As beach weather approaches, one concern tends to resurface with it: cellulite. Dimples on the buttocks and back of the thighs affect nearly 90 percent of women, yet treating them can be frustratingly elusive. Although complete elimination is not realistic, smoother looking skin is possible.
To understand why, it helps to know what cellulite actually is — and what it isn’t. “Cellulite is a multifactorial, inherited, and progressive condition that involves the fat packing units changing to be tighter and less elastic,” explains Omaha, NE dermatologist Joel Schlessinger, MD. These compartments of fat are pulled down by fibrous connective bands while the surrounding fat is pushed up, creating a dimpled surface.
Miami dermatologist Dr. Deborah Longwill adds that it’s rarely just one issue. “It’s not just about fat; it involves fibrous connective tissue, skin laxity and even circulation. That’s why a one-size-fits-all approach doesn’t work.”
From topical creams that offer subtle improvement to in-office procedures that release the fibrous bands responsible for breakouts, here’s what experts say are worth trying.
Featured Experts
- Joel Schlessinger, MD is a board-certified dermatologist in Omaha, NE
- Dr. Deborah Longwill is a board-certified dermatologist in Miami
- Daniel Schlessinger, MD is a board-certified dermatologist in Omaha, NE
- David Goldberg, MD is a board-certified dermatologist in New York
- Charles Galanis, MD is a board-certified plastic surgeon in Beverly Hills, CA
Topical support for skin quality
Creams do not cut fibrous bands, but can improve the quality and thickness of the skin over time. “I always tell my patients to look at topicals as supportive, not stand-alone solutions,” says Dr. Longwill. “Caffeine can temporarily tighten and tighten by reducing water retention. Retinol and peptides help stimulate collagen over time, which can improve skin thickness and smoothness.”
“There are some topical ingredients that provide marginal improvements in cellulite with consistent use,” says Dr. Joel Schlessinger. Recommends combination formulas over individual ingredients and highlights Jan Marini CelluliTx ($140), which includes caffeine, aminophylline, l-carnitine, theophylline, peptides, glucine and retinol.
Omaha, MD dermatologist Daniel Schlessinger, MD often recommends retinol-based body products for the same reason. “THE Replenix Retinol Smooth + Tighten Body Lotion ($94) uses medical-grade all-trans-retinol and edelweiss flower to support healthy collagen production, reducing the appearance of cellulite over time. Another ingredient that shows improvement in the appearance of cellulite is Augustinus Bader’s TFC8, or activator complex, found in The Body Cream ($200)’.
Muscle building and contour support
Building muscle won’t eliminate cellulite, but it can improve overall contour. “I’ve seen triathletes with cellulite, so I don’t think that has any serious effect on the outcome,” says Dr. Joel Schlessinger, adding that even very healthy patients are not immune. However, stronger muscles can provide a firmer base under the skin.
“Strengthening the underlying muscle can create a smoother base for the skin,” says Dr. Longwill. “I often recommend a combination of traditional strength training and treatments like CoolTone, which target and tone muscles in specific areas.”
Collagen stimulation treatments
When skin thinning or sagging increases dimples, collagen stimulation becomes the focus. “I’ve seen great results using a combination of Sofwave for collagen stimulation and RF microacupuncture,” says Dr. Longwill. “The combination of the two can be very effective in improving texture and firming the skin, especially in stubborn areas like the thighs or buttocks.” These treatments heat the dermis to stimulate collagen rebuilding, gradually thickening and tightening the skin.
Realistic expectations matter. “All of these procedures work to some degree,” says Dr. Joel Schlessinger, “but most patients are looking for a ‘Botox-like’ effect on wrinkles that translates into cellulite, and that’s just not even close to what these products can deliver.” They improve texture but do not release fibrous bands.
The carbon wave patch
For patients who want something non-invasive but more targeted, the Carbon Wave Patch emerges as a middle ground. The treatment combines a carbon-infused patch with a Q-switched Nd:YAG laser and takes about 10 minutes with minimal discomfort.
New York dermatologist David Goldberg, MD studied the technology. “You put it on the skin, you treat with a Q-switched Nd:YAG laser, and the laser activation of the carbon disconnects the bands,” he explains. “Clinically, the dimples are improved. You have some tightening of the skin. In the biopsies, you see changes in the fiber connections.”
The results aren’t permanent, he says, but the improvement is visible because the treatment directly targets the diaphragms, without incisions.
Avéli group circulation
When dimples are deeper and clearly bound, immediate band release remains one of the most definitive options. “Avéli addresses the dimpling of cellulite and the thickening of the collagen bands—diaphragms—that create a mesh and pull down the skin by anchoring certain points and allowing tissue to push up around that mesh,” explains Beverly Hills, CA plastic surgeon Charles Galanis, MD. “By cutting these bands, you release the tightened collagen and allow the tissue to wash away, eliminating irregularities in appearance through the surface of the skin.”
Avéli is best suited for patients with distinct, well-defined dimples rather than generalized laxity. Recovery usually involves compression and swelling for about a week, with continued improvement over the next month. Unlike clamping devices, it fixes the connection at the source.
The bottom line
The biggest misconception about cellulite is that it can be cured. “We have options for modest, at best, improvement, but treatments are out of our scope right now,” says Dr. Daniel Schlessinger. Smoother is realistic. It has not been deleted. The key is to choose the right level of intervention for what you’re actually seeing — and build from there.
