What is cellulitis and how do you get it. Comprehensive Guide to Cellulitis: Causes, Symptoms, and Prevention

09.11.197403.10.2021 by alexxlab

What is cellulitis? How do you get it? Is cellulitis contagious? Explore the causes, symptoms, and prevention strategies for this bacterial skin infection.

Содержание

Understanding Cellulitis

Cellulitis is a deep-seated bacterial infection that affects the skin and the underlying tissues. It is a common condition that can occur in various parts of the body, including the arms, legs, face, and abdomen. Cellulitis is often caused by the entry of bacteria, such as Streptococcus or Staphylococcus, through a break in the skin, which can happen due to a variety of reasons.

Causes of Cellulitis

Cellulitis can develop due to several factors that provide an entry point for bacteria to enter the skin. Some of the common causes of cellulitis include:

Skin injuries, such as cuts, scrapes, or puncture wounds
Existing skin conditions, like athlete’s foot or eczema
Surgical incisions or pressure sores
Weakened immune system, as seen in conditions like diabetes
Exposure to bacteria in lakes, rivers, or oceans
Use of hot tubs
Swelling in a limb due to trapped fluid (edema)

Symptoms of Cellulitis

The symptoms of cellulitis can vary from person to person, but some common signs include:

Redness and swelling of the affected area
Warmth and tenderness in the infected region
Pain or discomfort
Blisters or bruising
Fever, chills, headache, and weakness
Red streaks extending from the original site of infection

In some cases, cellulitis can be a medical emergency, especially if it affects a large area, causes numbness or tingling, or if the person has a weakened immune system or diabetes. It is important to seek immediate medical attention in such situations.

Is Cellulitis Contagious?

Cellulitis is not considered a highly contagious condition. The bacteria that cause cellulitis, such as Streptococcus and Staphylococcus, are commonly found on the skin and in the nose and mouth of healthy individuals. However, the infection occurs when these bacteria enter the skin through a break or injury. Cellulitis is not spread through casual contact, but it can be transmitted through direct contact with the infected area or through sharing personal items, such as towels or clothing, with someone who has cellulitis.

Preventing Recurrent Cellulitis

For individuals who have experienced multiple episodes of cellulitis, there are several steps that can be taken to help prevent future occurrences:

Maintain good skin hygiene: Keep the skin clean and well-moisturized to prevent cracks or breaks that can allow bacteria to enter.
Protect the skin: Wear appropriate clothing and footwear, and use gloves when necessary, to avoid injuries that can lead to cellulitis.
Treat skin conditions: Promptly address any existing skin conditions, such as athlete’s foot or eczema, that can increase the risk of cellulitis.
Manage underlying health conditions: Individuals with conditions like diabetes or weakened immune systems should work closely with their healthcare providers to manage these factors and reduce the risk of cellulitis.
Consider long-term antibiotic treatment: In some cases, your healthcare provider may recommend long-term antibiotic therapy to prevent recurrent cellulitis episodes.

Seeking Medical Attention

If you suspect you have developed cellulitis, it is crucial to seek medical attention promptly. Your healthcare provider can examine the affected area, perform any necessary tests, and prescribe the appropriate treatment, which typically involves a course of antibiotics. Early diagnosis and treatment are essential to prevent the infection from spreading and causing more serious complications.

Conclusion

Cellulitis is a prevalent bacterial skin infection that can be effectively managed with proper treatment and prevention strategies. By understanding the causes, symptoms, and risk factors for cellulitis, individuals can take proactive steps to maintain good skin health and reduce the likelihood of recurrent episodes. If you have any concerns about cellulitis, do not hesitate to consult with your healthcare provider for personalized advice and guidance.

Find out skin care tips to help prevent another episode of cellulitis

My husband has had cellulitis three times in a single year. What can he do to prevent recurrent cellulitis?

Answer From Lawrence E. Gibson, M.D.

To help prevent recurrent episodes of cellulitis — a bacterial infection in the deepest layer of skin — keep skin clean and well moisturized. Prevent cuts and scrapes by wearing appropriate clothing and footwear, using gloves when necessary, and trimming fingernails and toenails with care. Promptly treat any cuts or infections on the skin’s surface, such as athlete’s foot.

Factors that may increase your risk of cellulitis include:

Preexisting skin diseases, such as athlete’s foot
Puncture injuries, such as insect or animal bites
Surgical incisions or pressure sores
Immune system problems, such as diabetes
Injuries that occur when you’re in a lake, river or ocean
Hot tub use
Swelling of a limb caused by trapped fluid (edema)

If you frequently develop cellulitis, your doctor might recommend long-term antibiotic treatment to prevent recurrent infections.

Cellulitis infection: Is it contagious?

April 10, 2021

Show references

Cellulitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/cellulitis. Accessed Jan. 14, 2021.
Spelman D, et al. Cellulitis and skin abscess: Epidemiology, microbiology, clinical manifestations and diagnosis. https://www.uptodate.com/contents/search. Accessed Jan. 14, 2021.
Lebwohl MG, et al. Cellulitis and erysipelas. In: Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Jan. 14, 2021.
Office of Patient Education. Cellulitis. Mayo Clinic; 2016.

See more Expert Answers

Products and Services

Book: Mayo Clinic Family Health Book, 5th Edition
Newsletter: Mayo Clinic Health Letter — Digital Edition

Cellulitis | Cedars-Sinai

Not what you’re looking for?

What is cellulitis?

Cellulitis is a deep infection of the skin caused by bacteria. It
often affects the arms and legs. It can also develop around the eyes, mouth, and anus,
or on the belly (abdomen). Normal skin can be affected by cellulitis. But it often
happens after some type of injury causes a skin break, including trauma or surgery.
Once
the skin breaks, bacteria can enter and cause infection.

What causes cellulitis?

Cellulitis is often caused when
bacteria enter a wound or area where there is no skin. The most common bacteria that
cause cellulitis include:

Group A ß – hemolytic streptococcus (Strep)
Streptococcus pneumoniae (Strep)
Staphylococcus aureus (Staph)

Staph and strep bacteria are
commonly found on the skin and mucous membranes of the mouth and nose in healthy people.
The infection happens when there is a break in the skin that lets the bacteria
enter. Other causes may include human or animal bites, or injuries that happen in
water.

What are the symptoms of cellulitis?

Symptoms can be different for each
person. Common symptoms include:

Skin redness
Skin swelling
Soreness
Warm skin
Pain
Bruising
Blisters
Fever
Headache
Chills
Weakness
Red streaks from the original site of the cellulitis

Some cases of cellulitis are an
emergency. Always talk with your healthcare provider right away if you notice any
of the
following symptoms:

A very large area of red, inflamed skin
Fever
If the area affected is causing numbness, tingling, or other changes in a hand, arm,
leg, or foot
If the skin appears black
If the area that is red and swollen is
around your eye or behind the ear
If you have diabetes or have a weak
immune system and get cellulitis

Many of these symptoms can be
caused by other skin conditions. Always talk with your healthcare provider for a
diagnosis.

How is cellulitis diagnosed?

Diagnosis is often based on a health history and physical exam. Blood
and skin samples may be taken to confirm the diagnosis and the type of bacteria
present.

A bacterial culture can sometimes identify the organism causing the
condition. This helps guide treatment with the correct antibiotic.

How is cellulitis treated?

Your healthcare provider will
consider your age, overall health, and severity of the condition when finding the
best
treatment for you.

Getting treated right away can help prevent the spread of cellulitis. Treatment may
include:

Antibiotics, which can be given by
mouth (oral), shot (injection), or by IV (intravenously)
Keeping the area clean and applying
dressings as instructed
Surgery
If your arm or leg is affected,
raising (elevating) the arm or leg may help
Rest
Time to heal
Pain medicine as needed

Based on the physical exam,
your healthcare provider may treat you in the hospital, depending on the severity
of the
cellulitis. In the hospital, you may get antibiotics and fluids through an IV.

What are possible complications of cellulitis?

In most cases, cellulitis is easily treated with no complications.
But in some cases complications can be very serious. These can include extensive tissue
damage and tissue death (gangrene). The infection can also spread to the blood, bones,
lymph system, heart, or nervous system. These infections can lead to removing the
affected arm or leg (amputation), shock, or even death.

Can cellulitis be prevented?

To prevent cellulitis:

Use good personal hygiene.
Wash hands often.
Apply lotion to dry, cracked skin.
Use gloves when cuts and scrapes may happen.
Never go barefoot, always wear
protective footwear.

If skin breaks happen, keep the area clean and use an over-the-counter antibiotic
ointment. Watch for signs of infection. If you have diabetes, visually check your
feet for signs of skin breaks or infection. Also, don’t cut out warts or calluses,
and don’t cut toenails too short.

When should I call my healthcare provider?

Call your healthcare provider right away if a wound starts to swell,
turn red, feel warm, or get painful. Also call if the redness or warmth starts to
spread
from the wound.

Key points about cellulitis

Cellulitis is a deep bacterial infection of the skin.
It often causes redness, swelling, and
soreness.
Good hygiene, protective footwear, and
skin care can help prevent cellulitis.
Watch any breaks in the skin for signs of infection.
Untreated cellulitis can lead to amputation, shock, and even death.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
visit.
Know how you can contact your provider if you have questions.

Medical Reviewer: Michael Lehrer MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: Raymond Kent Turley BSN MSN RN

Not what you’re looking for?

Cellulitis (for Teens) – Nemours Kidshealth

What Is Cellulitis?

Cellulitis (pronounced: sel-yuh-LY-tus) is a skin infection that involves areas of tissue below the surface of the skin.

Cellulitis can affect any area of the body, but is most common on exposed body parts, such as the face, arms, or lower legs.

What Causes Cellulitis?

Many different types of

bacteriacan cause cellulitis. The most common ones are group A streptococcus and Staphylococcus aureus.

Cellulitis usually begins in an area of broken skin, like a cut, bite, or scratch. People who have body piercings may be at risk for cellulitis because the piercing hole is a chance for bacteria to get beneath the skin’s surface.

But cellulitis can also start in areas where the skin isn’t broken, especially in people who have chronic conditions (such as diabetes) or who take medicines that affect the immune system.

Cellulitis is not contagious. It can’t spread from person to person.

What Are the Signs & Symptoms of Cellulitis?

Cellulitis begins with a small area of skin that’s:

As this area begins to spread, a person may begin to feel ill and get a fever and, sometimes, chills and sweats. Swollen lymph nodes (or swollen glands) are sometimes found near the area of infected skin.

The time it takes for symptoms to start varies, depending on which bacteria cause the cellulitis. For example, someone with cellulitis caused by Pasteurella multocida, commonly found in animal bites, can have symptoms less than 24 hours after the bite. But cellulitis caused by other types of bacteria may not cause symptoms for several days.

How Is Cellulitis Diagnosed?

A doctor can usually diagnose cellulitis by examining the area of affected skin. Sometimes the doctor may check for bacteria by taking blood samples. Positive blood cultures mean that bacteria from the skin infection have spread into the bloodstream. This can cause septicemia (blood poisoning), a serious infection.

How Is Cellulitis Treated?

If you have a mild case of cellulitis, the doctor will probably prescribe antibiotics. These can usually cure cellulitis in 7 to 10 days. Even if you feel better sooner than that, it’s important to take all the

antibioticsprescribed for you. Otherwise, the infection can return.

People with severe cases of cellulitis might need treatment in a hospital with intravenous (IV) antibiotics.

Can Cellulitis Be Prevented?

To prevent cellulitis, protect skin from cuts, bruises, and scrapes. This isn’t easy, especially if someone is active or likes to play sports.

