiving a single treatment using the TS-GS system. Treatment areas were photographed prior to the procedure and at multiple time points post-treatment throughout the 3 years. In this open-label study, subjects served as their own controls. Effectiveness was assessed based on blinded independent physician panel assessments of improvement from baseline using a cellulite severity scale. Subject aesthetic improvement and patient-reported satisfaction were also collected. Results: The results of this trial supported Food and Drug Administration clearance of the device for the long-term reduction in the appearance of cellulite following TS-GS. Conclusion: These data further demonstrate the safety and efficacy of this treatment with no reduction in treatment benefits out to 3 years.
... 6 The number of original published articles reporting the efficacy of cellulite treatment increased rapidly in the last decade and several reviews or overviews were published on this issue. [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16] However, to our knowledge, no systematic review and meta-analysis has been performed so far. ...
... We considered only original articles in English reporting data on the efficacy of cosmetic treatments of cellulite from in vivo studies on humans. Two review team members (C.G. and F.T.) retrieved and independently assessed the potentially relevant articles, and checked the reference list of all papers of interest and that of several reviews [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16] for other pertinent publications. We considered conference papers whenever available, but we excluded conference abstracts, since the information was not sufficiently accurate to evaluate the quality measurement, as suggested by PRISMA guidelines. ...
Article
Background The number of original articles investigating the efficacy of cosmetic products in cellulite reduction increased rapidly in the last decade; however, to our knowledge, no systematic review and meta-analysis has been performed so far. Objective We conducted a systematic review of in vivo studies on humans adopting the PRISMA guidelines. Moreover, we used a meta-analytic approach to estimate the overall effect of cosmetic creams in cellulite treatment from controlled trials with more than 10 patients per arm, using thigh circumference reduction as the outcome measure. Methods Medline and Embase were searched up to August 2012 to identify eligible studies. ResultsTwenty-one original studies were included in the present systematic review. All studies were clinical trials, most of them recruited women only and 67% had an intra-patient study design. About half of the active cosmetic creams tested only contained one active ingredient among xanthenes, herbals or retinoids. The other studies tested cosmetic creams with more complex formulations and most of them included xanthenes. A total of seven controlled trials satisfied the inclusion criteria for the meta-analysis. The pooled mean difference of thigh circumference reduction between the treated and the controlled group was -0.46 cm (95% confidence intervals, CI: -0.85, -0.08), with significant heterogeneity between studies (P<0.001). Conclusion This article provides a systematic evaluation of the scientific evidence of the efficacy of cosmetic products in cellulite reduction and supports a moderate efficacy in thigh circumference reduction.
... In females, bands of connective tissue at the buttocks and posterior and lateral thighs are oriented longitudinally. These bands form fibrous septae that localize adipose deposits into channels, and in manifest cellulite, the skin surface changes via a reactive process to sustained hypodermal pressure caused by fat accumulation [3,4]. The condition affects up to 75-90% of post-pubescent females and as a clinical condition it can considerably affect their quality of life. ...
... However they do not add to any consensus surrounding the actual causes of cellulite despite an understanding that cellulite tissue is characterized by edema, vasoconstriction, adiposity, and a thick unyielding fibrosis [6][7][8] all of which are difficult to treat. Some treatments are directed through pharmacological restoration [3], and whilst topical treatments are wide-ranging, and often rational, their mechanisms of action still remain elusive. Despite the lack of consensus on the exact mechanisms of cellulite formation, it is clear, that removing or diminishing the "visual" aspects of the condition so readily seen on the skin surface, makes for a marked improvement in overall skin appearance and thus overall subject well-being. ...
Article
Full-text available
Cellulite occurs in females and is a common condition of altered connective tissue matrix and increased adipogenicity with visible dimples and orange‐peel appearance on the skins surface. Whilst advancements in methods continue to help our understanding, attempts to correct the appearance of cellulite topically have yielded limited success. Various kinds of non‐invasive body contouring methods such as whole body vibration have been reported with demonstrable visible improvements in the cellulite condition. The aim of this study was to evaluate volume reduction and improvement of the visible appearance of cellulite as judged both objectively (AEVA‐HE phase‐shift 3‐D fringe projection, macrophotography image grading) and subjectively (questionnaires) after application of a hand‐held localized vibrational device over 24‐weeks. The study was conducted on 40 healthy female volunteers who were instructed how to use the device on defined areas of cellulite of the outside and rear of the thighs (iliotibial band, and over biceps femoris region respectively). The initial 12 weeks of continuous massage application of the study were followed by a 12 week phase in which volunteers were split into 2 subgroups – one for assessment of regression effects and one for continuous application effects. AEVA (skin surface volume) measurements of cellulite‐related dimples correlated with questionnaires and visual image evaluation scoring, in that in the iliotibial region cellulite was significantly reduced at 12 weeks. In the regression subgroup cellulite returned to initial values soon after cessation of treatment, whereas in the continuous application subgroup, cellulite remained diminished. The effect of this device to reduce cellulite as observed in this study is proves that continuous use of vibrational massage is beneficial to mitigate visible signs of cellulite.
... Cellulite is characterized by dimpled or puckered skin of the buttocks and posterior and lateral thighs. This condition has also been described as resembling an orange peel and cottage cheese or as having mattress-like appearance (Hexsel et al. 2010a;Hexsel and Soirefmann 2011) (Fig. 1). ...
... Results of the magnetic resonance imaging analysis showed that cellulite depressions on the buttocks were significantly associated with the presence of underlying thick fibrous septa. It was found that all fibrous septa in the examined areas were perpendicular to the skin surface, and most of them were ramified (Hexsel and Soirefmann 2011;Hexsel et al. 2009b). ...
Chapter
Cellulite is characterized by dimpled or puckered skin of the buttocks and posterior and lateral thighs. This condition has also been described as resembling an orange peel and cottage cheese or as having mattress-like appearance. The evaluation of a patient with cellulite may be done most of the times on clinical examination and sometimes using image exams, such as ultrasound, magnetic resonance imaging (MRI), laser Doppler flowmetry (LDF) and thermography. The degree of cellulite is important to determine the more appropriate treatment and to monitor treatment improvement.
... Se ha sugerido que los retinoides incrementan el contenido y mejoran la arquitectura del colágeno dérmico, las proteínas dermoepidérmicas, las fibras de anclaje y las fibras elásticas, mientras que las vitaminas C y E actúan como antioxidantes protegiendo las membranas celulares de la toxicidad generada por los radicales libres. 12,15,18 • Tratamiento oral: Hay muy escasas publicaciones que aporten pruebas sobre la eficacia de extractos de plantas como la uva (Vitis vinifera), Ginkgo biloba, centella asiática, melilotus (Melilotus officinalis) y fucus (Fucus vesiculosus), entre otras. [19][20] • Drenaje linfático manual y mecánico: Se realiza mediante compresiones sobre sitios específicos del sistema linfático, con el fin de mejorar el flujo linfático y extraer linfa de los tejidos. ...
Article
Full-text available
Cellulite is a complex and multifactorial architectural skin disorder affecting 98% of women. It is characterized by a topographic modification of the skin evinced by dimpling and nodularity of the buttocks, lower limbs and abdomen. Despite the large number of available treatments very few are actually effective. Consequently, new therapeutic strategies are continuously emerging. However, combined therapies with mesotherapy, laser and radiofrequency provided better therapeutic outcomes, such as, pitting reduction, improvement of the skin texture and body contour. All patients expressed satisfaction for the results achieved
... 5 The exact etiology of cellulite is still a matter of debate, but most scientists will agree on the involvement of reduced microcirculation, interstitial liquid infiltration (edema), localized hypertrophy of adipocytes, oxidative stress, and persistent low grade inflammation, combined with extracellular matrix alterations. 4,[6][7][8][9] The extensibility, elasticity, and resilience of the skin are also abnormal. 10 Figure 1 schematizes all these elements. ...
