Dimples are adorable on freckle-faced children but not on the back of your legs. Bearing a resemblance to the skin of an orange peel or cottage cheese, the dents and puckers in skin (usually found on the buttocks and thighs, but also on the backs of arms and stomachs) show up around puberty and last throughout life. If you have a lot of clients asking about how to solve this woe, don't be surprised. More than 90 percent of women are affected by cellulite, and since myths and misconceptions of its causes and treatments abound, your clients may be looking for answers and effective services. Lucky for them, you're a professional. And whether you're experienced in cellulite treatments or thinking about introducing them, our guide will help you help them bare their arms and legs.
fact vs. fiction
Cellulite doesn't discriminate—it occurs in heavy people and skinny people alike, says body therapist Linda Brennan of Jacqueline's Advanced Skin Therapy in Dartmouth, Massachusetts, who treats the cellulite of her clients ages 18 to 68. That's because the layer of fat cells that cause the appearance lie just under the surface of the skin. When the skin's cells and connective tissue deteriorate and weaken, the lumpy fat beneath the dermis becomes visible. Due to hormones and the fact that women's fat cells tend to lie closer to the skin, females make up the majority of cellulite sufferers.
"It's a skin problem, not a fat problem," says Dr. Howard Murad, who has developed his own cellulite-fighting program. That means losing weight or undergoing liposuction will not get rid of this subdermal fat layer—but aiding skin mechanisms can help restore a smooth, unrippled appearance to the skin.
Alas, though modern science can put a man on the moon, there is no real cure for cellulite, say experts. They do agree that genes and age play a role in cellulite formation, while smoking, stress and lack of exercise are all thought to be contributing factors due to their tendency to thin skin and lead to loss of tone. However, experts denounce what doesn't help fight cellulite, including treatments that merely dehydrate the body, which may temporarily reduce the size of thighs, but not actually decrease the subcutaneous fat layer. When fluids are replenished, "the body will return to its same size," says Dr. Murad.
Recent technological developments have made it easier than ever to efficiently and effectively improve skin texture. The original innovation, Endermologie, kicked off the trend nearly two decades ago with its motorized rollers and suction that acts as a deep tissue massage to increase skin circulation and stimulate connective tissues. Brennan says her clients see quick and significant results. "Endermologie is wonderful for reducing cellulite, losing inches, and toning the skin," she explains. "It really recontours the body." A series of 35-minute treatments, followed by periodic maintenance treatments, are required to keep up the smoother results. Recently, LPG, the parent company of Endermologie, introduced Wellbox, a personal use version of the professional machine that retails in spas and physician's offices for $1,600. Even at that price, "Wellbox is experiencing zero price-resistance," says an LPG spokesperson.
Similar deep-tissue massage techniques are employed by cellulite machines from Bio-Therapeutic, Diamond Countours Systems, Synergie and Silhouet Tone. Besides helping tone skin, these machines reduce muscle tension and soften connective tissues. But they can go even further—for example, Silhouet Tone's Slim Concept machine integrates electrical currents to stimulate skin cell function and break down fat. In the course of 10 sessions, consecutively stronger currents are used on the skin for optimal effects. And at American Laser Center medical spas, the VelaSmooth machine uses infrared light and radio-frequency waves to heat underlying tissue in conjunction with the vacuum technology for increased benefits. The results are real: Medical director Dr. Kathleen Gilmore says that more than 85 percent of patients in a clinical study showed dramatic improvement in the reduction of visible cellulite and reduced thigh circumference after undergoing treatment protocol. "They did not actually lose weight, but they looked as though they had," she says.
As with any of these machines, treatments can be adapted to your client's needs. At Fusion Medical Spa in Naperville, Illinois, Dr. Jennifer Wise generally recommends a combination of procedures for each patient. "We might combine Endermologie with ultrasound for a better effect—the program could take anywhere from three to five treatments, or 15 to 20, depending on the person." She also carries a range of home care, from creams to algae baths, because, she notes, "the same things that created the cellulite will keep coming back."
anything but basic
Even the right creams and nutrients can provide a big benefit, as well as offer a less expensive option on your service menu. Murad's Firm and Tone Serum, a topical solution, uses cat's claw, horse nut tree extract and cayenne pepper to refine skin texture and stimulate blood flow. Used together with the Firm and Tone Dietary Supplement Pack—a complex that includes glucosamine, essential fatty acids and goji berry extract—the total regimen improves skin function and elasticity from the inside and the outside. "These are key nutrients," explains Dr. Murad. "We looked at the way the body actually works and then addressed the issue." The nutrients revitalize the skin and can even help diminish stretch marks.
For a more spa-like feeling, therapists might consider creating a multi-step body treatment that addresses all the issues cellulite presents. A three-pronged approach like the one from Biotone Spa will appeal to traditional clients who want pampering with their results: First, perform a stimulating exfoliation using a sea salt glow, then apply a firming seaweed mud. Finally, perform a massage that incorporates rolling and percussion to increase circulation. Even a stand-alone massage that incorporates manual lymphatic drainage can also be beneficial, notes Dr. Murad.
For a complete summer shape-up, Brennan suggests combining a targeted cellulite service with a sunless tanning series. (See page 90 for more about sunless tanning.) Smooth skin will look great with a little color, she says, and the darker tone can also help camouflage any trouble spots that remain. With the right custom program, your clients' lumps and bumps will be nothing but a memory.
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