HOW DOES IT FORM?
To understand the physiopathology of cellulite, it is of interest to know the structure of the skin and subcutaneous tissue and the difference between males and females.
The skin is the largest tissue of the human organism. It is constituted by 3 layers, situated horizontally, from the surface to the deepest: a) Epidermis (surface layer) b) Dermis (middle layer) c) Hypodermis or subcutaneous tissue (deep layer). To these layers are added other structures like hair, nails, sebaceous glands and sweat glands.
The epidermis constitutes the surface stratus or eternal part of the skin, it is thin and its surface cells become cornified.
The dermis is made of connective lax tissue composed by a certain cellular component (fibroblasts, among others), fibrous proteins (collagen, elastin), amophic fundamental substances (water, mucopolysaccharides, salts and glycoproteins) and a migratory cellular component (lymphocytes, plasmocytes, leucocytes). It is crossed by blood vessels, lymphatics and nerves.
The hypodermis is formed by a connective lax tissue made of large lobes of fat tissue (between 0.5-1.0 cm) limited by walls in the thin collagen fiber perpendicular to the surface (reticulae cutis), scant elastic fibers, blood vessels and lymphatics (adipose figures). It is in this layer where the primary alterations of cellulite reside.
The cause of the difference in the appearance of cellulite between males and females lies in the distinct disposition of the structure of the subcutaneous tissue between the sexes. In women, the lobes of fat tissue of the hypodermis are larger and are separated by thin walls of connecting tissue disposed to form perpendicular to the dermis; in addition, the separation of connective tissue between the deep dermis and the hypodermis is irregular and discontinuous. However, in males and females not affected by cellulite, these connective walls are thicker and are distributed in a polygonal pattern, sitting on a dermis-hypodermis separator of connective tissue that is flat and continuous. Due to these differences, the fat tissue is capable of protruding towards the surface, giving way to the appearance of 'orange skin'.
Mechanical pressure (pinch) is done and then, the appearance of an irregular surface on the woman, due to said pressure, is distributed exclusively upwards. In men this pressure is reflected in all directions and more than anything downwards, making for a more regular and flat distribution.
This different disposition of tissue comes hormonally conditioned (through the action of androgens), and the said changes begin to be noticed when testicular function begins in puberty of the child. At the same time, boys with a severe deficit of androgens (primary and secondary hypogonadism) present with the appearance and distribution of cellulite similar to that of a woman.