Article
Full-text available
Cellulite is a serious cosmetic concern for most of the 90% of women affected by it. To assess the clinical efficacy of a complex integral anti-cellulite gel. This double-blind, randomized, placebo-controlled study involved 44 healthy women, aged 25-55 years. Subjects had a normal to slightly overweight body mass index and presented slight to moderate cellulite on their thighs, buttocks, and/or hips at baseline. Subjects were randomly assigned to either the treated or placebo group and accordingly applied the active product or placebo on their hips, stomach, buttocks, and thighs, twice daily for 3 months. Skin tonicity, orange-peel aspect, and stubborn cellulite were assessed at day 0, 28, 56, and 84. A self-evaluation questionnaire was completed by all volunteers. At the end of the study, an average of 81% of the subjects applying the active product presented improvement in their cellulite condition versus 32% for the placebo group (all descriptors and sites combined). At day 84, skin tonicity, orange-peel appearance, and stubborn cellulite were improved in a significant manner (P<0.05) over placebo, on all studied areas. Skin tonicity improved on average by +41% for buttocks, +35% for hips, and +31% for thighs. Orange peel appearance was reduced on average by -25% for buttocks, -22% for hips, and -22% for thighs. Stubborn cellulite was reduced on average by -19% for buttocks, -24% for hips, and -22% for thighs. Circumference measurements decreased in a significant manner (P<0.05) over placebo, for the abdomen (average value of -1.1 cm) and thighs (average value of -0.8 cm). The product was well tolerated and perceived by the volunteers themselves as better performing than placebo on all criteria. All results validate the efficacy of the present integral formulation to significantly reduce signs of cellulite and reshape the silhouette.
... Cellulite appears to be the result of localized adipose deposits and edema within the subcutaneous tissue. There is evidence that estrogen hormone influence the formation of cellulite by the stimulation of lipogenesis and inhibits lipolysis, resulting in adipocyte hypertrophy.[1]Niosomes are non-ionic surfactant vesicles obtained on hydration of synthetic nonionic surfactants, with or without incorporation of cholesterol or other lipids.[2]Niosomes ...
Article
Full-text available
The aim of the present work was to prepare caffeine niosomes by thin film hydration method using various types of surfactants and applying different surfactant: cholesterol ratios for the treatment of cellulite. Surfactant used were (span 20, 60, 65, 80 and 85), cholesterol was added with (0, 10,20, 30, 40 and 50%). The prepared niosomes were evaluated by determination of particle size using transmission electron microscope (TEM), determination of entrapment efficiency (E.E. %) and in-vitrodrug permeation study through rat skin. The particle size of the prepared niosomes ranged between 174 and 380 nm, the highest entrapment efficiency of caffeine (94.18%) occurred with span 60 (F12S60) which contains Span 60: Cholesterol with ratio (50:50) respectively. While (F22S80) which contains Span 80: Cholesterolwith ratio (70:30) respectively gave the highest steady state flux of (62.51 μg cm-2 hr-1 ).The results revealed that Span 60 gave the highest entrapment efficiency and Span 80 gave the highest in-vitropermeation.
... Aside from androstanolon, a few cosmeceuticals might be an option [12]. A mesotherapeutically induced decomposing of fibrosclerotic cellulite structures through collagenases and hyaluronidases seems to be effective [13]. ...
... Therefore, this process can be due to Bodyfit (as a mixture of glycerin, water, coco-glucoside, caprylyl glycol, alcohol, and glaucine) that visibly reduces the appearance of cellulite, while contributing to an improvement in drainage and water distribution throughout the tissue. Therefore, as the cellulite diminishes, the skin firmness is restored 18 . Moreover, ginger extract increases the circulation due to its spicy ingredients and regulates the moisture due to its content of polysaccharides and amino acids 15 . ...
Article
Full-text available
Background: Cellulite is a common disease whose exact mechanism is unknown. This study was aimed to assess the safety and efficacy of an anti-cellulite preparation compared with placebo in a randomized double-blind, right-left comparison clinical trial. Methods: Twelve healthy women aged 22 to 58 years with mild to moderate cellulite on their thighs and buttocks participated in this trial. The anti-cellulite preparation (Three O cream, Pouya Varzan Tejarat Sepahan Co., Iran) and an identical placebo were randomly applied on the right or left thigh and buttock twice a day for 2 months. The mentioned areas were photographed and the circumference, subcutaneous fat thickness, and dermis density and thickness were measured before and after treatment. A satisfaction questionnaire was completed by all volunteers to assess their satisfaction with the efficacy of treatment on each side. Results: There was no significant difference between active and placebo treatment sides in any of measurements. About 90% of participants had an overall satisfaction of 5 and more than 5 based on a 0 to 10 visual analogue scale on the side of anti-cellulite cream. This score was similar on the sides treated with placebo and the active product. Conclusion: Although Three O cream provided more satisfaction in volunteers than placebo, the objective measurements did not show any difference between them.
... Treatment efficiency, then, will partly depend on the product residence time on the skin, the active ingredient release and its penetration up to the deep layers of the skin [12,13]. Caffeine is widely used in cellulite treatment due to its lipolytic action over adipocytes and also has a stimulating effect on the cutaneous microcirculation [14]. ...
Article
Full-text available
The use of bioahesive hydrogels for skin care presents important advantages such as long residence times on the application site and reduced product administration frequency. The aim of the present work was to develop bioadhesive hydrogels for skin application, using caffeine as a model active ingredient. Eight hydrogels were formulated using binary combinations of a primary polymer (carbomer homopolymer type C (Carbopol(®) 980) or kappa carrageenan potassium salt (Gelcarin(®) GP-812 NF)) and a secondary polymer (carbomer copolymer type B (Pemulen(™) TR-1), xanthan gum or guar gum). Hydrogels were characterised by means of physico-chemical (dynamic rheological measurements, spreadability and adhesion measurements) and sensory methods (projective mapping in combination with a check-all-that-apply (CATA) question). Caffeine hydrogels were formulated using two of the most promising formulations regarding adhesion properties and sensory characteristics. In vitro active ingredient release studies were carried out. Hydrogel formulations showed a prevalently elastic rheological behaviour. Complex viscosity of carbomer homopolymer type C hydrogels was higher than that of the kappa carrageenan hydrogels. Besides, complex viscosity values were dependent on the secondary polymer present in the formulation. Significant differences among hydrogels were found in detachment force, work of adhesion and spreading diameter results. Association of projective mapping with CATA allowed to determine similarities and dissimilarities among samples. Cluster analysis associated the samples in two groups. Two hydrogels were selected to study release of caffeine. Both hydrogels presented similar release profiles which were well described by the Higuchi model. Caffeine release was exclusively controlled by a diffusive process. Physico-chemical and sensory techniques enabled the identification of bioadhesive hydrogel formulations with positive characteristics for cosmetic applications. Formulations which combined carbomer homopolymer type C with xanthan gum or with carbomer copolymer type B were the most promising for bioadhesive skin products. Caffeine release profiles of selected formulations were not statistically different. Both hydrogels gradually released the active ingredient, reaching approximately 80% within the first five hours, and their profiles were well described by the Higuchi model. In this context, it could be concluded that the selected hydrogels, are suitable bioadhesive hydrogel formulations for cosmetic application on the skin. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
... Cellulite is by definition an edematous connective tissue infiltration, with polymerization of amorphous ground substance, which produces a fibrotic reaction manifested through nodules of different sizes. It is caused by lipid accumulation on adipocytes, which ends up retaining the greatest amount of lipids and fluids, resulting in a worsening of local circulation associated with the breakdown of collagen and elastin fibers [47]. ...
... In buttocks and thighs (sites where the lymphatic drainage and the vascular circulation are low), there is a higher predisposition to microedema increase in the subcutaneous fat layers, which fosters abnormalities in the skin. 10 Rossi proposed four evolutionary stages in the GLD pathophysiology 9 : ...
Article
Full-text available
Gynoid lipodystrophy (GLD) is a structural, inflammatory, and biochemical disorder of the subcutaneous tissue causing alterations in the topography of the skin. Commonly known as "cellulite," GLD affects up to 90% of women, practically in all stages of the life cycle, beginning in puberty. It is a clinical condition that considerably affects the patients' quality of life. It is a frequent reason for consultation, although the patients resort to empirical, improvised, nonevidence-based treatments which discourage and can be a source of frustration not only because of the lack of results but also due to the complications derived from those treatments. In this article, a panel of experts from different specialties involved in the management of this clinical skin disorder presents the results of a systematic literature search and of the consensus discussion of the evidence obtained from different treatments currently available. The analysis was divided into topical, systemic, noninvasive, and minimally invasive treatments.