To protect yourself:

Use elbow and knee pads while skating.
Wear a bike helmet when you’re riding.
Wear shin guards during soccer.
Wear long pants and long-sleeved shirts while hiking in the woods (this can also protect you from bug bites and stings).
Wear sandals on the beach.

If you do get a scrape, wash the wound well with soap and water. Apply an antibiotic ointment and cover the wound with an adhesive bandage or gauze. Check wounds often for the first few days to see if any signs of cellulitis begin. Pay attention to new piercings too. If they get red, swollen, and painful to the touch, have them checked out by a doctor.

When Should I Call My Doctor?

Call your doctor whenever any area of your skin becomes red, warm, and painful — with or without fever and chills. This is especially important if the area of skin is on the hands, feet, or face (particularly ear, nose, or eyebrow piercings) or if you have an illness or condition that suppresses the immune system.

Check with your doctor if you get a large cut or a deep puncture wound. Cellulitis can happen quickly after an animal bite. So call your doctor if an animal bites you, especially if the puncture wound is deep. Not too many people get bitten by other people, of course, but human bites can cause skin infections too.

What Can I Do to Feel Better?

Take the antibiotics prescribed by the doctor exactly as directed and for the full course. Follow your doctor’s suggestions for treating the area of cellulitis, such as elevating the affected part of your body or applying heat or warm soaks to it. You can also take over-the-counter pain relievers such as acetaminophen or ibuprofen to ease pain and keep a fever down.

After you’ve taken antibiotics for 1 or 2 days, your doctor may schedule an office visit to check that the area of cellulitis has improved. This means that the antibiotics are working against the infection.

Causes, Symptoms, Treatments and More

At first you thought you were imagining that red circle on your lower leg. It didn’t bother you much at the time, but now that it feels hot when you touch it and is starting to swell and maybe even expand, you’re pretty sure there’s something going on there. Your doctor is concerned that it’s a bacterial skin infection called cellulitis and wants you to come in ASAP. Cell-u-what? Here’s what you need to know.

What Is Cellulitis, Anyway?

Cellulitis is a serious skin infection that occurs when bacteria infect the deep layers of your skin and the tissue beneath it. It is most commonly caused by either Streptococcus pyogenes (strep) or Staphylococcus aureus (staph) bacteria. However, it can also stem from the more serious MRSA (methicillin-resistant Staphylococcus aureus), a type of staph infection that’s become more resistant to antibiotics.

Often, there is some type of cut or break in your skin that allows bacteria to enter, but sometimes there is no such event—or at least none that you can recall. Your skin may be cut or punctured in any number of ways, from a shaving nick to a tattoo or body piercing, or from injection drug use or an animal bite.

Though most people have never heard of cellulitis, it’s not a rare condition. In fact, there are more than 14 million cases of cellulitis in the United States each year. Both men and women can get cellulitis, and it equally affects both genders. And when it comes to age, while you can get cellulitis at any point in your life, it more commonly occurs in those who are middle-aged and older.

An important tidbit: Cellulitis is not commonly passed on to people around you and it’s not contagious like a common cold, but you can spread the bacteria to other people (known as a community-acquired infection). Let’s take a closer look at what’s behind this painful condition.

What Are the Symptoms of Cellulitis?

Cellulitis can show up on any part of the body, but often it develops on a foot or lower leg, places where certain conditions that may make you more susceptible to cellulitis can strike (more on what those are later). It is almost always unilateral, meaning it occurs on just one side of your body. In kids, cellulitis often appears on the face, as this is where they’re more likely to get scratches. The infection tends to occur close to where an initial skin injury took place, if there was one. These are some other common signs of cellulitis:

Redness

Cellulitis appears as one area or “sheet” of redness. It may start off at about the size of a quarter on your calf, for instance, and quickly grow to cover your entire lower leg. It is not raised, and there aren’t any spots or dots. It may be circular, but it could also take on other shapes as well.

Warm Skin

Your skin may feel warm when you touch the affected area. This heat is generated by your body’s immune system, which is trying to fend off the infection. You may also experience tenderness or pain when you touch the affected area.

Skin Damage

Your skin may appear pitted (which can look similar to the uneven, dimpled skin of an orange), and you may develop blisters in the area, too. In cases of severe infection, you will also see pus.

Additional Symptoms

Cellulitis can come on suddenly or more gradually, surfacing over several days or weeks and tending to grow redder, more swollen, and more painful with time. It may start off slowly, but once it is there, it may expand quickly. If the red area rapidly expands, your infection may be spreading to other parts of your body. Symptoms that raise the possibility that cellulitis is on the move include:

What Are the Risk Factors for Cellulitis?

Pretty much anyone can develop cellulitis and, once you’ve had it, you’re at higher risk for getting it again. This is often because of certain underlying and untreated—or undertreated—conditions you may have that can make you more susceptible to cellulitis. For instance, chronic skin conditions like athlete’s foot and eczema may help set the stage for cellulitis. Athlete’s foot can cause microscopic tears in the skin that serve as portals of entry for hungry bacteria. With eczema, your skin barrier may be compromised, especially if you scratch, enabling bacteria to enter and cause cellulitis. Chickenpox and/or shingles can increase your chances of developing cellulitis for similar reasons.

Other medical conditions make you more prone to cellulitis:

You Have Diabetes

Diabetes ups your risk of infection for a variety of reasons. For instance, you may develop ulcers on your feet if you can’t feel minor problems, like a cut, early on because of nerve damage. People with uncontrolled diabetes often have high blood sugar, and there is nothing that bacteria like to eat more than sugar. Put together elevated blood sugar and an open wound that goes unnoticed, and you have the perfect storm for cellulitis.

You Have Lymphedema

If your feet, legs, hands, and/or arms are swollen due to lymphedema, you are more prone to developing cellulitis. Lymphedema happens when lymph fluid builds up in the soft tissues of your body. It usually occurs in your arms or legs and can result from radiation therapy, the surgical removal of lymph nodes such as from cancer surgery, and some genetic conditions. Your lymph system is supposed to fight off infection, but when it’s overloaded, it can’t do its job and infections like cellulitis may occur.

Your Immune System Is Compromised

This can occur for many reasons, including taking steroid medications, chemotherapy to treat cancer, other medicines that suppress the immune system, and/or certain underlying diseases and conditions. Your risk for infection soars when your immune system isn’t working well. A compromised immune system just can’t do its job as it should, a job that includes fighting off intruders, such as the bacteria that can cause cellulitis, that make their way into the body.

You’re Overweight

Poor circulation in your arms, legs, hands, or feet due to excess weight can cause swelling, which sets the stage for cellulitis. When your skin stretches out, it becomes more prone to cracks and tears, which serve as portals for bacteria to enter.

You Had Heart Surgery

Heart surgery that involves having a vein removed from your leg and reconnecting it to your coronary artery to boost blood flow to your heart may increase your risk of cellulitis if the surgery results in leg swelling.

How Is Cellulitis Diagnosed?

Your doctor can likely take one look at the red area on your lower leg and tell you whether or not you have cellulitis. You may be asked to circle the area with a marker now, to see if it gets any larger in the future. (Doing this on your own is not a replacement for seeking a medical evaluation.)

There is no official cellulitis test, so your doctor will ask lots of questions and try to eliminate other diseases that may look like cellulitis. This list of cellulitis imitators includes:

Herpes infections
Chronic venous insufficiency (CVI). This vein diseases in your lower leg can mimic the appearance of cellulitis.
Contact dermatitis. Skin irritation from allergic or contact dermatitis can result in red patches similar to cellulitis.

You may need other tests, such as a complete blood count, or CBC, to see if your infection has started to spread. One part of this blood test, which involves taking a small amount of blood from a vein in one of your arms, looks at your white blood cell count. Your immune system uses white blood cells to fend off bacteria, viruses, and other foreign invaders when you’re sick. So, when you’re sick, your body needs to generate more white blood cells to fight these invaders off. A higher count of white blood cells in your CBC may indicate that your immune system is working overtime to fend off an infection.

If there is pus at the site of the infection, your doctor may take a culture and send it to a lab. Knowing what type of bacteria you are dealing with can help guide your treatment.

Cellulitis Complications

As cellulitis worsens, the bacteria enter deeper layers of your skin and potentially your bloodstream. Without treatment, the infection can spread to other areas of your body, namely your blood, joints, bones, and/or the lining of the chambers of your heart and heart valves, a condition called endocarditis.

Although rare, cellulitis may also lead to a very serious infection called necrotizing fasciitis, or flesh-eating bacteria. This is an extreme emergency. Strep bacteria are among the most common causes of cellulitis, and necrotizing fasciitis can happen when the infection is from a very aggressive strep strain called group A streptococcus (GAS). See your doctor ASAP if you experience severe pain and swelling of the affected skin area, or blistering.

Treatment for Cellulitis

If your doctor confirms that you have cellulitis, you will likely be started on oral antibiotics right away, probably a broad-spectrum antibiotic that targets the most common cellulitis culprits. More serious infections—such as those more widespread, those with additional symptoms like high fever and a general feeling of malaise, and those that oral antibiotics have failed to help—may need to be treated in the hospital with intravenous (IV) antibiotics. In these cases, information on what type of bacteria is causing the infection may help your doctor choose the best drug. When the infection is in an arm or leg, keeping the affected limb elevated can help decrease swelling and speed recovery.

When you catch cellulitis early, you will likely recover quickly and fully. You should see improvements in 24 to 48 hours of starting treatment. This means less pain and swelling, and the red area should start to shrink, too.

If you have had multiple bouts of cellulitis as well as risk factors such as lymphedema or diabetes, your doctor may consider putting you on a preventive course of antibiotics to keep repeat infections at bay. The risk and benefits of this practice must be weighed carefully, since overuse of antibiotics can lead to the development of superbugs—bacteria that don’t respond to treatment.

Learn More About Cellulitis Treatment Options

How to Prevent Cellulitis

Unfortunately, cellulitis is not a one-and-done illness. Once you’ve had cellulitis, you have a greater chance of getting it again, especially if you have underlying conditions that predispose you to it. The good news: Following these guidelines can help you minimize your risk of a future infection.

Start by taking good care of any and all skin wounds (even minor shaving nicks) when they happen. Clean all minor cuts and injuries that break the skin with soap and warm water, apply an antibiotic ointment, and cover with bandages until they heal. If your wound is deep, such as a dog bite, see your doctor.

When you have a wound, stay away from hot tubs, pools, and natural bodies of water like lakes and rivers, all of which can harbor bacteria that could infiltrate your broken skin barrier and cause another bout of cellulitis.

Prevention also means taking care of any and all underlying conditions that predispose you to cellulitis. If you have diabetes, check your feet daily for injuries or signs of infection, and make sure you see a podiatrist regularly. It’s also important to keep your blood sugar in the normal range. Work closely with your doctor to make sure you’re doing all that you can to keep your diabetes under tight control.

If you have had multiple cellulitis infections below the knee, see a doctor to find out if you have athlete’s foot. If you do, treat it to lower the chances that you will develop cellulitis again. This entails topical creams to get the infection under control, along with taking measures to prevent a repeat, including keeping your feet clean and dry and your toenails short and clean so bacteria stay out.
In general, it’s important to moisturize daily to keep your skin barrier intact so that it can do its job and keep bacteria out. If you tend to experience limb swelling, ask your doctor about wearing compression stockings or a leg wrapping to reduce swelling and stave off cellulitis.

