Definition of Cellulite: Edematuous-Fibrosclerotic panniculopathy (P.E.F.S.) or Liposclerosis

Cellulite is not only an unsightly condition that affects nearly all women, but rather a disfunction, referred to in medical jargon as edematous fibrosclerotic panniculopathy. The term cellulite, in fact, is absolutely improper because there is no inflammation process of the cell but a chronic-degenerative disfunction of the connective tissue.

We can define P.E.F.S. as a localized lipodystrophy (a clinical manifestation characterized by an abnormal or degenerative condition of the adipose tissue) of the subcutaneous connective tissue, with water retention, generated by the alteration of the metabolism of the fundamental substance.

"Cellulite", therefore, forms in the dermis. As a matter of fact, dermis is the location of elastin fibers (about 2%) of collagen (about 70%), of the fundamental (or amorphous) substance that is constituted by water, mucopolysacharides (which retain water), acids (ex: hyaluranic acid), lipids, proteins and organic salts. The nourishment and well-being of the connective cells depend on a complex exchange of liquids and substances, carried out by the circulatory systems formed by arteries, veins, capillaries, lymphatic vessels.

Every group of these cells is touched by a network of small capillaries that constitute a fundamental and precious network bringing oxygen and nourishment to the cells and cleaning them from the waists that will be discharged into the venous and lymphatic system. The interstitial and extra cellular fluid circulates in the interstices of the tissues and in the spaces between one cell and the other. The lymph is the part of its residue that is not reabsorbed by the venous circulation.

 Cellulite begins with the slowing of the interstitial fluid of drainage, which involves, as a side effect, a congestion that can be temporary or permanent. The entrance of these liquids in the venous capillaries wil be reduced, while the permeability of the arterial capillaries wil increase with a consequent slowdown of the circulation. Cellulite therefore is tied to an anomalous equilibrium between venous and lymphatic circulation, which may cause both to slow down to a modest degree, resulting in a series of alterations starting from water retention.

This first phenomenon is often neglected and thus tends to degenerate until becoming an inflammatory alteration of adipose connective tissue (panniculus adiposus) present in subcutaneous cell tissue (hypodermis) and made up of fat lobules (adipocytes), separated from one another by a dense lattice of precollagen and elastin fibres. 

The connective tissue between adipose cells is supplied by a rich lymphatic and capillary network, which had the task of favoring the exchange of nutrients between blood and tissues.

When this exchange is slowed, cellular hypertrophy occurs and fluids and metabolic toxins accumulate in the spaces between cell: when the vessel network is altered for any reason, there is first an accumulation of fluids in the interstitual space (edema).

Edema prevents proper local circulation, causing an increase in the number of connective cells and a consequent hardening of the tissue (sclerosis). In a second phase, the inner part of the skin, the "dermis", which connects the outer epidermis with the hypodermis and is rich in nerve structure, collagen and elastic fibres, can also be affected.

If not treated, cellulite degenerates into nodular  formations that are visible on the skin surface and other hard and painful to the touch. Cellulite is often associated with fat or adiposity: a wholly mistaken concept. In fact these are two absolutely distinct phenomena, though in some cases they may manifest themselves simultaneously.

Article by Sabrina Valvassori from Professional Guide To Recognising and Treating Cellulite

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