... Specifically, overexpression of angiotensin-converting enzyme has been linked to higher production of angiotensin II, a vasoconstrictive peptide, along with lower production of bradykinin, a vasodilatative peptide [89]. Breakdown of the extracellular matrix (ECM) due to enzyme hyperactivity may also play an important role in cellulite [90]. Normal ECM may potentially be restored by silencing enzymes like collagenase, elastase, and lipase. ...
Article
Nucleic acids (NAs) hold significant potential for the treatment of several diseases. Topical delivery of NAs for the treatment of skin diseases is especially advantageous since it bypasses the challenges associated with systemic administration which suffers from enzymatic degradation, systemic toxicity and lack of targeting to skin. However, the skin's protective barrier function limits the delivery of NAs into skin after topical application. Here, we highlight strategies for enhancing delivery of NAs into skin, and provide evidence that translation of topical NA therapies could have a transformative impact on the treatment of skin diseases.
... Quite disturbingly, the majority of such treatment attempts have been conducted in an empirical manner and without the application of rigorous scientific methodology. Because presently available "treatment" options are far from optimal, [7][8][9][10][11][12][13] new insights into underlying mechanisms are needed to improve therapy. Although debated for many years whether local blood-flow impairments or an increased thickness of the subcutaneous adipose tissue (SAT) are more important in the development of cellulite, [1][2][3][4][5][6] evidence is now emerging that these processes are interwoven and present two sides of one coin. ...
... Among the plants used for cosmetic purposes, the most frequently cited are those for cellulite treatment. Cellulite, also known as adiposis edematosa or dermopanniculosis deformans, mainly affects postpubertal females and is characterized by alterations to the skin surface, presenting as dimpled or puckered skin of the buttocks and posterior and lateral thighs, and seems to be attributable to structural, inflammatory, morphologic, and biochemical alterations in the subcutaneous tissue (Draelos 2005;Hexsel and Soirefmann 2011;Friedman et al. 2017). One the most reported species for cellulite treatment is common ivy (Hedera helix L.), whose leaves are rich in flavonoids, such as rutinoside and rutoside, and saponins, such as hederacoside, hederagenin, and hederin (Grauso et al. 2019b). ...
... However, they do not add to any consensus surrounding the actual causes of cellulite despite an understanding that cellulite tissue is characterized by oedema, vasoconstriction, adiposity and a thick unyielding fibrosis [6][7][8] all of which are difficult to treat. Some treatments are directed through pharmacological restoration [3], and although topical treatments are wide-ranging, and often rational, their mechanisms of action still remain elusive. Despite the lack of consensus on the exact mechanisms of cellulite formation, it is clear that removing or diminishing the 'visual' aspects of the condition so readily seen on the skin surface makes for a marked improvement in overall skin appearance and thus overall subject well-being. ...
Article
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Cellulite occurs in females and is a common condition of altered connective tissue matrix and increased adipogenicity with visible dimples and orange‐peel appearance on the skins surface. Whilst advancements in methods continue to help our understanding, attempts to correct the appearance of cellulite topically have yielded limited success. Various kinds of non‐invasive body contouring methods such as whole body vibration have been reported with demonstrable visible improvements in the cellulite condition. The aim of this study was to evaluate volume reduction and improvement of the visible appearance of cellulite as judged both objectively (AEVA‐HE phase‐shift 3‐D fringe projection, macrophotography image grading) and subjectively (questionnaires) after application of a hand‐held localized vibrational device over 24‐weeks. The study was conducted on 40 healthy female volunteers who were instructed how to use the device on defined areas of cellulite of the outside and rear of the thighs (iliotibial band, and over biceps femoris region respectively). The initial 12 weeks of continuous massage application of the study were followed by a 12 week phase in which volunteers were split into 2 subgroups – one for assessment of regression effects and one for continuous application effects. AEVA (skin surface volume) measurements of cellulite‐related dimples correlated with questionnaires and visual image evaluation scoring, in that in the iliotibial region cellulite was significantly reduced at 12 weeks. In the regression subgroup cellulite returned to initial values soon after cessation of treatment, whereas in the continuous application subgroup, cellulite remained diminished. The effect of this device to reduce cellulite as observed in this study is proves that continuous use of vibrational massage is beneficial to mitigate visible signs of cellulite.
... Methylxanthines (e.g., caffeine) penetrate the skin to act directly on adipose cells, promoting lipolysis, 13 and retinol can prevent in vitro human preadipocyte differentiation. 14 Table S1, http:// links.lww.com/DSS/A299). ...
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Background: The etiology of cellulite is unclear. Treatment of cellulite has targeted adipose tissue, dermis, and fibrous septae with varying degrees of success and durability of response. Objective: Results from clinical trials that target different anatomical aspects of cellulite can provide insights into the underlying pathophysiology of cellulite. Materials and methods: A search of the PubMed database and ClinicalTrials.gov website was conducted to identify clinical trials that have investigated treatments for cellulite. Results: A lack of trial protocol standardization, objective means for quantification of improvement and reported cellulite severity, and short-term follow-up, as well as variation in assessment methods have made comparisons among efficacy studies challenging. However, the lack of durable efficacy and inconsistency seen in clinical results suggest that dermal or adipose tissue changes are not the primary etiologies of cellulite. Clinical studies targeting the collagen-rich fibrous septae in cellulite dimples through mechanical, surgical, or enzymatic approaches suggest that targeting fibrous septae is the strategy most likely to provide durable improvement of skin topography and the appearance of cellulite. Conclusion: The etiology of cellulite has not been completely elucidated. However, there is compelling clinical evidence that fibrous septae play a central role in the pathophysiology of cellulite.
... Caffeine also stimulates the draining lymph systems Address all correspondence to Kristina Mladenov at kristina_mladenov@yahoo.com. in fatty tissues by removing accumulated fat and toxins, which can improve the microcirculation of blood vessels (1). The commercially available topical anticellulite formulations usually contain 1-2% of caffeine, although some products may have up to 3% of this ingredient (3). In addition, hair products containing caffeine have recently been used to prevent and treat alopecia. ...
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Caffeine is extensively used in cellulite and hair growth cosmetic products. Regulations in the field of cosmetics require manufacturers to list caffeine in the ingredient list on product labels, but its exact content in these products is not declared. On the other hand, daily exposure to caffeine from all sources may approach health reference values. For that reason, it is important to know the exact caffeine content in products for skin and hair care. Cosmetics are often viscous or semisolid products of very complex chemical composition. To analyze caffeine in these complex sample matrices by liquid chromatographic methods, an extraction step is often necessary. This article presents the applicability of the solid-phase extraction (SPE) procedure for the caffeine extraction and high-performance liquid chromatography (HPLC) determination in anticellulite gels, shampoos, and hair balsam. The samples of gels were centrifuged after ammonia addition to precipitate carbomer. In cellulite reduction, gel caffeine content was found to be in the range of 0.7-1.7%, whereas in the hair-care products, it was about 1.0%.
... Caffeine acts directly on adipose cells, promoting lipolysis and inhibiting phosphodiesterase. Caffeine also has a stimulating effect on the cutaneous microcirculation [6]. ...
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The aim of this study was to formulate and evaluate O/W emulsions based on collagen and naturals ingredients such as vegetable oils and butters, caffeine, ivy extract and pink pepper essential oil. The essential oil of pink pepper was obtained by hydrodistilation and characterized by GC-MS. The main components of this essential oil are: α-Phelandrene 35.84%, Limonene 17.31%, α-Pinene 1.98% (monoterpenes) and β-Phelandrene 13.04%, o-Cymene 4.65%, δ-Cadinene 3.27%, trans-Caryophyllene3.04%, Bicyclogermacrene 2.13% (sesquiterpenes). The emulsions obtained are stable and the pH values of emulsions correspond to the natural pH of the skin, indicating that emulsions can be safely applied to the skin. Results from the optical microscopy analysis show that emulsions have a creamy and foam "like" appearance. All the emulsions present adequate rheological properties. Further microbiological tests and other analysis are necessary for the obtained emulsions.