Along with these basic DIY prevent methods, these lifestyle changes can also help reduce your risk for repeat bouts of cellulitis:

Limiting alcohol use, since drinking too much dampens your immune system
Not smoking
Maintaining a normal weight

It’s scary to hear that you have cellulitis, but catching it early gives you a true head start on averting some of the potential consequences. Take your antibiotics as directed, and you should start feeling better ASAP. Now that you have had it once, you are at risk for getting it again, so make sure to clean all wounds carefully and stay on top of all underlying conditions that predispose you to cellulitis.

Meet Our Writer

Denise Mann

Denise Mann, MS is a veteran freelance health writer in New York. Her work has appeared on HealthDay, among other outlets. She was awarded the 2004 and 2011 journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery. She was also named the 2011 National Newsmaker of the Year by the Community Anti-Drug Coalitions of America. She’s also been awarded the Arthritis Foundation’s Northeast Region Prize for Online Journalism, the Excellence in Women’s Health Research Journalism Award, the Gold Award for Best Service Journalism from the Magazine Association of the Southeast, a Bronze Award from The American Society of Healthcare Publication Editors, and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Mann has a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill.

Cellulitis – symptoms, diagnosis, treatment

Cellulitis is a bacterial infection of the skin and underlying flesh. Symptoms include redness and swelling, often accompanied by a general feeling of being unwell. The face, neck, arms and legs are the areas most commonly affected. Treatment is with antibiotics.

Causes

Cellulitis is usually caused by bacteria that may be present on your skin, or in external sources such as water, soil or animals that you come in contact with. Cellulitis is often, but not always, preceded by a skin problem such as a scrape, cut, puncture wound, bee or wasp sting, ulceration, or surgical wound; or another skin condition such as eczema, psoriasis, athlete’s foot or scabies. Other factors than can increase the chances of developing cellulitis include:

Problems with circulation in the limbs
Diabetes
Alcoholism
Obesity
Swelling of the legs
Pregnancy
Weakened immune system , eg: HIV/AIDS
Previous cellulitis.

A variation of the condition, called orbital cellulitis, affects the tissues around the eye. This form of cellulitis can be caused by bacteria that have spread from the nose, throat or sinuses.

Signs and symptoms

The onset of cellulitis is often sudden. A clearly defined area of skin becomes red and tender. It rapidly turns bright red, shiny, swollen and feels hot. The affected area may keep growing in size and be painful to touch.

During the initial stages of the rash there is often accompanying fever, chills, headache, nausea and a general feeling of being unwell. Lymph nodes near the affected area may become swollen and tender.

Cellulitis is a serious infection. A doctor should be seen if the affected area is larger than a 10 cent coin. If the cellulitis is near an eye, very painful, or growing rapidly, see a doctor urgently.

Diagnosis

Cellulitis can usually be diagnosed from its characteristic appearance. Blood tests and tissue cultures may be used to confirm the presence of bacterial infection. In cases of orbital cellulitis, a CT scan (computerised tomography) may be recommended in order to precisely identify the extent of the infection.

Treatment

It is important to seek prompt medical advice if cellulitis is suspected so that an accurate diagnosis can be made and effective treatment given. The condition is treated with antibiotics, usually penicillin-based. In most cases treatment with oral antibiotics is all that will be required to adequately treat the condition. Oral antibiotics are usually given for 5–10 days. In many cases improvement in symptoms occurs within 48 hours of starting treatment.

In cases where the cellulitis is severe, or where oral antibiotics do not prove effective, hospitalisation and treatment with intravenous antibiotics may be required.

If orbital cellulitis is suspected, assessment and treatment from an eye specialist (ophthalmologist) may be required as the potential complications of the condition include loss of vision and meningitis.

In all cases elevation of the affected area (where possible) and bed rest is important. Measures such as cold packs and pain relieving medication may be used to reduce pain and discomfort.

In rare cases:

The bacteria that caused the cellulitis can spread to the bloodstream and travel throughout the body. This is known as sepsis which can be life-threatening, and will require urgent hospital treatment.
The infection can spread to the deep layer of tissue known as the fascial lining. Necrotizing cellulitis and necrotizing fasciitis are severe forms of cellulitis that require immediate medical attention.

It is possible for cellulitis to recur. This is particularly true of patients who have an underlying medical condition such as diabetes, postphlebitic syndrome or HIV infection. In selected patients where recurrence is a serious problem, on-going preventative treatment with antibiotics may be recommended.

Prevention

Good skin care can help to prevent cellulitis:

Inspect your feet daily for signs of injury or infection
Wash and dry hands properly
Moisturise your skin regularly, to help prevent cracking and peeling
Trim your fingernails and toenails carefully, taking care not to injure the surrounding skin
Avoid sharing towels and bed linen
Wash linen, towels and clothing regularly
Wear appropriate footwear and gloves to protect feet and hands
Treat skin infections early, eg: athlete’s foot.

Children with cellulitis should avoid school or pre-school until the affected area has dried up, or for at least one day after oral antibiotic treatment has been started.

References

Leversha, A. and Naylor, D. (2019). Cellulitis (Web Page). Starship Clinical Guidelines. Auckland: Starship Child Health. https://www.starship.org.nz/guidelines/cellulitis [Accessed: 31/01/20]
Mayo Clinic (2015). Cellulitis (Web Page). Rochester, MN: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762 [Accessed: 31/01/20]
Ministry of Health (2018). Cellulitis (Web Page). Wellington: New Zealand Government Ministry of Health. https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/cellulitis [Accessed: 31/01/20]
Stanway, A. (2016). Cellulitis (Web Page). Hamilton: DermNet New Zealand. https://www.dermnetnz.org/topics/cellulitis/ [Accessed: 31/01/20]
O’Toole, M.T. (Ed.) (2017). Cellulitis. Mosby’s Dictionary of Medicine, Nursing & Health Professions (10th ed.). St Louis, MI: Elsevier.

Last Reviewed – February 2020

Cellulitis, Facial

Cellulitis is an infection of the deep layers of skin. A break in the skin, such as a cut or scratch, can let bacteria under the skin. It may also occur from an infected oil gland (pimple) or hair follicle. If the bacteria get to deep layers of the skin, it can be serious. If not treated, cellulitis can get into the bloodstream and lymph nodes. The infection can then spread throughout the body. This causes serious illness. Cellulitis on the face is especially dangerous if it affects the skin around the eyes.

Cellulitis causes the affected skin to become red, swollen, warm, and sore. The reddened areas have a visible border. You may have a fever, chills, and pain.

Cellulitis is treated with antibiotics taken for 7 to 10 days. Symptoms should get better 1 to 2 days after treatment is started. Make sure to take all the antibiotics for the full number of days until they are gone. Keep taking the medicine even if your symptoms go away.

Home care

Follow these tips:

Take all of the antibiotic medicine exactly as directed until it’s gone. Don’t miss any doses, especially during the first 7 days. Don’t stop taking it when your symptoms get better.
Use a cool compress (face cloth soaked in cool water) on your face to help reduce swelling and pain.
You may use acetaminophen or ibuprofen to reduce pain. Don’t use these if you have chronic liver or kidney disease, or ever had a stomach ulcer or gastrointestinal bleeding. Talk with your healthcare provider first.

Follow-up care

Follow up with your healthcare provider, or as advised. If your infection doesn’t go away on the first antibiotic, your healthcare provider will prescribe a different one.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

Fever higher of 100.4º F (38.0º C) or higher after 2 days on antibiotics
Red areas that spread
Swelling or pain that gets worse
Fluid leaking from the skin (pus)
An eyelid that swells shut or leaks fluid (pus)
Headache or neck pain that gets worse
Unusual drowsiness or confusion
Seizure
Change in eyesight

Cellulitis: Causes, Pictures & Treatment

Cellulitis is a bacterial infection that typically affects the skin and the tissues beneath the skin. Cellulitis can occur anywhere on the body. Periorbital cellulitis (infection of the eyelids or other soft tissue around the eyes) is a particularly serious form of cellulitis.

Cellulitis is most frequently caused by the bacteria Staphylococcus aureus (including methicillin-resistant S. aureus, or MRSA), Streptococcus pneumoniae, and beta-hemolytic streptococci (including the strep bacteria that cause strep throat). Whenever the offending bacteria enter through a break in the skin—for example, from an injury or insect bite, or through a disorder that breaks the skin, such as cracks or peeling from dry skin, a stye, or a hordeolum (localized bacterial infection of an oil gland or eyelash follicle in the eyelid margin)—they can quickly lead to inflammation and infection.

Cellulitis can be serious and sometimes requires hospitalization; however, in many people, cellulitis responds promptly to antibiotic therapy. The infection can be harder to eliminate in people who have chronic medical conditions, especially conditions that suppress the immune system.

Orbital cellulitis (invasive infection of the soft tissues around the eye) is particularly dangerous for everyone, but especially for children. It often spreads from the sinuses, where S. pneumoniae is the most common cause, but S. aureus and S. pyogenes (the bacterium that causes strep throat) can also cause it. The infection can advance rapidly and in some cases, may cause blindness or other life-threatening complications.

Seek immediate medical care (call 911) if you, or someone you are with, have signs of cellulitis on your face, particularly near your eyes, including painful red, warm or inflamed skin; a rash or sore that appears suddenly and grows rapidly within 24 hours; tight, or a glossy appearance to the inflamed area.

Also seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms of sepsis (a life-threatening reaction to infection, oftentimes one that has spread to the blood), such as severe difficulty breathing and sweating, which may be combined with high fever (higher than 101°F), pale or blue lips, and rapid heart rate (tachycardia). There may also be a change in mental status, such as confusion.

Seek prompt medical care if you are being treated for cellulitis but your symptoms recur or persist.

90,000 causes, symptoms, diagnosis and treatment of lipodystrophy

Cellulite (lipodystrophy) is a persistent change in subcutaneous fat. Cellulite zones are characterized by the presence of clearly visible bumps and depressions. Skin relief defects progress with age. Patients complain of redness of the skin with slight exertion. In the summer months, an uneven tan is formed, and foci of depigmentation appear. Lipodystrophy is localized on the forearms, thighs and buttocks.

Statistics

Signs of lipodystrophy are detected in 75% of girls aged 20-35 years. After reaching the age of 40, foci of cellulite appear in 95% of women. The affected areas are the buttocks, thighs, abdomen, knees and arms.

The accumulation of fluid in the inner layers of the skin provokes the formation of an “orange peel”, 95% of women who are faced with lipodystrophy and neglected prevention suffer from it.

Men rarely suffer from cellulite (less than 10% over the age of 40) due to the presence of a significant amount of collagen in the body, a developed muscular system and a relatively thick skin.

Reasons for development

Lipodystrophy develops under the influence of several factors:

burdened heredity;
unbalanced diet;
pathology of the endocrine glands;
sedentary lifestyle;
high emotional and intellectual stress.

Cellulite areas on the thighs and buttocks remain the result of problems with venous blood flow.Excess fat deposits become a risk factor. Lipodystrophy on the abdomen may indicate pathologies of the gastrointestinal tract, unstable lymph nodes, stress or depressive conditions. Signs of cellulite in the neck area are often associated with muscle cramps or arthritis.

Stages of lipodystrophy

Types of cellulite and stages of its development are determined by doctors based on the intensity of destruction of subcutaneous fat.

