出典: Nojiyan

Therefore, since we know half the world are talking about cellulite, what exactly is it, what causes it, how can you grade it and is there any treatment available for the condition. For a start, many may be surprised to understand that the term cellulite is not actually a medical term and there's some dispute about the etiology of the condition. Some people claim that French and Italian doctors used the term cellulitis over one century ago to explain a condition of fats located under women's skin, which give a dimpled or peau d'orange appearance. The problem was extremely common and most physicians from the period considered so that it is normal and were more interested in the fact that Felix Hoffman had just invented Aspirin. The decades passed, the world went to war twice and conventional medicine was not interested in treating an ailment, which did not reflect an underlying illness.

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Even just in the early seventies, when Martin Luther King cleared his throat and addressed one fourth of a million people by the Lincoln Memorial, the problem was still largely unheard of. However, all that was about to alter in 1973, when Ny beauty salon owner Nicole Ronsard wrote her book 'Cellulite, Those Lumps, Bumps and Bulges you could not lose before'. For the reason that year, fat must have began to bug the conscience of coastal America since the New York Times best seller non-fiction list best seller for your month was Dr. Atkins' Diet Revolution.

For the reason that year, Ireland joined the most popular Market and the comely maidens at the crossroads danced to Driving while impaired, but in America the game was up....the problem cellulite was now outside and the world would not be the same again! Even worse, as more and more women learned that they too had these lumpy deposits all over their bodies, many charlatan doctors and fly by night companies started offering all kinds of dubious cures and preyed them upon their insecurities. One Italian chemist called Gianfranco Merizzi invented a brand new tablet that contained ginko, soya, fish oil, evening primrose oil, bioflavins, and many of the other normal suspects having a promise it would cure the dreaded condition. The CEO from the company, Rexall even continued CNBC in March 1999 claiming 90% rate of success for their product. Obviously, they could not provide any scientific evidence to validate their results when challenged.

Another company, Relax-Cizor, then appeared on the market with a type of new cellulite machine, using iontophoresis paddles and Faraday current to get rid of the offending dimples. It wasn't long before they ran foul from the FDA who charged them with fraudulent advertising. They forgot to say that the machine also was accountable for inducing hernias, creating abnormal cardiac rhythms, and inducing miscarriages. The device was apparently repackaged and later sold in Europe where laws are considered not as stringent. It never ceases to amaze me how these companies can flourish about this side from the big pond and no-one seems to question them whenever they use 18th century terminology like Faraday current or iontophoresis to describe a simple thing like electromagnetism or electricity. Imagine selling the latest pc to someone using Pascal or Babbage terminology. It is fair to state most people would immediately recognise the spoof!

However, it was not the case with cellulite because nobody had bothered to scientifically evaluate just what the problem was. Accept is as true nor not, it took until 1996, for Dr. Neil Solomon in the Johns Hopkins University to look more closely in the phenomena of cellulite. Inside a paper of this period, this doctor concluded that under the microscope cellulite looked no different from ordinary fat. In 1998, some researchers at the Rockefeller Institute examined the situation more closely plus they concluded that there was no significant difference between the appearance or purpose of fatty tissue or even the regional blood flow between individuals who had cellulite and people who did not. Additionally they stated there was some characteristic within female skin that built them into more prone to developing the condition.

Meanwhile, as the new wonder pill Viagra hit the planet market, the sale of miracle creams containing caffeine, green tea extract, theophylline and theobromine from cocoa continued and something company even produced a tablet that promised to consider away cellulite as the patient slept. Things went from the sublime towards the surreal as another company promised to remove the cellulitic condition by wrapping their customers in a kind of snap wrap that caused water loss by perspiration and compression from the swollen tissues. The product was marketed through television and it caused the U.S. Federal Food and Drug Administration (FDA) and the Ftc (FTC) to consider notice and produce regulations and guidelines for the advertising of cellulitic products. The quickly realised that they needed to be more scientific within their approach plus they quickly produced literature stating that caffeine used topically could actually reduce fat content in cells by blocking an enzyme that inhibits fat breakdown. As the pace quickened, others claimed that an alkaloid in cocoa called theobromine could penetrate towards the subcutaneous fat layer and help stimulate the release of stored fat. Into this new age of scientific enlightenment came other prophets who claimed that horse chestnut contained a chemical called aescin, which could reinforce the strength of veins, support circulation and prevent swelling. Regardless of the rash of scientific opportunism, there is little on the market that could really reduce the cellulitic condition. It did not take a genius to realise that it would require more than tablets to get rid of those stubborn fibrous bands of tissue.