... It is an aesthetical problem, unacceptable for most women, involving the microcirculatory and lymphatic system, as well as the presence of excess subcutaneous fat that swells within the dermis [1,2]. the most common one, being simple in the application and relatively cost-effective compared to other approaches [6,9]. Moreover, female consumers prefer topical formulations to oral supplements/forms, mainly due to the increasing possibility of side effects associated with the latter ones [10]. ...
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The present work focuses on the production of topical anti-cellulite devices through a supercritical one-step process consisting of the polymer foaming and impregnation of caffeine into PLA/PBAT/CaCO3 films to obtain a biocompatible and biodegradable patch. Field Emission Scanning Electron Microscopy analysis revealed that porosities were formed in the polymeric support when in contact with the supercritical CO2. Atomic force microscopy revealed the presence of caffeine on the polymer surface in the form of needles. The impregnation kinetics determined at 17.0 MPa showed an increase in caffeine loadings with the contact time (up to 16.5% and 23.0% wcaffeine/wfilm at 40°C and 35°C, respectively), corresponding to higher caffeine loadings than the ones contained in commercial products (about 3%). The release of caffeine was simulated by UV-vis spectrophotometry: pure caffeine dissolved instantly in the dissolution medium, whereas its release was prolonged up to 2 days when it was impregnated within the PLA/PBAT/CaCO3 film.
Chapter
Marine macroalgae biomass is often used for the production of ingredients in cosmetics. These ingredients can have one of the three main functions: (1) they are considered as additives which contribute to the organoleptic properties; (2) they are used for stabilisation and preservation of the product; (3) or finally, they are bioactive compounds which fulfil a real cosmetic function and activity. This chapter presents the bioactivities of molecules or extracts used for cosmetic applications, and discusses some perspectives for the development of new compounds and specific extraction methods. Metabolites derived from seaweeds have been shown to be active in antiaging skin care, anticellulite treatment and slimming, as well as having antioxidant, photoprotective, moisturising, and whitening properties. Among the various classes of seaweed components, sulphated polysaccharides, peptides, carotenoids, fatty acids, and phytohormones exhibit antiaging and antioxidant properties, while mycosporine-like amino acids, flavonoids have an antiphotoaging activity. Flavonoids (i.e. phlorotannins) are lipolytic agents which are isolated from macroalgae and which also inhibit melanogenesis. A better knowledge of algae genetics and the improvement of algae cultivation or co-cultivation will provide new opportunities for the development of bioactive compounds.
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The purpose of this study was to assess the reduction effect of cellulite among obese women who wore the slimming garment made of special drug delivering fabric.
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Two simple liquid chromatography (LC) separation methods coupled with ultraviolet diode array (UV-DAD) and an electrospray ionisation mass spectrometry (ESI-MS) detection have been developed for the determination of caffeine and iodide content in cellulite reduction cosmetic products. The presence of these substances in cosmetics available in the market should be taken into account in order not to exceed the limits allowed when co-administered with drugs, dietary supplements in order to avoid eventual acute or chronic intoxications. The compounds were separated by reversed phase chromatography with water (0.02% trifluoroacetic acid) and acetonitrile gradient elution and detected by UV-DAD at 254 nm and by ESI-MS ionization mode positive for caffeine and negative for iodide. Paracetamol was used as internal standard. Linearity was studied with UV-DAD in the 5 (10 for iodide) to 200 μg g−1 range, and with ESI-MS in the 0.1 (0.2 for iodide) to 2 μg g−1 range. Good determination coefficients (r2 = 0.99) were found in both UV-DAD and ESI-MS detection. At three concentrations spanning the linear dynamic ranges of both UV-DAD and ESI-MS assays, mean recoveries were always higher than 90% for the different analytes and intra-assay and inter-assay precisions were always better than 15%. This method was successfully applied to the analysis of substances under investigation in cellulite reduction cosmetic products freely sold in European herbalist shops, perfumeries and supermarkets.
Chapter
The application of marine resources for the formulation of cosmetics has been known for centuries. Marine organisms produce unique compounds, which are not found in terrestrial sources, to provide protection against hard environmental conditions. They have been used both to confer: Physicochemical functional properties to the cosmetic product, such as texture, emulsifying properties or color, Bioactive properties, including remineralizing, emollient, hydrating, antioxidant, sunscreening among others. In this chapter, the major functional and biological activities of components isolated from marines sources, including micro and macroorganisms and with special emphasis on algae, are reviewed in relation to their application to cosmetics. Both the traditionally used compounds and fractions and those isolated and characterized in recent years are presented.
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Cellulite is present in 90% of post-adolescent women. Several technologies have been developed for treating cellulite; however, they all involve some degree of massage or mechanical manipulation. The purpose of this study was to assess the effectiveness of a low-level laser light device employing green 532 nm diodes as a stand-alone procedure without massage or mechanical manipulation for improving the appearance of cellulite in the thighs and buttocks. This double-blind study randomized subjects to undergo treatment with the LLLT device (N = 34) or sham treatment (N = 34). During a 2-week treatment phase, each subject received three weekly treatment sessions 2–3 days apart. During each session, the front and back of the hips, thighs, and waist were exposed for 15 minutes (30 minutes total). Nineteen subjects in the LLLT group achieved a decrease of one or more stages on the Nurnberger–Muller grading scale (55.88%) versus three subjects (8.82%) in the sham-treated group (P < 0.0001). Two LLLT-treated subjects achieved 2-stage improvements on the Nurnberger–Muller Scale at the 2-week study endpoint and four did at the 6-week follow-up evaluation versus none of the sham-treated subjects at either time point. Subjects treated with LLLT achieved a significant decrease in combined baseline thigh circumference at the 2-week study endpoint and 6-week follow-up evaluation (for each, p < 0.0001 vs. baseline) versus no change for sham-treated subjects. LLLT-treated subjects also showed significant decreases in mean baseline body weight (P < 0.0005), BMI (P < 0.001), and percent BSA affected by cellulite (P < 0.0005) versus no change for any parameter among sham-treated subjects. Most LLLT-treated subjects (62.1%) were Very Satisfied or Somewhat Satisfied with the improvement in cellulite they received versus 25.8% of sham-treated subjects. There were no reports of adverse events. Low-level laser therapy using green 532 nm diodes is safe and effective for improving the appearance of cellulite in the thighs and buttocks. In contrast with other technologies, LLLT is effective as a stand-alone procedure without requiring massage or mechanical manipulation. Future studies will assess the long-term benefits of LLLT for the treatment of cellulite. Lasers Surg. Med. 45: 141–147, 2013.
Chapter
Cellulite affects more than 80% females and is an aesthetically troublesome issue. The clinical manifestation is nodules and fibrosis in subcutaneous areas of the pelvic region, predominantly on the buttocks and thighs. The etiology is multifactorial consisting of genetic tendency, hormonal disorders, and endothelial disruption. There is no satisfactorily proven theory for the clinical presentation and the treatment modalities of cellulite. There are limited number of peer-reviewed studies outlining the effective cellulite treatment protocols. The chapter summarizes the probable pathophysiology, classification, and various treatment options that are documented in literature. Newer, emerging treatment options for cellulite are also mentioned that can lead to future successful outcomes in cellulite removal.
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Cellulite is a condition that affects the vast majority of women. Although it is of no danger to one's overall health, cellulite can be psychosocially debilitating. Consequently, much research has been devoted to understanding cellulite and its etiopathogenesis. With additional insights into the underlying causes of its clinical presentation, therapeutic modalities have been developed that offer hope to cellulite sufferers. This review examines evidence for topical treatments, noninvasive energy-based devices, and recently developed minimally invasive interventions that may finally provide a solution.