Lipodystrophy stage	Description
The first	Microscopic edema appears on the skin.The relief remains smooth. Regeneration in the cellulite zone is impaired – cuts heal slowly, hematomas persist for a long time. Decay products accumulate in the intercellular fluid
The second	The skin becomes bumpy. The lymphatic system is unable to ensure the outflow of fluid from the subcutaneous fat. Foci of compaction of fatty deposits are formed
Third	Visual changes are clearly visible.The “orange peel” effect appears. Swelling of the tissues leads to compression of the arteries, blood circulation is impaired. Extensive hematomas are formed. Connective tissue grows around the fatty deposits – micronodules appear (nodule – spherical constriction)
Fourth	The skin in the affected areas retains tuberosity when muscles are relaxed. Micronodules merge into macronodules.The skin takes on a bluish tint. Palpation of the affected areas is painful

Control methods

Cellulite treatment begins with an analysis of the location of destruction foci on the patient’s skin. This procedure is mandatory – different parts of the body react differently to hardware or manual procedures. Elimination of lipodystrophy is a complex task based on the restoration of blood and lymph circulation. Patients are prescribed physical exercises, massage, wraps, electrical stimulation.

The procedures prescribed by the doctor allow you to solve several problems at the same time:

to break down fats;
to prevent the formation of new fatty deposits;
to ensure the outflow of fluids from fabrics;
to increase the tone of the subcutaneous vessels;
to conduct muscle stimulation;
Align skin relief.

Their solution is facilitated by hardware procedures: pressotherapy, microcurrent electrical stimulation, electrolipolysis.The listed manipulations ensure the restoration of blood flow and increase the intensity of lymph movement. Thanks to this, the normal state of the subcutaneous tissue of the patients is restored, the relief of the skin is normalized.

Liposuction remains a radical method of treating lipodystrophy. Surgical manipulation is prescribed for patients with a genetic predisposition to the accumulation of subcutaneous fat on the thighs or abdomen. Before the operation, a biomaterial is to be submitted for laboratory analysis.Often, doctors refer patients for x-rays or computed tomography. Visualization of the lipodystrophy focus allows planning the course of surgery.

Forecast and prevention

The diagnosis of cellulite assumes that the treatment will begin at the first stage – before the formation of deposits under the skin. In this case, it is enough to eliminate the cause of cellulite, which provokes the instability of fat metabolism. The outlook remains favorable. In parallel, the patients are treated for background pathologies (endocrine disorders) and get used to a balanced diet.

The set of procedures for advanced cellulite changes: the reason for this is significant changes in the subcutaneous fat. Patients are shown lymphatic drainage procedures, ultrasound therapy and deep massage. If these methods are ineffective, the doctor may refer the patient to liposuction. Removal of fatty deposits from affected areas is a standard surgery. A favorable prognosis remains, the rehabilitation period does not exceed 2 weeks.

Preventing cellulite requires careful body care.Doctors recommend that patients use anti-cellulite drugs, lead an active lifestyle, and give up bad habits. A regular visit to a bath or sauna can improve blood flow and lymphatic drainage. In a similar way, massage sessions act on the subcutaneous fat.

Questions and answers

Why is cellulite dangerous?

Many people believe that cellulite is not harmful to health, and its only negative consequence is a change in the aesthetics of the body.Destructive changes in subcutaneous fat affect the state of blood vessels, muscles, lymph nodes and skin. Late stages of lipodystrophy can lead to the development of secondary infections and life-threatening complications.

Can cellulite be treated at home?

At home, you can independently perform physical exercises aimed at preventing or treating cellulite. Taking medication or participating in hardware procedures is only permissible as directed by a doctor.Fans of “folk methods” should be aware of the risks that accompany the use of self-made products.

90,000 what is it, from which it appears, stages in the article of the cosmetologist Yudin T.V.

Date of publication February 28, 2020 Updated April 26, 2021

Definition of the disease. Causes of the disease

In medical terminology cellulite is usually called acute purulent inflammation of the subcutaneous fat, which is a frequent manifestation of phlegmon.This is a formidable surgical disease in which tissue inflammation is observed without a tendency to limit the purulent process. The disease is manifested by hyperthermia, redness, edema, pain and general symptoms of intoxication.

However, now this term is often used in a different sense. In a non-medical environment, when talking about cellulite, they usually mean cosmetic defects on the skin surface (ripples, tuberosity, retraction, “orange peel” effect). In this article, cellulite is considered precisely as a cosmetic defect that is not a disease.

Main areas of cellulite on the body

Cellulite can occur on any part of the body where fatty tissue accumulates, but most often it manifests itself on the skin of the outer and back of the thighs and on the buttocks.

In 80-90% of all sexually mature women, cellulite is manifested to some extent ^[10]. According to epidemiological studies, it is more common in fair-skinned women than in Asian women ^[11]. Cellulite can also occur in men, but much less frequently.The causes of cellulite in men are associated with a lack of androgenic hormones during hypogonadism (testicular failure) or receiving estrogen therapy (for example, for prostate cancer) ^[12].

Skin changes characteristic of cellulite were described at the beginning of the 20th century. It is noteworthy that various terms were used to denote these changes – gynoid lipodystrophy, nodular liposclerosis, panniculosis, edematous-fibrosclerotic panniculopathy, deforming dermopanniculosis, edematous adiposis ^[10].Now the term “gynoid lipodystrophy” is most often used in scientific circles.

Causes of cellulite

Heredity – a genetically determined slowdown in metabolic processes, impaired blood flow and lymph flow contribute to the development of cellulite.
Hormonal factors – to a greater extent, estrogens affect, or rather the conversion of androgens to estrogens in adipose tissue.
Bad habits: smoking and alcohol abuse.With alcohol abuse, the kidneys are disrupted and fluid begins to linger in the tissues. Smoking leads to peripheral vasospasm and fluid retention.
Lack of sleep. Sleep deficiency leads to a decrease in activity and a slowdown in many metabolic processes in the body, among which is a delay in the excretion of fluid, leading to the appearance of cellulite.
Wearing high heels and tight clothing leads to fluid retention due to mechanical compression of blood vessels and obstructed lymph flow.
Stress and psychological causes. Stress is accompanied by an increase in blood glucose levels, which causes thirst and increased fluid intake. Also, psychological reasons can lead to overeating and weight gain.
Improper diet, insufficient fluid intake, lack of activity .

Diseases that may be accompanied by cellulite:

Hypotheriosis . In case of illness, the production of thyroid hormones is disrupted, the rate of breakdown of fats from food decreases, and the breakdown of glycogen – a source of glucose that forms “reserve” carbohydrates.
Varicose veins leads to impaired blood flow, thickening of subcutaneous tissue and collagen fibers, which is manifested by the “orange peel”.
Renal failure – Water exchange is impaired and fluid stagnation occurs in the tissues. The disease is often accompanied by cellulite, even with a normal weight of the patient.
Polycystic ovary occurs due to hormonal imbalance, which can be caused by diseases of the hypothalamus, pituitary gland, adrenal glands, pancreas or thyroid gland.With the disease, the production of hormones responsible for metabolic processes, water balance, lymph and blood flow is disrupted.

Bumps, ripples and “orange peel” on skin are not considered a pathology, but are physiological features. Despite the widespread occurrence, the metabolic and structural basis of such defects has not yet been clarified ^[1].

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Symptoms of cellulite

Symptoms of cellulite directly depend on the stage of its development.At the initial stages, the visible changes are insignificant, so the patient may not notice them. The first symptoms are a slight unevenness on the surface of the skin, pallor, a decrease in temperature and skin elasticity in the affected areas.

As the disease progresses, the current symptoms become more pronounced. New vascular manifestations appear in the form of expansion of venules, numerous microaneurysms (expansion of capillaries) and hemorrhages in adipose tissue. Soreness of the affected areas may occur.Due to the thinning and atrophy of the epidermis with gynoid lipodystrophy, significant vascular changes may appear.

Pathogenesis of cellulite

The term “gynoid” refers to a typical female body type with a predominant localization of adipose tissue in the femoral-gluteal region, the so-called “pear” type.

Gynoid lipodystrophy is a sex-related condition of the skin and subcutaneous fat, which is influenced by many factors.At the same time, there are few studies concerning the physiology of cellulite. The main causes of cellulite: sexual dimorphism of the structure of the skin (differences between men and women), changes in part of the connective tissue, vascular changes, inflammatory factors, hormonal influences.

Initially, the development of cellulite was associated with changes in biochemical and metabolic processes in adipose tissue. However, no differences were found in the metabolism of adipocytes (fat cells) in the affected and unaffected areas of the hips and buttocks.

Anatomical hypotheses also do not fully explain the development of gynoid lipodystrophy, but only partially describe individual links of pathogenesis, which is based on structural changes in connective tissue septa (shares of , particles), as well as adipocytes themselves.

Sexual dimorphism of the skin structure

According to the hypothesis of Nurnberger and Müller, the manifestations of cellulite are associated with the peculiarities of the dermal-hypodermal junction in women in the form of bulging of “adipocytic papillae” into the dermis ^[5].This theory is supported by the fact that men of this structure are not observed ^[3], which is confirmed by imaging research methods ^[2] ^[3]. Nevertheless, it is not possible to explain the manifestations of cellulite only by this feature of the structure of the skin. First, the size of these bulges is not correlated with the severity of skin manifestations ^[1]. Secondly, in women on areas of skin without cellulite, bulging of the adipocytic papillae is also visualized ^[2].

Changes in the connective tissue septa separating the adipocyte lobules

The process of accumulation of adipose tissue in the buttocks and thighs is more typical for women than for men, since it is associated with the realization of the effects of female sex hormones secreted by the gonads and adrenal cortex. Most important are estrogens, or rather the conversion of androgens to estrogens in adipose tissue, where estrogen beta receptors are expressed. One of the main mechanisms of the effect of sex hormones on adipose tissue is the direct regulation of the activity of lipoprotein lipase (the main enzyme for regulating the accumulation of fat in adipocytes).In women of reproductive age, it is stimulated by estrogens in the adipose tissue of the thighs and buttocks, where the activity of this enzyme is higher than in the subcutaneous fat of the abdominal region. The result is an accumulation of lipids to provide adequate energy reserves for a woman during pregnancy and lactation.

Local accumulation of adipose tissue creates a constant vertical tension in the dermal-hypodermal layer under the influence of gravitational forces ^[1] ^[7].The more adipose tissue, the higher the force of this tension. Any mechanical force inside the skin is transferred to connective tissue cells ^[8]. Cells feel mechanical tension and, through a feedback mechanism, increase metabolism to remodel their structure, which is necessary to support the surrounding tissues ^[1].

However, obesity and local accumulation of adipose tissue alone are not the only factors in the development of cellulite ^[13].According to some researchers, the relationship between body mass index and the severity of gynoid lipodystrophy is explained not only by the remodeling of connective tissue septa, but also by an increase in the volume of adipocyte lobules, which leads to an increase in bulging on the skin surface ^[5].

At the same time, weight loss can affect the severity of the external manifestations of cellulite in different ways. In most cases, a decrease in body weight causes a decrease in the signs of cellulite, but sometimes they can increase.This can occur with an initially low body mass index and no decrease in the percentage of hip adipose tissue ^[6]. Perhaps this is due to the mechanical properties of the skin itself, showing signs of cellulite. Such skin is less elastic and firm. There is evidence that cellulite symptoms can also be reduced by correcting the skin condition ^[7] ^[9].

Changes in microcirculation in the dermis

Microcirculation includes five components: arterioles, venules, capillaries, lymphatic and interstitial tissues.Normally, the volume of arterial capillary filtration (fluid leaving the capillary into the intercellular space) corresponds to venous absorption (fluid coming from the intercellular space into the venules). Disruption of this balance can occur for many reasons: an increase in intracapillary pressure, a decrease in plasma osmotic pressure, an increase in the hydrostatic pressure of interstitial fluid, a decrease in lymphatic outflow, which leads to intercellular edema.

