CELLULITE, CELLULITIS and ORANGE PEEL--SKIN

CAN  an ORANGEPEEL--SKIN  EFFECTIVELY
be REVIVED to a PEACH--SKIN ?

It may clear up things when we point to the distinction between
 º Cellulitis (French: Cellulite, German: Zellulitis),
 º Orangepeel-skin (French: Peau d'orange, German: Orangenhaut),
 º Overweight.
  • Cellulitis is an infection caused by microbes. It can be treated by antibiotics. Patients often refer to cellulitis when they mean "orangepeel" or "Orangenhaut". In that case I shall use "orangepeel" in this page.
  • A built up overweight is often called cellulitis by patients. It is not so. Overweight can be treated very effectively, see this website. The orangepeel-skin of the same patient can hardly be corrected.
What has gone wrong in an orangepeel-skin ?
The human skin varies considerably in its composition over the body. Compare the skin of the lips, the face, the back of the hand. An orangepeel skin is found on the thighs, not in the face or at the chin. The next part concerns skin where orangepeel formation is frequently found.
The skin has been built up from three materials, collagen, elastin (elastic fibres) and amorphous mass. The collagen is synthesized by fibroblasts, in soluble form. It will get a "hard" form by polymerization. It will find its way around fatcell structures and form a rigid structure by cross-linking. With growing age the forming of soluble collagen falls back, the hard form lasts a lifetime.
The cross-linked collagen connects skinspots by collagen-strings with the underlying layers. When excessive fat is stored under the skin the skin layers dermis and epidermis (outerskin) and the horny layer (see also the images connected to the mainpage) will be gradually pushed outward between the fixed skinspots (which cannot move because they are hold by the collagen strings). The effect shows like a padded Chesterfield sofa. This is what in the case of excessive fat is called orangepeel. The lumps of fat are separated by septae, partitions of rigid collagen forming a compartmented layer filled with fat, under the skin.
 
What would be needed to "reconstruct" the skin
The answer is simple however difficult to realize:
1. The collagen strings and the septae in the subcutaneous cell tissue must be destroyed, that is broken up into smaller molecules that can be carried off by drainage.
2. The skin must rebuild its collagen structure; that requires new synthesis of collagen in soluble form.
  * With aging a human's capacity to synthesize collagen falls back.

Breaking down the collagen structure.
what happens when Liposuction or Lipolysis is applied?
Liposuction works on the fatcell layer below the dermis, so will also affect the collagen septae but only accidently the collagen strings that pull the skinsurface down. Between collagen strings the pushed-up skin may contract more or less because of the elimination of the pressure. Whether this happens, depends on any trace of remaining skin-elasticity with aging.
Electrolipolysis will not ionize the collagen structure however will improve circulation. It may stimulate the functioning of the elastic fibres.
 
Liposuction and Electrolipolysis both being effective in weight reduction, neither Liposuction nor Lipolysis will result in a major improvement of the appearance of the orangepeel skin.
 
A candidate to (partly) break down the structure of an orangepeel- skin however is ultrasound with its capacity to split large molecules. Applied frequencies are 3 MHz (typical penetration depth 6-7mm) or 1 MHz for deeper penetration (typically 11-12mm). (The ultrasound frequency applied to measurement is higher, till 20 MHz, to acquire sufficient accuracy.)
 
How to induce the generation of new collagen?
Theoretically one would think of injecting collagen subcutaneously, as it is known from injecting wrinkles with collagen to smooth and stretch the skin of the face. That however would not prove a very practical idea:
1. The amount of collagen needed would be a multiple of that used to smooth wrinkles; collagen is very expensive.
2. The collagen available is bovine not human by origin; it has to be tested for allergic reactions of a patient for quite some time before application can be approved.
3. The injected collagen seems to remain passive, that is induction of skin-restructuring activity if any has not been proven to our knowledge.

Another option is to bring a material into the skin from which the skin can synthesize its collagen. The basic material is vitamin-A related, see box.
Kligman cs.  31 ) have performed a double-blind test with retinol to a group of woman aged 28 to 45 years. The age is interesting because of the decreasing capacity with age to synthesize collagen and the increasing crosslinked degree with age.
The retinol had to be stabilized (by the addition of antioxydants). Earlier research has proven that the retinol is converted to retinoic acid (RA) in the skin. RA is active in the generation of new collagen. Kligman cs. found a considerable increase of collagen in dependance of the retinol treatment.
 
Conclusion : for the treatment of orangepeel skin (also referred to as cellulite) the tools for breaking down the orangepeel structure and reconstructing a smooth skin structure are emerging. The application of ultrasound to breakdown the orangepeel- collagen structure and retinol to induce a reconstruction of the skin seem promising.
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Cellulitis is an infection of subcutaneous tissue or of the skin, caused by microbes after an injury or after an insect bite. Treatment requires antibiotics.
The rugged skin of an obese person is not infected, it does not suffer cellulitis, it is an orangepeel skin.

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Vitamine-A / Retinol
 Many animals produce vitamin-A, plants produce a provitamin-A only, the carotenoids.
Vitamin A is unstable when exposed to light, air or heat.
Vitamin-A occurs in several forms:
"vit-A ALdehyd" or "retinAL",
"vit-A ester" or "retinyl ester".
"vit-A alcohOL" or "retinOL",
"vit-A acid" or "retinoic acid",
They differ in instability.
Retinal historically refers to the vitamin A function in the retina of the eye.
Retinyl is a rather stable form used for vitamin A storage in the body.
Retinol or after conversion the very unstable retinoic acid is used for collagen synthesis.
Retinol is an OtC article. The basic material is not expensive, however the addition of stabilizers (see left), euphemistically called your UV-protection, and sometimes a time-release mechanism may rise the retail price.
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Active and Inactive Fat cells