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Cellulitis is one of the most common cosmetic problems concerning millions of women all around the world, and is characterized by some changes which causes typical orange peel appearances in abdominal and pelvic areas and lower extremities. Lots of factors playing roles in cellulite progress such as gender, ethnic origin and environmental factors are as important as genetic tendency. Although, most of the treatment options used in cellulitis treatment provides a medium level recovery; these effects are mostly reversible. We can classify existing cellulitis treatment methods such as; attenuation of aggravating factors; physical, chemical and thermal methods and pharmacologic treatments. With regards to attenuation of aggravating factors; weight loss is one of the most important treatment options. Endermologie, subcision, mesotherapy, ultrasound, phototherapy, lasers, liposuction, radiofrequency and selective cryolysis are very important and effective treatment modalities in cellulitis treatment on which they have physical, chemical and thermal effects. Moreover, currently so many pharmacologic agents are in use in cellulitis treatment and the efforts to create newer and more effective treatment options are still going on day by day.
Chapter
Cellulite is a cosmetic condition frequently found on the thighs and buttocks of women. It is clinically characterized by relief alterations on the skin surface, at variable degrees. Its etiology is unknown. Initially, it was thought to be a mere increase of fat in subcutaneous tissues associated with an altered lymphatic and venous flow. In the recent years, other elements seem to be involved on its appearance, like adipocyte hypertrophy, connective tissue abnormalities, and fibrosis. Hormonal influences in collagen are being studied as a relevant cause for cellulite. A variety of treatments have been proposed to treat the cellulite condition. This chapter discusses the most important treatments for cellulite.
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Cellulite is a dermatological condition that affects 80-90% of postpubertal women across all races and makes the skin surface to resemble an orange peel or a mattress. There are several theories postulated to explain the aetiopathogenesis of cellulite, and a number of different therapeutic regimens have been developed in recent years, from topical treatments to mechanical or energy-based devices. In this article, the currently available treatment modalities are reviewed in the light of the recent literature
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Cellulite consists of relief alterations of the skin surface due to subcutaneous septae that pull the skin down and fat herniation from the subcutaneous tissue to the dermis. Given a pathogenesis that involves deep structures, cosmeceuticals can be used in patients presenting mild cellulite as well as adjuvant treatment of other therapeutic modalities that target the septae, fat and dermis. Cosmeceuticals products that alter the structure of the dermis, subcutaneous fat, circulation and lymphatic drainage are described in the treatment of cellulite, along with associated studies.
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Today, topical application of pharmacologically active chemicals and local application of physical, mechanical and thermal methods are available in order to eliminate cellulite which is an aesthetic problem that affects the majority of women. Many products on natural or synthetic originated anti-cellulite active ingredients have been developed with topical application studies performed on cellulite developed parts. Formulations developed against cellulite are usually in the form of gel, emulsion, cream, lotion or foam. In recent years the use of pharmaceutical delivery systems have become important in order to increase the penetration into the skin, to provide access to layers, to show activity, to regulate the release, to enhance the stability and to reduce the adverse effects of the active ingredients in these formulations. The use of liposomes, phytosomes, ethosomes and nanosomes which are the vesicular carriers of the carrier systems has drawn attention in both researches and existing products. Methods for measuring the performance of anti-cellulite products and efficacy evaluation for research and development of existing products are available with non-invasive device tool analysis. The use of anti-cellulite topical formulations has become widespread with cost advantages and it is expected that these formulations will develop and become diversified and spread more with both scientific and technological progress. Keywords: Cellulite, topical applications, herbal actives, pharmaceutical delivery systems, efficacy evaluation.
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Background:. Age-associated skin laxity contributes to worsening of cellulite appearance. This study evaluated the effects of microfocused ultrasound with visualization (MFU-V; Ultherapy) in combination with diluted calcium hydroxylapatite (CaHA; Radiesse) on cellulite appearance and on neocollagenesis. Methods:. Twenty women (18–55 years old) with skin laxity and moderate-to-severe cellulite on the buttocks and thighs were retrospectively enrolled. MFU-V was applied using 4 and 7 MHz transducers (25 lines/transducer/site) and immediately followed by subdermal CaHA injection (1 ml/buttock or thigh). Photographs at baseline and 90 days were assessed by 2 independent, blinded evaluators using a 5-item cellulite severity scale. One subject scheduled for thighplasty received treatment with 6 different CaHA dilutions (0.3 ml/5 cm2) followed by MFU-V. Tissue specimens from each dilution site were examined under polarized light microscopy to assess neocollagenesis. Results:. Both evaluators reported statistically significant improvements compared with baseline for each item on the cellulite severity scale (P < 0.001) with a 4.5-point improvement in mean overall score (P < 0.001) after a single MFU-V/CaHA treatment. At 90 days, histologic analysis showed peak neocollagenesis in samples treated with the 1:1 dilution, whether with CaHA alone or in combination with MFU-V. The highest conversion of collagen type III into collagen type I at month 3 occurred in samples injected with 1:1 and 1:0.6 CaHA dilutions without subsequent MFU-V treatment. Both procedures were well tolerated, and subject satisfaction was high. Conclusions:. Combination treatment with MFU-V and diluted CaHA is effective for improving skin laxity and the appearance of cellulite on the buttocks and upper thighs.
Article
Resumen Introducción La celulitis es un trastorno localizado de la grasa subcutánea muy frecuente en las mujeres. Existen múltiples tratamientos con eficacia limitada y mejoría a corto plazo. El sistema de subcisión de los septos fibrosos asistida por vacío puede obtener una apariencia y morfología más lisa y uniforme de glúteos y cara posterior de muslos. Se realiza a través de un control preciso del área y profundidad tratada. Metodología Realizamos un estudio observacional prospectivo de una serie de 10 mujeres mayores de 18 años, tratadas con este procedimiento para el abordaje de la celulitis en glúteos y cara posterior de muslos. Las variables estudiadas incluyen la escala de gravedad de celulitis, escala de satisfacción, escala de mejoría estética global y los efectos adversos a las 2 semanas y 6 meses tras realizar el tratamiento. Resultados La mayoría de las pacientes tienen una satisfacción adecuada con el tratamiento. Nueve pacientes presentan una mejoría en la puntuación de la escala de gravedad de celulitis de ≥ 1 punto y ≥ 1 grado. Los efectos adversos locales son transitorios y leve-moderados incluyendo dolor, hematoma, seroma, edema e hiperpigmentación postinflamatoria. Conclusiones Este procedimiento constituye una alternativa terapéutica efectiva y segura con mejoría en la escala de gravedad de celulitis, mejoría estética global y satisfacción general.
Article
Objective The aim of the present study was to evaluate the influence of the incorporation of caffeine as a model active ingredient on the quality attributes of a bioadhesive emulgel formulation previously optimized by Quality by Design (QbD) tools. Emulgels are emerging topical drug delivery systems for cosmetic or pharmaceutical uses, which combine the advantages of both emulsions and gels. Methods In this work, the observed and predicted values for spreadability, phase separation by centrifugation and detachment forces performed by texturometer, were compared with those of the control and active‐containing emulgel formulations. In addition, rheological properties, release of caffeine and comparative in vitro /ex vivo bioadhesion properties were evaluated using human skin. Results The flow curves of emulgel formulations showed the typical pseudoplastic and no thixotropic flow with yield stress. The incorporation of active ingredient did not produce significant changes. All emulgels were uniformly spread and no significant differences in spreadability values between control and caffeine containing formulations and neither respect to those predicted values from experimental design optimization were found. Emulgel formulations showed appropriate detachment forces values and no significant differences between caffeine loading and control emulgel formulations were observed. Conclusion Caffeine was successfully vehiculized in this optimized bioadhesive emulgel formulation, which showed high robustness regarding the process variability. There were no significant changes in the critical quality attributes after the incorporation of the active ingredient and a promising stability was observed for at least one year. Results suggested that the optimized emulgel is an interesting topical biodhesive delivery system for cosmetic applications, including agents for skin conditioning, not present in gels formulations.