Such changes can be caused by many exogenous (external) and endogenous (internal) factors, including:

Influence of the central nervous system (vasomotor centers, hypothalamus, renin-angiotensin-aldosterone system, afferent influences upon irritation of pain and temperature receptors) …
The effect of the adrenergic sympathetic nervous system, which is responsible for the innervation of certain types of body tissues through the excitation of adrenoreceptors by norepinephrine and adrenaline. When the alpha receptors are stimulated, the lumen of the blood vessels narrows, the action on the beta receptors causes the expansion of the blood vessels.
Humoral factors: catecholamines, acetylcholine, prostaglandins, dopamine, histamine, serotonin, vasoactive interstitial peptide, chemical factors (ion concentration, acidity).
The effect of pharmacological substances (beta-adrenomimetics, alpha and beta-blockers, phosphodiesterase inhibitors, as well as venoactive drugs and drugs affecting lymphokinetics) ^[13].

Gynoid lipodystrophy may be associated with chronic venous insufficiency. These conditions share common signs and symptoms, including spider veins, microhemorrhages, sensory disturbances, tingling sensations, heaviness in the legs, involuntary painful muscle contractions, tenderness on palpation, and a decrease in skin temperature of the affected area as measured by thermography ^[13].

Analysis of interstitial fluid showed an increase in protein concentration and interstitial pressure. This may be due to the insufficiency of the precapillary sphincters involved in the regulation of blood flow in the skin, and the simultaneous accumulation of hydrophilic hyperpolymerized glycosaminoglycans in the basement membrane of the capillaries. Glycosaminoglycans are part of the intercellular substance of the connective tissue and bind water molecules in large quantities, due to which the intercellular substance takes on a jelly-like consistency.As a result of the accumulation of glycosaminoglycans, edema is formed, and due to edema tissue hypoxia (oxygen starvation) occurs, which triggers the process of division and reproduction of fibroblasts synthesizing collagen fibers ^[14]. In addition, hypoxia leads to the formation of new blood vessels and an increase in adipocyte size. With long-term existence, this process leads to thickening and sclerosis of the connective tissue septa in the deep layers of the dermis and superficial layers of subcutaneous adipose tissue ^[13] ^[14] ^[15].

Many researchers support the theory of the development of gynoid lipodystrophy due to the formation of edema and tissue hypoxia, but some studies do not confirm it ^[5] ^[16].

Inflammatory factors

Data from some histological studies of skin areas with manifestations of cellulite indicate the detection of infiltration of connective tissue septa by macrophages and lymphocytes, which indicates the presence of a process of chronic inflammation in this area ^[17] ^[18].However, in other cases, histological studies did not reveal signs of inflammation ^[1] ^[5] ^[19].

Hormonal influences

The hypothesis about the influence of hormonal factors, especially the hormone estrogen, is confirmed by several facts:

cellulite is primarily characteristic of women;
manifestations occur after puberty;
Symptoms worsen during pregnancy and while taking estrogen-containing drugs ^[13].

In this case, hyperestrogenism may not be of an absolute nature, but be the result of a change in the ratio of concentrations of sex hormones, as well as an increase in the number of estrogen receptors ^[20].

The consequences of hyperestrogenism are associated with the accumulation of glycosaminoglycans in the basement membrane of blood vessels. As a result, edema, tissue hypoxia are formed, fibroblasts proliferate and, as a result, thickening of the connective tissue septa. An excess of estrogen increases the activity of alpha-adrenergic receptors in adipocytes, which prevents lipolysis (breakdown of fats).At the same time, lipoprotein lipase is activated, which is involved in lipogenesis (fat formation) ^[13].

Other hormones and substances involved in lipid metabolism can potentially also influence the development of gynoid lipodystrophy, shifting the balance of the lipolysis-lipogenesis process towards lipogenesis ^[13]. Although, as noted above, obesity itself and local fat accumulation is not cellulite and does not always correlate with its severity.

Classification and stages of development of cellulite

Clinical data indicate that cellulite has several stages of development.At the same time, external manifestations are interconnected with tissue changes ^[1] ^[21].

Stage 1. There are no visual manifestations on the skin, either at rest or during muscle contraction or folds. Pathomorphologically, a slight thickening of the papillary layer of the dermis, an increase in capillary permeability, diapedetic microbleeds (associated with increased capillary permeability), spindle-shaped microaneurysms in postcapillary venules can be detected.

Stage 2. External symptoms in the form of small tubercles and depressions on the surface of the skin are visible when muscles are strained or the skin is gathered into a fold, they are not noticeable at rest. There may be pallor, a decrease in temperature and skin elasticity in the affected areas. Histologically determined:

hyperplasia and hypertrophy of connective tissue fibers surrounding adipocytes and capillaries;
thickening of the basement membrane of the capillaries;
microhemorrhages – areas with small hemorrhages, or bruises;
capillary ectasias (the so-called “spider veins”) – expansion of capillaries, small distal blood vessels located close to the surface of the skin.

Stage 3. Visual manifestations in the form of tuberosity and / or the so-called “orange peel” are noticeable at rest and become more pronounced with muscle contraction or gathering of the skin in a fold. A decrease in temperature, pallor of the skin persists. With deep palpation, pain may be felt. The pathomorphological sign is the division of adipose tissue into micronodules due to the surrounding of groups of adipose cells with collagen fibers, which at this stage is actively synthesized by fibroblasts.The border between the dermis and subcutaneous tissues is erased due to the increase in the volume of micronodules and the development of the process of sclerosis in them with the inclusion of adipocytes in the connective tissue of the deep dermis. At this stage, vascular changes occur: expansion of venules, numerous microaneurysms and hemorrhages in adipose tissue.

Stage 4. The visual signs are the same as in the third stage, only more pronounced. On palpation, large painful nodes adhered to the dermis are clearly expressed.Pathomorphologically, the subcutaneous tissue loses its lobular structure, due to the proliferation of connective tissue, macro-nodes are formed. The epidermis becomes thinner, its atrophy occurs, numerous telangiectasias appear (expansion of small vessels of the skin), microvaricosis of the affected area.

To assess changes and dynamics of manifestations in clinical practice, the Nuremberg-Muller scale ^[13] is used.

Stage 0 – the absence of irregularities on the surface of the skin in the standing / lying position or when taking the skin in a fold (pinch test).
Stage 1 – No irregularities on the surface of the skin in the standing / lying position. The pinch test reveals the “orange peel” effect.
Stage 2 – in a standing position, with muscle tension or when the skin is tucked in a fold, a moderate unevenness of the skin surface appears in the form of an “orange peel” effect.
Stage 3 – The orange peel effect is seen at rest, standing and lying down.

According to clinical manifestations, several forms of cellulite are distinguished ^[13].

Hard cellulite

Occurs in adolescents and young women who lead an active lifestyle, go in for sports. The tissues are dense, the severity of external manifestations does not change depending on the position (lying or sitting), stretch marks are often present on the skin. On palpation, the tissues are dense, slightly displaced; when the skin fold is captured, the “orange peel” symptom is determined.

Flaccid cellulite

Observed in women with a sedentary lifestyle.It is accompanied by a decrease in muscle tone and tissue laxity. May occur with a sharp decrease in body weight. The flabbiness of the tissues is noticeable during external examination: the tissues are shaken in time with the movements, when the position of the body changes. Disorders of microcirculation in the form of dilation of small vessels and microvaricose veins can be observed. There is information that this form can occur in women after 40 years in the event that before that they had a solid form of cellulite, but did not engage in its correction.

Edematous cellulite

It is manifested by an increase in the volume of the lower extremities and a positive Godet symptom (preservation of a visible impression on the skin after pressing with a finger).The skin is thinned, there are complaints of heaviness and pain in the legs. This is the most serious form of cellulite, but it is rare.

Mixed cellulite

It occurs most often and is characterized by a combination of different manifestations in different parts of the body ^[13].

Complications of cellulite

If you do not fight cellulite in a timely manner, then the visible clinical manifestations will intensify, and treatment will become difficult. The patient expects an increase in the symptoms of telangiectasia, microhemorrhage, paresthesia (sensitivity disorders).There may be heaviness in the legs, cramps (convulsions occurring against the background of insufficiency of capillary circulation), tenderness on palpation, as well as a decrease in the temperature of the skin of the affected area according to thermography ^[13].

The progression of cellulite with the subsequent increase in edema and tissue hypoxia leads to the formation of new blood vessels and an increase in adipocytes in size. In addition, the process of fibroblast proliferation is enhanced, with long-term existence this process leads to thickening and sclerosis of the connective tissue septa in the deep layers of the dermis and superficial layers of subcutaneous fat ^[13] ^[14] ^[15].An excess of estrogen prevents the absorption of fats and at the same time activates the process of their formation ^[13]. All this further complicates the treatment process, creating already irreversible processes that require radical treatment methods.

Diagnosis of cellulite

In addition to evaluating external manifestations, the diagnosis of cellulite also includes a Ricoux tetrad, which consists of the following signs determined by palpation:

increase in the thickness of subcutaneous tissues;
increase in tissue density;
Increase in sensitivity and soreness;
decrease in mobility.

Additional research methods can be used for correct diagnosis and assessment of the effectiveness of therapy.

To assess the effectiveness of the impact, anthropometric methods are often used – measurement of height, weight, circumferences of various parts of the body, calculation of body mass index. This method makes it possible to diagnose obesity and localized fat deposits. However, it cannot be used to assess the degree of gynoid lipodystrophy, since when these indicators change, the degree of cellulite may not change ^[22].

Bioimpedance analysis – measurement of electrical resistance of body parts in different parts of the body. Allows you to determine the percentage of fat and muscle tissue, since different tissues conduct electric current differently. For example, muscle is much denser than fat. The disadvantage of this method is that it does not assess the functional state of the tissues and does not reveal any disturbances in the microcirculation of the affected area ^[23].

Magnetic resonance imaging and computed tomography also determine only the volume of adipose tissue, but do not allow assessing the state of the dermis and microcirculation.In this regard, these methods are used only for the diagnosis of obesity ^[24].

Thermography is based on the measurement of thermal infrared radiation from the body and gives the true temperature of only the uppermost layer of the skin with a thickness of 2-3 mm. A direct relationship has been established between changes in body surface temperature and processes occurring in the body. Since the pathogenesis of gynoid lipodystrophy includes microcirculatory changes, the thermography method is suitable for assessing the severity of changes in cellulite.

The disadvantage of this technique is the measurement error due to high sensitivity to various external influences: ambient air temperature, exposure to sunlight, smoking, the phase of the menstrual cycle, etc. ^[13].

Ultrasound can be used to assess changes in gynoid lipodystrophy. When using a transducer with a frequency of 7.5-10 MHz, it is possible to assess the subcutaneous adipose tissue, visualize nodules, determine their diameter, as well as the state of the surrounding connective tissue.After the appearance of sensors with a frequency of 20-30 MHz, it became possible to visualize the papillary and reticular layers of the dermis and establish the presence of edema in this area. The use of Doppler ultrasonography makes it possible to assess the state of the microvasculature of the altered area ^[25].

Three-dimensional optical topography helps to study the skin microrelief from the obtained gradient images. The undoubted advantage of this method is its non-invasiveness and simplicity ^[34].

The most accurate method for diagnosing the stage of gynoid lipodystrophy is the histological examination of biopsy materials. However, due to its invasiveness, widespread use of this method is impossible ^[26].