During this time period, another technology entered the market. It had started its earlier life in France as a deep tissue massage for horses until a company called LPG systems chose to try its effect on cellulite. The company called the procedure, Endermologie(r) and claimed it could increase circulation by 200%, by expelling toxins and water develop while the underlying connective fibres were stretched. The product was again heavily marketed in gossip columns and on the TC networks. Despite many numerous studies, the clinical proof of the procedural effect remains ambiguous. One study performed in 1998, showed a mean index reduction in body circumference of between 1.34 and 1.83cms. It had been the same year that President Bill Clinton risked impeachment over his affair with Monica Lewinsky. Despite this evidence, another clinically controlled trial by Collins yet others, Cellulite Treatment, A Myth Or Reality. A controlled trial of two therapies Endomologie and Aminophylline cream' was published in Plastic and Reconstructive Surgery 104:1110-1114, 1999. This research found no objective difference in the thigh girth or thigh fat depth of 52 ladies who were measured by ultrasound. It further showed that only 3 of 35 patients with aminophylline-treated legs and 10 of 35 patients with Endermologie-treated legs actually felt their cellulite appearance had actually improved. The authors figured neither of these two treatments was good at improving the appearance of cellulite. Despite these findings, the Endomologie (r) procedure remains widely marketed and the process has became popular in some quarters. My very own impression in the experience of many colleagues would be that the procedure typically takes 10 to 20 treatments to see any results and the patient has to do a couple of maintenance treatments per month to maintain any beneficial effect.

Therefore, where does that leave us concerning the scientific evaluation of cellulite? There is no doubt; most doctors now agree that cellulite is more often seen in women due to hormonal reasons. The scientific rationale behind it has not been fully evaluated and a cynic would state that this conclusion isn't particularly hard to make. We know that cellulitic fat is arranged in large chambers of macromolecules that are separated by columns of collagen fibres. It doesn't take a University qualification to figure out that whenever extra fat is stuffed in to these fibrotic compartments, it will cause them to bulge out, giving the surface dimply appearance of cellulite. Scientists also know that the 'dimpling' is created worse due to underlying bloating and fibrosis caused by impaired circulation and destruction from the tissues in this area. This is the main reason that many treatments can give a temporary solution to the problem. The effect is only temporary because essentially, cellulite is localised fat 'caught in a jail' of surrounding scar tissue and these fibrotic walls must be broken down before we can see a more long-term solution to the problem.

Recently, there has been two substantial alterations in the continuing war against those offending dimples. In 2003, the Lipodissolve (r) procedure was introduced to the Irish market. During this procedure, phosphotidyl choline is injected directly into subcutaneous fat in an effort to dissolve it. It is not surprising that this method could be evaluated in order to see its impact on cellulite. In 2004, Network Lipolysis invited me being European Group Leader for that evaluation of this pharmaceutical within the treatment of cellulite. The injections are quite painful as well as in my experience not necessarily successful for the resilient condition. It takes multiple treatments to determine any decrease in size and also the dimpling effect often remains. We've treated nearly 500 patients with this particular compound in differing areas to date and our results will quickly undergo scientific evaluation included in a European trial.

This year, a new medical device arrived, which offers to be the most fascinating development to date in the battle against cellulite. The product is called the VelaSmooth (r) and also the machine has already undergone rigorous medical testing in the usa. The products functions by using a mixture of bipolar Radio Frequency, Infrared light, and suction in an effort to safely and effectively re-contour the skin surface. In numerous studies in both Israel and the United States, it looks the most effective treatment open to date. The unit apparently works by allowing radiofrequency to heat fat tissue to some depth of 10mm and also the makers claim this process increases oxygen intracellular diffusion. The infrared light area of the product heats subcutaneous fat to a degree of 3mm and increases skin elasticity.

The suction device is similar to Endomologie (r), for the reason that it can manipulate and lessen the skin. The process requires two treatments a week for 5 to 6 weeks and the effects last about six months before requiring a top up treatment. The total cost is about e750 for that complete package. Our clinic was selected to trial the brand new technology for the European market and that we shall start evaluating our results in a few months.

Where does that leave us? I feel it will take a combination of the above treatments to eventually solve the problem of cellulite. Such as the old spaghetti westerns, we will need technology like Velasmooth (r) to collapse the walls of the jail and a compound like Phosphotidyl Choline to dissolve the baddies contained within. The trials surrounding this combination therapy have previously begun in Canada and Italy and gradually patients are realizing medicine and doctors finally becoming interesting in dealing with this tenacious condition.