Article
Cellulite is a multifactorial condition induced by topographic alteration of skin giving rise to ‘orange peel’ appearance. It is a universal aesthetic problem affecting 85% of post pubertal females. The present article provides an exclusive overview of all aspects related to cellulite, including its clinical manifestation, etiology, pathophysiology, evaluation and classification. Approaches for reducing cellulite appearance are innumerable. Conventional therapeutic strategies and modern practices such as physical, mechanical methods - including subcision and mesotherapy- and pharmacological agents, oral and topical routes, are reviewed. Novel delivery systems based on nanocarriers incorporating anti-cellulite agents developed in the past decade have been enumerated and analyzed for their efficacy in delivering drugs to target sites. Two main carrier based systems have been reviewed; lipid and polymer based carriers. Methylxanthines, specifically caffeine, has been critically evaluated due to its lipolytic effect of fat cells through inhibition of phosphodiesterase enzymes. The main challenge of this active moiety is its inability to penetrate the closely packed lipophilic stratum corneum. Its incorporation in such delivery systems have shown promising results in its bioavailability and efficacy. However, despite the utilization of nanocarriers in achieving targeted drug delivery has been demonstrated, yet its application in this indication has emerged recently and is limited. It is anticipated that this is a golden opportunistic research area to be exploited and developed.
Chapter
Although it is a niche field, skincare textiles have seen an upward trend in the last years. Some researchers affirm that in the coming years, most textile products will belong to the technical or functionalized textiles. By obtaining this kind of textiles, the passive role of textile materials has transformed into an active role by having a skincare effect and their applications exist in the medical, health care, cosmetic or pharmaceutical industries. Skincare textiles are functional fabrics impregnated with skincare ingredients that are in time‐release onto the skin. Most used active agents with skincare effects are aromas and perfumes, anti‐cellulite agents, moisturizing agents, antioxidants, UV blockers, anti‐aging agents, relaxing agents, refreshing agents, vitamins or antimicrobial agents. The active compounds can be applied directly to the textile material or by microencapsulation.
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Background: Over the past few years, noninvasive devices based on radiofrequency and/or lasers and light sources technologies are being used for the treatment of cellulite. Objectives: To evaluate the effects of an expedited treatment for cellulite and body measures. Methods: Fifteen female subjects aged from 20 to 42 years were enrolled. All the subjects underwent three treatment sessions of 30 minutes for each area in three consecutive days. Subjects were evaluated at 7, 30, and 60 post treatment. Outcome measurements included Cellulite Severity Scale (CSS) grading, body mass index (BMI), and thigh circumferences were recorded. Celluqol(®) and a satisfaction questionnaire were also applied. Results: At 2 months, improvements in at least one of the four CSS categories were found in 14 of the 15 subjects (93%) while 60% of patients showed improvement in both the number and depth of depressions at follow-up visits. Most of patients (93%) reported that they would get the treatment again. Discussion: This was the first study to examine the effects of this device on cellulite performed over a shortened treatment period. The treatment proved to be safe and effective, representing a new treatment modality that is also time and cost-effective for physicians and patients.
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Gynoid lipodystrophy (cellulite) is an extremely controversial topic. A lack of knowledge regarding specific aetiopathogenic factors, as well as the opportunism of some professionals and the media, has fuelled debate regarding the scientific basis of this condition. This article reviews the clinical, epidemiological, histopathological and therapeutic aspects of cellulite.
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The venoconstrictive action of the topical application of Ruscus extract was evaluated in a randomized, double-blind study involving 18 healthy volunteers, using duplex B-scan ultrasonography. Within 2 1/2 hours of the application of 4 to 6 g of a cream containing 64 to 96 mg Ruscus extract, the diameter of the femoral vein decreased by an average (median) of 1.25 mm, while placebo (base of the cream) was associated with a diameter increase of 0.5 mm (means) (p = 0.014). The decrease in venous diameter reflects good percutaneous absorption of the active substance. To date, venoconstrictive action has been demonstrable only indirectly with the aid of plethysmographic methods; it has now been measured directly under orthostatic conditions.
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Cellulite is a physiological condition that presents etiologic plurality. Caffeine and its derivatives are used in anticellulite cosmetics due to their lipolytic activity on fatty cells. Siloxanetriol alginate caffeine (SAC) is a silanol derived from organic silicon. Radicals primarily from SAC are caffeine and the mannuronic acid. This study aims to analyze the effects of caffeine and siloxanetriol alginate caffeine on fatty tissue by histological evaluation. Formulations were developed with caffeine, caffeine + sodium benzoate or SAC and were applied topically for 21 days on Wistar female mice. The study regarded the histological aspects by determination of diameter and number of fatty cells with a light microscope. Emulsion with caffeine caused a reduction of 17% on the diameter of the fatty cells compared with the control. The emulsion with caffeine + sodium benzoate did not cause alterations on cell diameter. Emulsion with SAC provoked reduction on fatty cell diameters of 16%. No significant alterations were observed on the diameter of the fatty cells treated with gels, although it was noticed that gel with SAC promoted a reduction of 26% on the number of fatty cells. Emulsion with SAC was considered more indicated to promote the lipolytic action on fatty tissue, acting as a complement to treat cellulite. When sodium benzoate was added to the preparations, it inhibited the caffeine efficiency. Gel was not an adequate vehicle to be incorporated with caffeine and SAC.
Article
Cellulite is a multifactorial condition that is present in 80% to 90% of postpubertal women and is one of the most intolerable esthetic imperfections. There are several theories on the pathophysiology of cellulite, and a number of different therapeutic regimens have been developed, from topical treatments to mechanical or energy-based devices. In this brief review, we summarize the scientific landscape to determine the clinical evidence with regard to the safety and efficacy of cellulite treatment options. Clinical protocols and the author’s experience using a combination of internal and external procedures are also discussed. Studies using laser and light modalities along with radiofrequency have shown improvements in cellulite and a good safety profile, but acoustic wave therapy, subcision, and the 1440-nm Nd:YAG minimally invasive laser have demonstrated the most beneficial results in cellulite reduction. Although there is paucity of scientific evidence for treatments that improve cellulite, future emerging options and their combination may pave the way to eradicate this primarily cosmetic esthetic concern. Keywords: Cellulite, pathophysiology, adipocytes, radiofrequency, lasers
Article
A group of 20 women with moderate cellulite of the thighs were treated twice daily on one side for 6 months with a 0.3% stabilized retinol cream while the opposite side was treated with the vehicle, following a double-blind format. Objective measurements included ultrasound measurement of thickness using a 20 MHz B-scan, and laser Doppler velocimetry for blood flow. The panelists and a dermatologist estimated the degree of improvement on a global scale. Of 19 subjects, 13 rated the retinol side as more improved, 7 registering good effects. The dermatologist's estimates were largely congruent with those of the subjects. There was also a marked reduction in the density of hypoechogenic areas on the retinol sides, from 53% to 18% of black pixels on image analysis. Blood flow measurements were unchanged on the vehicle sides but increased significantly on the retinol sides. Thickness measurements by ultrasound scan were unchanged on the vehicle sides but increased significantly on the retinol sides, from 1.44 to 1.60 mm. Retinol may be viewed as a prodrug which the skin metabolizes to retinoic acid. The beneficial effects of retinol are consistent with previous reports of increased synthesis of glycosaminoglycans and collagen.
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Triterpene and steroid saponins and sapogenins of medicinal plants (Aesculus hippocastanum L., Hedera helix L., Ruscus aculeatus L.) are claimed to be effective for the treatment/prevention of venous insufficiency. In this work we evaluated the inhibitory effects of these plant constituents on the activity of elastase and hyaluronidase, the enzyme systems involved in the turnover of the main components of the perivascular amorphous substance. The results evidence that for Hedera helix L., the sapogenins only non-competitively inhibit hyaluronidase activity in a dose-dependent fashion, showing comparable IC50 values (hederagenin IC50 = 280.4 μM; oleanolic acid IC50 = 300.2 μM); both the saponins hederacoside C and α-hederin are very weak inhibitors. The same behaviour is observed for serine protease porcine pancreatic elastase: the glycosides are devoid of inhibitory action, while genins are potent competitive inhibitors (oleanolic acid IC50 = 5.1 μM; hederagenin IC50 = 40.6 μM). Constituents from Aesculus hippocastanum L. show inhibitory effects only on hyaluronidase, and this activity is mainly linked to the saponin escin (IC50 = 149.9 μM), less to its genin escinol (IC50 = 1.65 μM). By contrast, ruscogenins from Ruscus aculeatus L., ineffective on hyaluronidase activity, exhibit remarkable anti-elastase activity (IC50 = 119.9 μM; competitive inhibition). The mechanism of elastase inhibition by triterpene and steroid aglycones, with a nitroanilide derivative as substrate, is discussed.