Treatment of cellulite

Since the development of gynoid lipodystrophy is influenced by many factors and the process of pathogenesis includes various interrelated links, it is advisable to use an integrated approach for treatment, taking into account the stage of the disease and the prevailing symptoms.

Physical and mechanical methods of treatment

Vacuum massage

The use of this type of massage is based on the hypothesis of the development of cellulite due to impaired microcirculation in the affected area and the formation of stagnation and hypoxia here. The effect of vacuum improves microcirculation of the massaged areas, provides a lymphatic drainage effect, reduces the volume of these areas and increases tissue mobility ^[12] ^[27].

This type of massage includes instrumental and hardware techniques. The first include the use of vacuum cans, the second – special devices for vacuum massage.

LPG massage is done using a special attachment that captures a skin area using a vacuum and crushes it with rollers.

According to research, the effectiveness of the procedure may depend on the operator performing the procedure, as well as on the time, nature and intensity of exposure ^[12] ^[28].

Pressotherapy

The essence of this apparatus method of influence consists in sequential compression of body parts using a pneumatic massager in the direction of the lymphatic and venous outflow. The method is effective for lymphatic, venous or mixed edema, therefore it can be used as part of the complex therapy of gynoid lipodystrophy ^[29].

Electrophoresis

Galvanic current of low strength and low voltage, supplied through the electrodes, has a positive effect on the tone of smooth muscles.This leads to an increase in vascular tone following their expansion, which can have a beneficial effect on local metabolism. In addition, the current allows drugs to pass through the stratum corneum for local action ^[33].

Ultrasound therapy

High-frequency vibrations in themselves have a thermal and vasodilating effect, can be used for better penetration of drugs through the skin (phonophoresis).

Cavitation

Ultrasonic cavitation, which is based on the action of ultrasound, causes the destruction of fat cells and is used for invasive or non-invasive liposuction ^[12].

Radiofrequency lifting

The essence of the method consists in the thermal effect on the lower layers of the skin using RF-electric pulses. During radiofrequency therapy, chaotically located collagen threads are remodeled into unidirectional ones by the destruction of intermolecular hydrogen bonds, followed by the synthesis of new threads.Unlike most other techniques that act with heat, RF therapy is very mild and localized: only skin and subcutaneous fat cells are warmed up ^[35].

Laser therapy

As with RF therapy, collagen is remodeled in the skin matrix, but instead of electrical impulses, the thermal effect of the laser is used. Due to this effect, the visual signs of cellulite are reduced ^[36].

Manual massage

Intensive mechanical massage and manual lymphatic drainage are most often used for gynoid lipodystrophy.The technique of lymphatic drainage massage includes light rhythmic effects on the area of the lymph nodes, as well as in the direction of the lymphatic and venous outflow. Manual mechanical massage mainly consists of intensive rubbing, kneading and squeezing techniques. The main effect is to reduce local edema and, as a consequence, reduce the circumference of the massaged areas in the short term ^[30].

A common mistake of masters and a delusion of clients is the idea that massage for cellulite should be painful.The appearance of hematomas at the site of manual exposure is a technical mistake. Given the pathogenesis of cellulite, hematomas can lead to a deterioration in the condition of tissues due to the development of post-traumatic edema, hypoxia and subsequent fibrosis in this area.

Instrumental techniques for soft tissue mobilization

Soft tissue mobilization with special instruments (Graston technique, RockBlades) is actively used by chiropractors and chiropractors.These instruments can provide lymphatic drainage effect on tissues with the same effect as with manual massage ^[30].

Liposuction

Liposuction is an effective method of body shape modeling. However, its use in the fight against the manifestations of cellulite is not justified, since it often causes complications in the form of an increase in the roughness of the skin surface due to postoperative fibrosis ^[12].

Subcision

The essence of this method is to restore the anatomical structure of subcutaneous fat by destroying the connective tissue septa using a special needle ^[12].

Pharmacotherapy

Given the pathogenesis of gynoid lipodystrophy, it is possible to use drugs that affect adipocytes, connective tissue and microcirculation. They can be used systemically, locally and transdermally (through the skin) ^[12].

The drugs that contain methylxanthines have the greatest proven lipolytic effect. By blocking phosphodiesterase, they promote the breakdown of fats and reduce the volume of fat cells ^[37].

Among the drugs that affect the connective tissue, the most studied are organic silicon preparations. They inhibit the degradation of elastic fibers, as well as normalize the hydrophilicity (the ability to absorb water well) of the proteinglycans of the basement membrane of the capillaries. As a result, the permeability of the vascular wall is normalized, which prevents edema and tissue hypoxia. When exposed to fat cells, the synthesis of cyclic adenosine monophosphate is stimulated, which in turn provides lipolysis ^[31].

Substances that affect microcirculation include vegetable extracts rich in saponins, ginkgo biloba extract containing bioflavonoids, and rutin (one of the bioflavonoids included in the vitamin P group). They normalize the permeability of the vascular wall and increase the tone of the venous walls. In addition, they reduce platelet aggregation, thereby preventing the formation of microthrombi ^[32].

Cosmetics for home use

There are many creams, ointments and topical preparations for the treatment of gynoid lipodystrophy.Literature data indicate that the effectiveness of most of them in studies was not determined due to the great variety. Therefore, the use of such drugs is associated with the risk of allergic reactions ^[4].

Cryolipolysis

The method is based on cooling the subcutaneous fat and leads to the destruction of fat cells with their further absorption and natural processing by the body.

Lipolytic injections

There are lipolytic preparations of direct and indirect action.The former destroy the fat cell itself, while the latter only start the processes leading to the splitting of the fat drop. The action of indirect lipolytics is milder, but the cosmetic effect is less pronounced than that of direct ones.

Wraps

Wraps with warming, cooling or other anti-cellulite agents cause superficial irritation of the skin, which improves microcirculation, accelerates metabolic processes and lymph flow in the problem area. Also, essential oils can be used.

Consumption of collagen

It is hypothesized that the intake of collagen restores the firmness and elasticity of the subcutaneous fat, which helps to get rid of irregularities on the surface of the skin. However, there is insufficient scientific evidence for this hypothesis.

Proper nutrition

In combination with other methods, you can use the general principles of good nutrition. The diet is not used as an independent method of treatment.There is no specific diet designed to treat cellulite.

Physical activity

A sedentary lifestyle contributes to the accumulation of fat and the development of cellulite. For this reason, physical activity helps fight cellulite.

Forecast. Prevention

Although cellulite is not a disease, the prognosis of depends on the timely initiation of treatment. The sooner a person begins to use certain methods of correcting this condition, the sooner he will receive a favorable result.

Prevention of this condition consists in correcting risk factors, which implies maintaining a healthy lifestyle: balanced diet, regular physical activity, control of mental state, anxiety, elimination of stressful and psycho-traumatic situations. These measures will help prevent the appearance of cellulite and minimize its appearance in cases where it is impossible to completely avoid them.

Infectious cellulite – causes, symptoms of the disease, diagnosis and treatment methods

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication.In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

Cellulite: causes, symptoms, diagnosis and treatment.

Definition

Infectious cellulitis, or, as it is also called, streptococcal cellulitis, acute indurative cellulitis, bacterial cellulitis, is a deep inflammatory lesion of the skin and subcutaneous tissue, accompanied by induration, redness, swelling, pain.

Cosmetologists do not understand cellulite as an inflammatory process, but a lobular structure of subcutaneous adipose tissue, an uneven deposition of subcutaneous fat, which manifests itself externally as uneven skin. It is necessary to clearly distinguish between the dermatological nosology “cellulite” and the cosmetic problem “pseudo-cellulite”, or gynoid lipodystrophy.

Cellulite disease has nothing to do with an aesthetic defect, which is commonly referred to as “orange peel”.

Causes of the appearance of cellulite

Cellulite is usually caused by bacterial flora – group A streptococci, Staphylococcus aureus, pneumococcus.The process is associated with an open wound surface or a skin abscess. In some cases (with diabetic ulcers of the lower extremities, severe tissue ischemia, after animal bites), other microorganisms, mainly aerobic gram-negative bacteria, can become the cause of cellulite. Yeast-like fungi of the genus Candida , pathogenic fungi, parasites, viruses are considered rare causative agents of cellulite. There is an allergic variant of cellulite – eosinophilic cellulitis (Wells syndrome).

Cellulite on intact skin is called “erysipelas”.Erysipelas is an acute form of cellulite, which occurs with the involvement of the lymphatic tissue in the inflammatory process, where the pathogen multiplies. Erysipelas affects the upper layers of the skin, while cellulite spreads to deeper tissues. However, it is often quite difficult to draw a clear line between them, so they use a single term “cellulite”.

About half of patients with cellulite experience recurrences. The recurrent course of the disease is often associated with pathologies of the venous and lymphatic systems.As a rule, traumatic or surgical interventions cause the first manifestations of cellulite. Cellulite of the lower extremities usually occurs in older patients against the background of hypostatic phenomena (varicose veins, lymphostasis, etc.), as well as fungal diseases of the feet due to a violation of the barrier function of the skin.

Cellulite develops in places of skin damage as a result of microtrauma, cracks, cuts, burns, punctures, animal and insect bites, trophic ulcers, and edema of any etiology.The most susceptible to recurrent infection are patients with diabetes mellitus, obesity, liver cirrhosis, renal failure, as well as cancer patients and people who have foci of chronic infection or reduced immunity.

Most often, cellulite is localized on the legs, face, ears, although it can also affect other parts of the body.

Classification of the disease

The following clinical variants of cellulite are distinguished:

erythematous,
erythematous-hemorrhagic,
erythematous vesicular,
erythematous-vesicular-hemorrhagic,
erythematous-bullous-hemorrhagic.

Cellulite symptoms

The disease begins acutely, usually within 1-3 days after exposure to a provoking factor. The clinical picture of cellulite is characterized by diffuse redness with blurred edges, the area of inflammation is hot and painful on palpation. The lesions rapidly increase in size, becoming plaque-like and edematous. Sometimes there are red stripes – this is due to the transition of the infection to the lymphatic vessels, which become inflamed, causing hyperemia along the vessels.Cellulite develops more slowly and less acutely around the ulcers.

In the area of inflammation, there is a feeling of fullness, burning, pain. Redness in a few hours turns into bright erythema with clear uneven contours, edema and skin infiltration are observed. Blisters may appear often with hemorrhagic contents.

In severe cases (less than a third of patients), fever up to 38–40 ° C, chills, tachycardia, low blood pressure, headache, and general malaise are possible.

Diagnostics of cellulite

The diagnosis of cellulite is based on visual assessment of clinical manifestations and laboratory confirmation. The main diagnostic measures include:

complete blood count;

Which doctors should I contact

It is possible to prevent the development of cellulite at an early stage, therefore, when the first symptoms appear, you should consult a dermatologist, general practitioner (family doctor).It is recommended to consult a surgeon for patients with ulcerative skin defects if surgical treatment of the ulcerative surface is necessary. Consultation
a general practitioner and
an endocrinologist is needed in the chronic course of cellulite to exclude concomitant pathology and determine the required amount of diagnostic and therapeutic measures.

Treatment of cellulite

The basis of the treatment of infectious cellulite is antibacterial therapy, taking into account the sensitivity of the pathogen to certain drugs.Antibiotics of a wide spectrum of action are used, which is associated with the difficulties of laboratory verification of the pathogen. Antimicrobial cellulite treatment includes the use of antibacterial agents active against streptococci and staphylococci, for a course of 5 to 10 days in the case of uncomplicated cellulite. In severe forms of cellulite, antibiotic therapy is carried out using drugs that are effective against both streptococci and staphylococci, and gram-negative aerobic microorganisms, until negative culture results are obtained.If the inflammation is autoimmune, then antibiotics are not required. Corticosteroid medications are often prescribed to relieve inflammation.

