Ask any 10 women about cellulite, and 8 of them will probably respond with grimaces, eye rolls, or exasperated sighs - while those lucky other two shrug and smile. Cellulite shows up on the buttocks, thighs, and bellies of so many women, and yet it's considered a flaw, a condition - even a disease! Squeeze it, pinch it, poke it, or try to hide it under concealing clothes or beneath the shade of a tan, but it persists. Oh, cellulite, so common, so hated, yet so misunderstood...

What is cellulite? Proteins just beneath the skin's surface form a layer that gives skin its elasticity. These fibrous cords also connect our skin to our muscle. Between the skin and the muscle lies a store of fat. When the fat presses against the fibrous net, you get that familiar dimpled flesh effect of cellulite with its "orange-peel" or "cottage cheese" appearance. It's the same effect you'd get if you pulled a net down over a blob of jelly. While it is not a pathological condition, cellulite is an aesthetic problem most commonly forming around the areas of the hips, thighs, and buttocks. It can also be found on the breasts and upper arms.

Why does cellulite happen? The fibrous layer beneath our skin can become stretched or less able to rebound. As we age, our skin naturally loses some elasticity, so that layer of fat beneath the skin becomes more visible. Weight gain can also make cellulite more apparent, as excess fat strains against the skin. However, cellulite can also be present in thin people, because everyone has layers of fat beneath the skin surface. Other risk factors include genetics, diet, and hormone changes.

Who gets cellulite? Cellulite shows up on the skin of women of all shapes and sizes, from supermodels to super-moms, from skinny-minny socialites to the woman next to you on the morning train. A sedentary or stressed-out life may predispose a woman to cellulite.

Why do men rarely have cellulite? First off, men gain less weight around their thighs and hips than women do. And men's thicker skin and way of storing fat - their fat-storing cells are smaller so they store fat in smaller amounts - rescue them from the blight of bumpy cellulite.

Can you get rid of it? Women try melting it, massaging it, and medicating it away. Some even wear anti-cellulite skivvies, specially designed undergarments that work a bit like support hose. But no cream, potion, or treatment has been scientifically proven effective in miraculously zapping cellulite. Even those treatments that result in minimal improvements don't tend to hold up over time.

The simple fact is that cellulite is a result of fat. You can mask fat or hide it, but you can't magically erase it. To shake off cellulite with lifestyle changes, you'll need to do the same sorts of things you'd do to get rid of other body fat: eat a healthy diet, high in fibre and low in fats, drink plenty of water, and stay active with regular cardio and strength training exercise. Massage and stimulation of your circulation may help, too, though it's just another of the many scientifically unproven theories about cellulite.

With recent advances in cosmetic technologies, there are many promising treatment options for cellulite reduction. But there is not yet an effective single treatment available for a long-term solution. Remember, cellulite is not a pathological condition! As long as you are living a healthy lifestyle and keeping a positive self-image, a few ripples shouldn’t concern you too much.

Cellulite fighters: Sensible or silly?

Here's a quick run-down of some of the ways we've tried to fight cellulite:

We've tried to tighten our skin. Suction, mechanical massage, and light-based devices using infrared light and radiofrequency energy were tried to tighten the skin and improve the appearance of cellulite. The devices, such as VelaSmooth and VelaShape, demonstrated some improvement; however, their long-term effectiveness is not proven. One of the notable side effects is post-treatment bruising.

We've tried to vacuum out the fat. Liposuction or more refined "ultrasonic liposculpturing" have been used to try to eliminate the fat at its source. However, these techniques have been ineffective in reducing the appearance of cellulite and may make the cellulite appear worse.

We've tried to shrink the fat. Could slathering on creams shrink fat cells and smooth out the cellulite ripples? Clinical results on caffeine, herbals, and retinol varieties have demonstrated some improvement, but long-term follow-up is needed.

We've tried to shrink the fat chamber. If there's less space for fat, there will be less fat, right? That's the logic behind subcision, in which an 18-gauge needle is inserted into the skin to, in effect, snap the fibrous cords that web beneath the skin. Bruising, pain, and poor research reporting mar the results of clinical testing of the treatment.

Amy Toffelmire