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Tanned skin has long been viewed as attractive in today's culture. With more recent developments in the benefits of vitamin D as well as because of strong marketing by the indoor tanning industry, more individuals have been tanning indoors and outside. Many people don't realize that the ultraviolet light they seek to tan their skin and boost their vitamin D levels is the same radiation that causes aging of the skin and skin cancers.
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Treatments for localized adiposities range from topical creams to liposuction. Most treatments lack a substantial proof of efficacy. The unpredictable treatment outcome can be related to the fact that cellulite adipose tissue is physiologically and biochemically different from subcutaneous tissue found elsewhere in the body. Part II of this two-part series on cellulite reviews the various treatment options that are currently available for human adipose tissue including, but not limited to, cellulite. It also focuses on newer techniques that can be potentially useful in the future for the treatment of cellulite.
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Cellulite is a topographic skin change that is nearly ubiquitous in postpubertal women. Treatment remains elusive. The various treatments currently available are only partially or temporarily effective. Newer therapeutic modalities continue to evolve without much understanding of the complex nature of cellulite. The successful treatment of cellulite will ultimately depend upon our understanding of the pathophysiology of cellulite adipose tissue. Part I of this two-part series on cellulite reviews how the concept and perception of cellulite has evolved over time and its proposed etiologies. The article also focuses on the physiology of human adipose tissue, particularly regarding cellulite.
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The term cosmeceutical was created over 25 years ago to define products with active substances that cannot be considered cosmetics or drugs. Cosmeceuticals are increasingly popular, with sales representing one of the largest growing segments of the skin care market. These products are found in many forms, including vitamins, peptides, growth factors, and botanical extracts. Cosmeceuticals that contain topically applied vitamins have an increasing role in skin care.
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Cellulite is characterized by alterations in the relief of the skin surface. Magnetic resonance imaging (MRI) is recognized as a reliable technique for measuring adipose volume according to body site and for the visualization of the subcutaneous structures. To compare subcutaneous tissue in areas with and without cellulite on the buttocks of same subjects using a noninvasive technique. Thirty female patients with cellulite on the buttocks underwent MRI. An area with cellulite and another without cellulite on the contralateral buttock were selected. Two soft gelatin capsules of different sizes were used as skin markers to differentiate the areas with and without cellulite. Fibrous septa were visualized in 96.7% of the area with cellulite depressions; most of them were ramified (73.3%) and presented a high-intensity signal on T2 images (70%). All fibrous septa found in the examined areas were perpendicular to the skin surface. The average fibrous septa thickness was 2.18 +/- 0.89 in the area with cellulite and 0.27 +/- 0.64 in the area without cellulite. Results of the MRI analysis showed that cellulite depressions on the buttocks were significantly associated with the presence of underlying fibrous septa.
Article
The venoconstrictive action of the topical application of Ruscus extract was evaluated in a randomized, double-blind study involving 18 healthy volunteers, using duplex B-scan ultrasonography. Within 2 1/2 hours of the application of 4 to 6 g of a cream containing 64 to 96 mg Ruscus extract, the diameter of the femoral vein decreased by an average (median) of 1.25 mm, while placebo (base of the cream) was associated with a diameter increase of 0.5 mm (means) (p = 0.014). The decrease in venous diameter reflects good percutaneous absorption of the active substance. To date, venoconstrictive action has been demonstrable only indirectly with the aid of plethysmographic methods; it has now been measured directly under orthostatic conditions.
In canine cutaneous veins cooling augments and warming depresses the responses to sympathetic nerve stimulation. In these veins the extract of Ruscus aculeatus (Ruscus) causes contractions due to alpha-adrenergic activation. To determine the effects of temperature on the response to Ruscus, rings of canine saphenous veins were studied at 24 degrees, 37 degrees and 41 degrees C. At 37 degrees C, Ruscus caused an increase in isometric tension which was depressed by prazosin and rauwolscine. Cooling inhibited the response to Ruscus, while warming augmented it. Rauwolscine potentiated, and prazosin reversed the effect of cooling on contractions evoked by Ruscus. Prazosin reduced, and rauwolscine augmented the effect of warming. These experiments demonstrate that temperature affects the venoconstriction induced by Ruscus in an opposite fashion as that to sympathetic nerve activation, presumably because the alpha 1-adrenergic component of the response to Ruscus predominates.
Article
Acute drug therapy is the mainstay of treatment for migraine sufferers, with prophylaxis reserved for those with frequent or severe attacks. The majority of treatments have been in use for many years, although their value is often poorly documented due to a lack of well-controlled trials undertaken with defined diagnostic criteria and study end-points. Analgesics with anti-emetics, nonsteroidal anti-inflammatory drugs and ergot derivatives are used for acute treatment. Recently, the selective 5-HT1 receptor agonist sumatriptan has become available and been shown to have significant benefits over traditional therapies for the acute treatment of migraine. Beta-blockers, flunarizine and 5-HT2 antagonists have been used for prophylaxis, and although many patients report a reduction in attack frequency, breakthrough attacks still occur.
Article
Author's Note: This article represents a combination of knowledge from the skin care industry (Dr. Marenus) and the dermatologic community (Dr. Draelos). The first of the two-part article discusses current understanding of the etiology of cellulite while the second part presents purported treatments. Cellulite is a condition affecting 85% of postadolescent women characterized by dimpled tissue on the upper outer thighs, posterior upper thighs, and lower buttocks. A better understanding of the etiology of cellulite has been obtained through ultrasonic analysis of the upper thigh and buttock tissue demonstrating herniation of the subcutaneous fat into the dermis. The initial changes leading to cellulite formation appear to be deterioration of the dermal matrix and vasculature, particularly loss of the capillary networks, leading to excess fluid retention within the dermal and subcutaneous tissues. This loss of the capillary network is thought to be due to engorged fat cells clumping together and inhibiting venous return. A variety of treatments, to include xanthines, herbal derivatives, heating, massage, and skin kneading, have been put forth as possibly reducing the dimpled skin appearance.
Article
Permeation of caffeine through human skin and artificial membranes (mounted in modified Franz type diffusion cells) was evaluated, either from saturated solutions or from commercially available topical formulations (all containing 3% caffeine). Data interpretation of the caffeine diffusion through human skin does not implicate transfer through pores despite caffeine being a relatively polar molecule. No correlation was found between transfer though the synthetic membranes (cellulose acetate impregnated with isopropyl myristate and silicone rubber soaked in isopropyl myristate) and that observed through skin. The synthetic membranes can be used for assessing product performance in quality assurance but will give little indication of its performance in vivo. The study investigated the percutaneous permeation of caffeine through human skin in order to obtain a mechanistic interpretation of its route of permeation. Synthetic membranes were also examined to determine if they could be used as models for human skin. Different commercial formulations investigated to determine the significance of enhancement strategies.
Article
Excessive subcutaneous adipose tissue is typically treated by physically removing the fat through liposuction, but cost and accessibility have popularized alternative treatments for reducing adipose tissue thickness. The purpose of this study was to test the absolute and relative effectiveness of a liposome-encapsulated caffeine-based cream in modifying subcutaneous adipose tissue. Forty-one patients consented and completed the double-blind, single-center, placebo-controlled study. Caliper measurements, tape measurements, and photographs were taken over a 2-month period. Both concentrations of the cream were found to significantly reduce the thickness of the adipose tissue in all areas of the body. In addition, the more concentrated cream was significantly more effective than the less concentrated cream in the areas of the hips and the triceps. The caffeine-based liposome-encapsulated cream significantly reduced the thickness of the subcutaneous fat over a 2-month period.