Care for local foci of erysipelas and cellulite includes bed rest and an elevated position of the affected areas to reduce local edema. Cool, sterile saline dressings reduce pain and are especially indicated for bullous lesions. Applying moist heat can help localize cellulite-related abscesses.

Note that local therapy is indicated only for bullous, hemorrhagic manifestations of the disease.

In most cases of typically flowing cellulite, there is no need to prescribe topical agents – systemic antibacterial drugs are enough.
In complex and severe cases, surgery may be required to remove gangrene, tissue necrosis.

Among physiotherapeutic methods of treatment, the use of ultraviolet radiation, laser therapy and photodynamic therapy is recommended.Hyperbaric oxygenation is used in patients with progressive cellulite, when surgical excision of abnormal tissue may be crippling.

Complications

Cellulite treatment should be started immediately after the doctor prescribes it, and it is imperative to fully follow all recommendations. The patient should not stop treatment as soon as he feels improvement, otherwise the disease may spread, causing serious complications.

Complications of cellulite can be abscesses, osteomyelitis, septic arthritis, thrombophlebitis, bacteremia, necrotizing fasciitis, as well as lymphangitis and glomerulonephritis.

Recurrent infection of the lower extremities can be complicated by the development of dermal fibrosis and thickening of the epidermis. In older people, cellulitis of the lower third of the leg can be complicated by thrombophlebitis. In addition, inflammation of the subcutaneous tissue can trigger the development of meningitis.
In severe cases, cellulite turns into gangrene. In turn, gangrene is often complicated by necrosis, in which the affected skin and subcutaneous fat die off. This can lead to sepsis and death.

Prevention of cellulite

In order to prevent recurrence of cellulite, it is effective to use bicillin, which is injected intramuscularly. The duration of bicillin prophylaxis is 3 years, one prophylactic course per year.

The success of the preventive treatment of cellulite also depends on the effectiveness of the treatment of diseases that predispose to the onset and recurrence of cellulite – diabetes mellitus, mycosis of the feet, microcirculation disorders, carbohydrate metabolism.

To prevent cellulite, you need to observe personal hygiene, monitor the condition of the skin – it should always be clean, you should not allow it to peel or crack.

You should not get carried away with local antibacterial agents, as this can lead to a violation of the natural microflora of the skin and a weakening of its barrier function.

For the prevention of cellulite and erysipelas, it is necessary to adhere to the general recommendations:

Be careful when working with raw fish, poultry or meat;
when working with the ground, it is recommended to wear rubber gloves;
timely treat fungal infections; wounds on the skin must be thoroughly washed so that the infection does not get into the underlying tissues;
at the first symptoms of inflammation, you should consult a doctor.

Sources:

Plieva L.R. Cellulitis versus cellulite. Russian Journal of Skin and Venereal Diseases. 2015; 18 (6). S. 42-49.
Federal clinical guidelines for the management of patients with pyoderma. Russian Society of Dermatovenereologists and Cosmetologists. Moscow, 2015.
Plavunov N.F., Kadyshev V.A., Chernobrovkina T.Ya., Proskurina L.N. Features of the clinic and differential diagnosis of erysipelas. Overview. Archive of Internal Medicine.2017; 7 (5). S. 327-339. DOI: 10.20514 / 2226-6704-2017-7-5-327-339

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

Information checked by expert

Lishova Ekaterina Alexandrovna

Higher medical education, work experience – 19 years

90,000 causes of occurrence, under what diseases occurs, diagnostics and methods of treatment

IMPORTANT!

Gynoid lipodystrophy: causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment.

Women’s magazines are full of headlines about cellulite, and the phrase “orange peel” is not always associated with citrus fruits.

But in fact, what we used to call cellulite has another name – gynoid lipodystrophy.This type of lipodystrophy is based on a violation of metabolic processes in the subcutaneous fat. At the same time, fat is distributed unevenly under the skin, which leads to the formation of irregularities on the skin surface.

Lipodystrophy occurs in 85-95% of women, which is associated with the structural features of the subcutaneous fat and the influence of female sex hormones.

gynoid lipodystrophy is non-inflammatory structural changes in the subcutaneous fat in women, the key link in the development of which is local hypertrophy of adipocytes (adipose tissue cells).Gynoid lipodystrophy is not included in the International Classification of Diseases 10 revision (ICD-10), since it is not considered a disease;
cellulitis is an acute infection of 90,730 soft tissues, characterized by diffuse serous inflammation with hyperemia, edema and local soreness. In the typical course of uncomplicated cellulite, the subcutaneous fatty tissue with proper skin is affected, but in rare cases the inflammatory process can spread to deeper structures (fascia, muscles).

In men, body fat is distributed predominantly in the upper body, and in women, in the thighs and lower abdomen. The fat layer itself in women is thicker, and the skin, on the contrary, is thinner. The basis of subcutaneous fat is connective tissue fibers (mainly collagen).

Fibers form partitions, forming a cellular structure. In men, these cells are located diagonally to the surface of the skin, and in women – perpendicular. Therefore, the accumulation of fat practically does not change the relief of the skin in men, in contrast to the female figure.

It should be noted that the structure of subcutaneous fat is genetically determined and is different in all women. There is no direct relationship between overweight and lipodystrophy; it also develops in thin women.

There are several stages of cellulite development.

1st stage (“soft cellulite”). External changes are very weak. There is a slight swelling of the tissues, bruises and scratches heal more slowly than usual, when palpating the subcutaneous fat layer is soft.Changes take place at the cellular level. The permeability of small vessels increases, fluid is retained in the intercellular space.

2nd stage. Puffiness increases in the affected areas, appears the “orange peel” effect, which is noticeable when the muscles are strained or the skin is compressed. The elasticity of the skin decreases, the fat deposits become denser, the circulation of blood and lymph in the capillaries becomes difficult.

3rd stage (“hard cellulite”). The “orange peel” effect manifests itself at rest, in any position of the body.Swelling of the subcutaneous tissue is very pronounced. Disruption of microcirculation increases, bruises appear on the skin. The connective tissue thickens and grows, the accumulations of fat cells form nodes.

4th stage (nodal). Large knots are easily palpated, can form conglomerates that are painful to the touch. Expressed edema, which further interferes with normal blood circulation and enhances the pathological changes that began in the early stages. Stage 4 lipodystrophy requires mandatory treatment.

Complications of gynoid lipodystrophy:

– traumatized nodes easily suppurate, forming abscesses that are difficult to treat;
– enlarged nodes can compress the lymphatic vessels, thereby preventing the outflow of lymph.

Lipodystrophy can take several forms.

Hard cellulite. As a rule, visible only when the skin is folded into a fold – the “orange peel” effect is visible. Often accompanied by stretch marks – striae.This form of lipodystrophic changes is mainly found in girls and young women with an active lifestyle.

Flaccid cellulite. Characterized by sagging skin. The location of “cellulite” foci changes with a change in body position. Often accompanied by decreased muscle tone. This type of cellulite occurs in women over 40, especially after a sharp loss of body weight.

Edematous cellulite. After pressing on the skin, a fossa (depression) is preserved in the affected areas for several seconds.The skin becomes thinner, turns pale. This type of cellulite is often accompanied by swelling and a feeling of heaviness in the legs.

Mixed cellulite. The most common form. It is a combination of different types of “cellulite”.

Reasons for the appearance of cellulite

A number of factors influence the onset of gynoid lipodystrophy.

The most common are hereditary predisposition and hormonal imbalance. The causes of hormonal imbalances are pregnancy, the puerperium, menopause, depression, stress and the use of contraceptives.
Changes in the structure of subcutaneous adipose tissue can cause low levels of estrogen – female sex hormones.
Decreased production of thyroid hormones can also contribute to the appearance of cellulite.
Changes in the function of the pancreas affect lipid metabolism, which leads to impaired fat storage.
With varicose veins, the circulation of blood and lymph changes, swelling appears and a pathological process starts in the subcutaneous fat.
Kidney diseases affect the water-salt balance, which, as a rule, leads to fluid retention in tissues and provokes changes in the structure of subcutaneous fat.
With obesity or a sedentary lifestyle, the accumulation of fat in fat cells – adipocytes, increases, and lack of physical activity impairs blood circulation and contributes to the progression of the lipodystrophic process.
Rapid weight loss or significant fluctuations in body weight negatively affect the elasticity of the subcutaneous structures and also contribute to the development of gynoid lipodystrophy.

Thus, the appearance of gynoid lipodystrophy can accompany the following conditions:

Obesity.
Hypothyroidism.
Chronic pancreatitis.
Varicose veins.
Diseases of the urinary system (glomerulonephritis, chronic renal failure).
Polycystic ovary syndrome.
Depressive disorders.
Other.

Which doctors should I contact

Most often, women are worried about the appearance of the skin, and they turn to cosmetologists and plastic surgeons. However, doctors of different specialties can treat the immediate cause of this pathology: Diagnostics and examinations

To clarify the diagnosis, the doctor may prescribe:

Blood test for thyroid hormones (thyroxine – T4, triiodothyronine – T3, thyroid stimulating hormone – TSH), antibodies to thyroperoxidase, antibodies to thyroglobulin.

Stages and types of cellulite, effective treatments

Cellulite, or gynoid lipodystrophy, is a change in the structure of the patient’s subcutaneous fat layer. These changes lead to disruption of lymphatic outflow and microcirculation, resulting in damage to cells and intercellular substance in adipose tissue. It is difficult for cells to excrete waste products, however, the assimilation of substances begins to occur even more actively than in a healthy state.As a result, fat cells intensively accumulate not only fat, but also various liquids, toxins and other substances of little use.

The first symptom of cellulite is the edematous appearance of the skin, which it takes at the first stage of the development of the disease, shortly after the normal circulation of lymph and blood is disturbed. After a while, fat cells begin to gather in nodes, causing tissue fibrosis, or proliferation of connective tissue with the formation of scar changes. At this stage, the so-called “orange peel effect” appears, when the surface of the skin is covered with small bumps.

Causes of the onset and development of the disease

Despite the fact that the disease is extremely common among the fair sex, cellulite is poorly studied (however, not all doctors consider gynoid lipodystrophy to be a disease). It is only known that malnutrition is only one of the possible reasons for its occurrence. Cellulite can also form due to hormonal disorders, heredity, impaired peripheral blood supply, ethnic characteristics, a sedentary lifestyle, severe stress, smoking, and frequent weight fluctuations.

Stages of cellulite

In modern cosmetology, four stages of cellulite are distinguished. How to determine which of them is observed in a patient:

1) Pre-cellulite

The stage of cellulite is characterized by a slowdown in the intensity of blood flow in the capillaries, impaired venous outflow, an increase in the permeability of the capillary walls and the appearance of problems with lymph circulation. In other words, the entire state of the subcutaneous fat layer at this stage indicates the imminent occurrence of serious damage to it.
At this stage, the “orange peel” does not appear yet, but there is a significant decrease in skin elasticity, slight swelling of the tissues. It is possible to suspect the formation of cellulite by such a sign as the rapid appearance of bruises, even from weak blows.

The first stage of cellulite is the stage when a simple treatment can give the maximum effect. In this state, it is worth excluding fatty and spicy foods from the diet, quitting smoking, and increasing physical activity.It will also be useful to visit the sauna, use special creams and attend anti-cellulite massage sessions.

2) Initial.

If in the previous stage the pre-cellulite phenomena were not effectively eliminated, then the initial stage of cellulite begins. Toxins begin to accumulate in the tissues, oxygen starvation develops, and edema forms. The venous system ceases to cope with all the fluid that needs to be removed from the body, and as a result, the pressure inside the tissues increases.Due to the lack of oxygen, the connective tissue begins to acquire the shape of a “mesh”.
Externally, you can detect cellulite of the 2nd degree by taking the skin “in a fold”. When performing such an action, the effect of “orange peel” should appear, while in a relaxed state it will not yet be visible. In addition, the elasticity of the skin will continue to decrease in the affected areas, and pallor may appear.
In order to cure stage 2 cellulite, it is necessary to achieve the normalization of the processes of fluid circulation and oxygen delivery in adipose tissues.To the methods of treatment described for the previous stage of the development of cellulite, it is worth adding a special hardware cosmetology massage.

3) Micronodular.

Grade 3 cellulite occurs when damaged fat cells begin to fuse into clusters. Microcirculatory disorders and swelling become even more severe, and the “honeycomb” formed by the connective tissue begins to spread to more cells.
Externally, stage 3 cellulite already causes the “orange peel” effect without any additional actions, it is noticeable in any position of the patient’s body.Medium and small nodules can be palpated. With deep pressure on the affected areas with this degree of cellulite, painful sensations can occur.
Such signs of the stage of cellulite mean that diet and exercise alone, combined with gentle massage, with the help of which the second stage of cellulite can be eliminated, will no longer be sufficient to solve the problem. You will need to undergo a course of lipolipolysis or electrolipolysis, as well as ultrasound procedures.Power massage can also be used to treat this degree of cellulite, the photo of which you can see below.

4) Macronodular.

Grade 4 cellulite is the most severe form of the disease and is quite rare. At this stage, there is severe edema, lymph congestion, serious violations of venous outflow and an extremely extensive lack of oxygen in the tissues.
In patients who are diagnosed with stage 4 cellulite, edema and scars form, the nodes become large, clearly visible and more and more painful.On the surface of the skin, hardened areas and depressions are clearly visible. The disease can also cause a change in the temperature of the fatty tissue in the damaged area. The skin takes on a bluish tint. You will see this stage of cellulite photo below.

The fourth stage of cellulite is a pathological condition that will require serious treatment to get rid of. One of the most common methods of treating an ailment at this stage is liposuction. This procedure does not always mean surgical intervention, since modern technologies allow it to be performed even with the help of ultrasound equipment.As a result of liposuction, it is possible to restore normal blood flow and ensure adequate nutrition of the adipose tissue.

Types of cellulite

We have considered the signs of the stages of cellulite, but there are also several types of them:

Hard cellulite. This is the name of a disease in which the subcutaneous tissues acquire a granular consistency, become dense to the touch. Most often, dense cellulite forms on the legs of young girls or muscular women who are actively involved in sports.
Edematous cellulite. So they say in the event that the subcutaneous tissues become rather doughy to the touch, and touching them turns out to be painful. Most often, edematous cellulite can be found on the thighs of patients.
Soft cellulite. A mild type of disease occurs when the subcutaneous tissues acquire a spongy, loose consistency, and touching them does not cause pain. The ailment can be accompanied by striae and weakening of muscle tissue. This type of cellulite often forms on the abdomen, inner thighs, and arms.

How to remove cellulite? Cellulite treatment by professionals

The main causes of cellulite are:

1. Overweight or hypertrophy of subcutaneous fat.
2. Violation of blood microcirculation and venous outflow.
3. Consolidation of connective tissues.

Fat cells (or adipocytes) are found in connective tissue capsules. With the proliferation of subcutaneous fat, the vessels are compressed, due to which the blood supply and venous outflow deteriorate.Puffiness increases, which leads to even greater ischemia and hardening of the connective tissue septa, which thicken and lose their elasticity. All this together creates the “orange peel” effect.

BOOK A COSMETOLOGIST

How to get rid of cellulite?

Of course, proper nutrition and an active lifestyle are an important factor in the treatment of cellulite. But the most effective solution to this problem can be at the RTH clinic, with the help of innovative devices:

1.The Fractora Body Tite FX device helps to remove cellulite through liposuction by reducing the volume or thickness of subcutaneous fat. On average, it takes about 6-8 treatments to achieve the desired effect. The essence of the technique lies in the effect of a current of a certain frequency on adipocytes, which are destroyed by heating the fatty tissue.
2. LPG lymphatic drainage massage on the CelluM6 apparatus helps to improve blood microcirculation and venous outflow, eliminating puffiness. The course of anti-cellulite massage is about 8-10 procedures.
3. Conducting mesotherapy allows you to normalize the condition of the connective tissue. The cosmetologist individually selects, depending on the stage, an effective remedy for cellulite.

Mesotherapy cocktail of drugs is used for painless injections and does not require a rehabilitation period.

Thus, the Real Trans Hair clinic has the most modern technologies and tools that help remove cellulite and eliminate all the causes of its occurrence.Say goodbye to orange peel forever and regain your self-confidence!

90,000 Cellulite treatment: stages, causes, methods of getting rid of

Outwardly, it looks like an uneven surface, alternating bumps and depressions. This is not just an external defect, cellulite impedes the circulation of blood and lymph, and stagnation occurs in the locations of fat cells, toxins and toxins accumulate.

Help! The orange peel effect is observed regardless of age, gender, race, weight and athletic performance.But after 30 years, the dermal layer of the skin is no longer as strong and elastic and cellulite appears in every second woman. But in men, cellulite is formed less often – this is due to the structural features of the subcutaneous fatty tissue, a different hormonal background and vascular tone.

Do I need to get rid of cellulite

Cellulite is not dangerous to health and does not need treatment in its initial stage. Moreover, small dimples in the skin can be regarded as an indicator of health.

A doctor’s consultation is needed when the fat deposits are so deformed that they disrupt the nutrition and blood supply to the tissues.

The desire to make the skin perfectly smooth at any cost is an understandable desire for perfection. The procedures that cosmetologists recommend to combat cellulite really locally heal the skin and have a beneficial effect on the body. And if you act in a complex way, combining sessions in the spa with the transition to a healthy lifestyle.you will not only get rid of the “orange peel”, but also avoid many diseases and early aging.

Stages of development of cellulite

The causes of cellulite are different – stress, malnutrition, sedentary lifestyle, long heels and heredity.

There are three degrees of cellulite:

Initial stage. The skin looks smooth, but if you press on it with your finger or lightly squeeze it, dense small nodules appear.The skin is not elastic enough, loose, with the first signs of swelling. A slight pale shade appears.

It is possible to change the situation; it is enough to improve blood circulation and nutrition of problem areas with the help of lymphatic drainage procedures.

Development of cellulite. To detect bumps and depressions in the subcutaneous tissue, you no longer need to press on the skin. It is easy to feel by touch seals and subcutaneous nodules, similar to scars. Outwardly, the skin is pale, cold, sensitive, and painful in places.Edema is clearly expressed.

At this stage, lymphatic drainage is not enough, they will be complemented by spa treatments and thermal effects with mud wraps. This will restore muscle firmness. The course of treatment is long, at least 6-8 weeks, followed by at least a long supporting stage.

Stage of development of fibrosis. The subcutaneous nodules become larger, the cavities between them harden, the compartments between the tubercles of cellulite are clearly visible. The skin in the affected areas is painful and paler and colder to the touch than other areas of the body.Bruises and scrapes in areas with cellulite take longer to heal.

Enlarged fat cells inhibit the flow of blood and lymph, edema is clearly visible. Fibrosis is formed – fibrous connective tissue that reduces the functionality of the skin.

Fibrosis and excess fat deposits can be removed and flushed out with the help of medical procedures, so that the blood vessels and tissues are relieved of the pressure. The course of treatment will last at least 3 months, supportive therapy will include regular weekly therapeutic and prophylactic measures.

Diagnostics

Most often, the presence and degree of cellulite is assessed by a doctor based on the results of a visual examination. In this case, the thickness of the skinfold is measured (plikometry) and the circumference of the thigh. The results of such measurements are subjective and not always accurate.

A new accurate method for the diagnosis of cellulite – contact thermography. The thermograph records the temperature difference that occurs in the area affected by cellulite due to a violation of the blood circulation.Depending on the development of the pathology, the patient’s thermal map will be different – it can show stagnation of blood and lymph, nodular thickenings. Thermography will reveal areas of cellulite that are not detectable by palpation.

Systemic cellulite treatment is carried out by the following specialists:

cosmetologist;
endocrinologist;
angiosurgeon;
surgeon.

How to cure cellulite

It is very difficult to completely get rid of cellulite , since it is impossible to remove subcutaneous fat.It cannot be lost, like regular fat, through exercise and a special diet, but you can restrain unwanted body work. This requires:

Lead a healthy lifestyle. Give up bad habits and smoking, because nicotine destroys vitamin C, which is responsible for tissue regeneration. Compliance with the daily regimen will start the natural processes of rejuvenation. Physical activity and adherence to the drinking regime will prevent dryness and loss of elasticity. It is important to avoid stress, excess weight.
Eat right. It is the basis for a good metabolism, cell and tissue health. The basis of the menu should be low-fat protein products, fiber, cereals, dairy products, vegetable oils. But sausages, coffee, pastries, sweets, pickles and pickles are prohibited. You will have to follow the principles of a balanced diet and avoid harmful effects forever.
Go in for sports. Movement is the main enemy of cellulite, it improves blood and lymph circulation, burns fat.Running, Nordic walking, swimming, cycling, skiing, fitness work great.

Surgical removal of cellulite is prescribed by a doctor in extreme cases, it is a complex operation and it does not always solve the problem once and for all. As complications, defects and deformation of the skin surface can appear.

Effective methods of cellulite treatment

Local treatment is based on methods of lymphatic drainage, lipolysis (fat breakdown) and forceful breaking of subcutaneous fat capsules.When used correctly, these methods help restore the elasticity of the connective tissue.

The most commonly used:

wraps for problem areas with mineral mud, salts, plant extracts. The procedure enhances microcirculation and drainage;
mesotherapy – targeted introduction of cocktails of active substances under the skin. So metabolism, tissue repair and fat accumulation are destroyed at times;
massage – manual, hardware, and subsequently supporting self-massage.Breaks down fat capsules and makes the skin more elastic;
ozone therapy. Ozone restores damaged tissues and starts cell metabolism;
LPG massage, combines the action of vacuum, roller and vibration massage. Accelerates lymph flow, eliminates edema, breaks down fat accumulations;
shock wave therapy. The structure of tissues is restored by the directed action of low-frequency sound waves. This is an excellent way to treat cellulite, the effect comes after two procedures;
electrical stimulation.”Orange peel” changes its structure under the influence of small current discharges;
carboxytherapy – carbon dioxide treatment. Improves blood circulation;
RF lifting (thermage) – due to the activation of molecular processes, the tissue affected by cellulite is heated. Therefore, lipolysis is more active, a collagen framework is formed, and edema disappears.
Ultrasonic cavitation, directed at destroying fat cells using ultrasound.

Vitamin and tonic supplements, sorbents, neutralizing toxins, digestive stimulants and decongestants are used as an addition to the treatment with devices and in keeping with a healthy lifestyle.

Attempts to get rid of cellulite with the help of miraculous creams and dietary supplements are ineffective.