Article
This report describes rapid analytical HPLC for the quantification of five UV filters (octyl methoxycinnamate, benzophenone-3, benzophenone-4, octyl triazone and octocrylene) and of caffeine in various skin layers (stratum corneum, dermis, epidermis and receptor fluid) and in cosmetic preparations. The predominant purpose of the study was to establish standard operating procedures for rapid analysis of the compounds in various skin samples. Particular attention was paid to the preparation of biological samples whose natural constitution could interfere with the quantitative analysis. Our methods used the isocratic chromatographic mode in an RP-HPLC with UV detection and did not involve centrifugation or evaporation. Our results were validated in terms of specificity, linearity, precision, accuracy and limits of detection and quantification. The first results, obtained after in vitro experiments, are presented in this report.
Article
Cellulite is a common phenomenon that particularly affects the thighs and buttocks of women. Little scientific evidence exists to support any of the many advertised treatments for it. A total of 52 of 69 women, who were divided into three groups, completed a 12-week, randomized, controlled trial in which the effectiveness of two different treatments for cellulite was assessed. The patients acted as their own controls. The treatments investigated were twice-daily application of aminophylline cream and twice-weekly treatment with Endermologie ES1. Group 1 (double blind) received aminophylline to one thigh/buttock and a placebo cream to the other. Group 2 (singly blind) received Endermologie to one thigh/buttock. Group 3 received Endermologie to both sides and used the same cream regimen as group 1. Results were assessed subjectively by the patient and by clinical examination and photographic assessment by the surgeon (before and after the trial). Morphologic assessment included body mass index, thigh girth at two points, and thigh fat depth measurement by ultrasound. No statistical difference existed in measurements between legs for any of the treatment groups (paired t test, p > 0.4). The best subjective assessment, by the patients themselves, revealed that only 3 of 35 aminophylline-treated legs and 10 of 35 Endermologie-treated legs had their cellulite appearance improved. The authors do not believe that either of these two treatments is effective in improving the appearance of cellulite.
Article
There are glaring discrepancies in the microanatomical descriptions of cellulite in the literature. We revisited this common skin condition in women with a microscopic examination of 39 autopsy specimens. A control group consisted of 4 women and 11 men showing no evidence of cellulite. The lumpy aspect of the dermohypodermal interface appeared to represent a gender-linked characteristic of the thighs and buttocks without being a specific sign of cellulite. Incipient cellulite identified by the mattress phenomenon was related to the presence of focally enlarged fibrosclerotic strands partitioning the subcutis. Such strands possibly serve as a physiologic buttress against fat herniation limiting the outpouching of fat lobules on pinching the skin. These structures might represent a reactive process to sustained hypodermal pressure caused by fat accumulation. Full-blown cellulite likely represents subjugation of the hypertrophic response when connective tissue is overcome by progressive fat accumulation. Histologic aspects reminiscent of stretch marks are identified within the hypodermal strands, resulting in clinical skin dimpling.
Article
There is virtually no knowledge of the ingredients of cellulite creams in the dermatological literature. In the present study, the ingredients of cellulite creams, the frequency of their use and whether the ingredients have been reported to cause allergy were investigated. In the 32 products tested, 263 ingredients were used. On average each product contained 22 ingredients (range 4 to 31). Botanicals and emollients predominated; altogether 44 different botanicals and 39 different emollients were used in the 32 products. Caffeine, present in 14 products was the most common additive, apparently representing an "active" ingredient. In other respects the compositions of the products were similar to those of skin creams. All products contained fragrance. The creams were microbiologically pure. Concentrations of preservatives did not exceed limit values in the regulations. No formaldehyde was present (detection limit 10 ppm). The well-known allergens isothiazolinones or dibromoglutaronitril were declared only in a few products. In spite of the large number of substances used in cellulite creams, their safety seems acceptable for most users. Because, however, one fourth of the substances used have been shown to cause allergy, the risk of adverse effects should be taken into account when using cellulite creams.
Article
A double-blind, randomized, placebo-controlled study was conducted with 46 healthy female volunteers in order to test an anti-cellulite product containing retinol, caffeine and ruscogenine. An evaluation of different parameters related to cellulite appearance, i.e., the skin macrorelief, the dermal and hypodermal structures, the skin mechanical characteristics, and the cutaneous flowmetry was assessed using several non-invasive methods. This combination of different evaluation methods resulted in the demonstration of significant activity of the anti-cellulite product versus baseline and showed its superiority versus the placebo in skin macrorelief (decrease of the "orange peel" effect) and an increase in cutaneous microcirculation. By using a combination of methods, it was possible to detail the activity of an anti-cellulite product and to show superiority of the product in comparison with the placebo.
Article
Little is still known concerning subcutaneous adipose tissue and cellulite, and controversial questions are still under discussion. Magnetic resonance imaging and spectroscopy were used to address two unresolved questions relating to the anatomy and physiology of subcutaneous adipose tissue. Using high spatial resolution magnetic resonance imaging we characterized the topography of the dermo- hypodermal junction, and the three-dimensional architecture of the subcutaneous fibrous septae. Using proton spectroscopy, we measured water and lipid fractions within a fat lobule, and T1 and T2 values of the detected compounds. All these data were analysed according to sex and presence of cellulite. MR imaging quantified deeper indentations of adipose tissue into the dermis, and evidenced for the first time a great increase in the thickness of the inner fat layer in women with cellulite. Moreover, 3D reconstruction of the fibrous septae network showed a higher percentage of septae in a direction perpendicular to the skin surface in women with cellulite; but our study also depicted the tortuous aspect of this network. MR proton spectroscopy could not show any differences related to sex or presence of cellulite concerning T1 and T2 relaxation times of the detected compounds within a fat lobule, neither the unsaturated lipid fraction, the saturated lipid fraction, nor the water fraction. Magnetic resonance imaging showed that the 3D architecture of fibrous septae couldn't be modelled simply as perpendicular planes for women and tilted planes at 45 degrees for men. MR spectroscopy did not confirm the hypothesis of increased water content in the adipose tissue of women with cellulite as suggested by others, except if such water would be located in the connective septae.
Article
Cellulite is defined as skin relief alterations that give the skin an orange peel or mattress appearance. The lesions tend to be asymptomatic and may be considered the anatomic expressions of the structures in the affected area, such as the fat and subcutaneous septa. The present article reviews the most important botanical extracts used as active ingredients in the treatment of cellulite, as well as the steps to obtain these botanicals as raw material and their standardization and quality control, which are important to guarantee their therapeutic action. The current literature was reviewed, and we also obtained information from the manufacturers of the products that contained botanicals because of the few publications about this subject. The reduction in fat deposits through the continuous use of anticellulite products depends on the availability of the active ingredient at the action site, the concentration of the ingredient in the formulation, and the physiochemical characteristics particular to each active ingredient. The botanicals used in topical products must have standardized extracts, which would permit each phytomedicine to have the same effect anywhere in the world. New scientific research is necessary to verify the efficacy and ideal concentrations of such substances.
Article
The aim of this study was to investigate the mechanism(s) underlying the antiadipogenic effect of retinol that we recently reported in primary cultured human preadipocytes. Exposure of human preadipocytes to the potent alcohol dehydrogenase inhibitor, 4-methyl-pyrazole, failed to alter the antiadipogenic effect of retinol (3.5 microm), suggesting that the latter effect is due to retinol per se rather than to its oxidation product, retinoic acid (RA). Moreover, retinol, in contrast to what is generally observed with RA, did not alter the expression of the major adipogenic transcriptional factors PPARgamma and C/EBPalpha but, like RA, reduced transcription of an adipospecific gene controlled in part by C/EBP, the ob gene. These results indicate that retinol per se inhibits the adipo-conversion of human preadipocytes and suggest that the mechanisms of this antiadipogenic action implies at least in part inhibition of C/EBP transcriptional activity.
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Treatment of cellulite: Part I. Patho-phisiology
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Anti-inflammatory and spasmolytic botanical drugs
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Cellulite: From standing fat herniation to hypodermal stretch marks
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