“For the last two decades I have been following all research relative to cellulite and the paper referenced below (Cellulite: from standing fat herniation to hypodermal stretch marks) is one of the best ever written on the subject. Indeed, we can say that cellulite is an example of deep, vertical stretch marks (as opposed to the most superficial and horizontal stretch marks proper) but with one added component that adds complexity and makes cellulite even more difficult to treat: superficial fat accumulation. ”
Cellulite and stretch marks on legs: are they connected?
Stretch marks vs cellulite | In summary
Similarities and differences between cellulite and stretch marks
Stretch marks, cellulite, dermis and hypodermis
Cellulite, stretch marks, estrogen and menstrual cycle
Early treatment and prevention are preferred for both cellulite and stretch marks
How rapid expansion, stretch and consequent contraction of connective tissue results in cellulite and/or stretch marks
Stretch marks, cellulite, collagen and elastin
How to treat cellulite and stretch marks
Radiofrequency and ultrasound for cellulite and stretch marks
Laser treatment for stretch marks and cellulite
Natural cream actives against both cellulite and stretch marks
Real cellulite / stretch mark creams
Cellulite: from standing fat herniation to hypodermal stretch marks
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Stretch marks vs cellulite | In summary
Cellulite and stretch marks share many features but differ significantly: stretch marks affect only connective tissue, whereas cellulite involves adipose tissue, connective tissue, and blood or lymphatic vessels, making it more complex. Stretch marks develop in the dermis, cellulite in the deeper hypodermis, and both are unaffected by superficial methods such as exfoliation, dry brushing, or chemical peels. Deep microneedling can help stretch marks slightly but has no effect on cellulite.
Both conditions typically occur in women of reproductive age, reflecting hormonal influences, particularly oestrogen, on collagen and elastin metabolism. They are easier to treat in early stages: red or purple stretch marks respond better than white, established ones, while early-stage cellulite is more manageable than hardened, painful forms. Both arise from connective tissue expansion—skin stretching from weight gain or growth spurts in stretch marks, and fat cell expansion in cellulite—followed by tissue shortening through myofibroblasts.
Both conditions involve disrupted fibroblast collagen and elastin production, so fibroblast stimulation and collagen remodelling are important. Treatments include high-power radiofrequency for skin tightening and collagen stimulation, ultrasound for deeper tissue remodelling, and certain lasers for stretch marks (though lasers are too superficial for cellulite).
Natural active compounds beneficial for both include EGCG from green tea, curcumin from turmeric, centella asiatica triterpenes, forskolin, and caffeine, which aid tissue healing, collagen remodelling, and microcirculation. Caffeine and forskolin also help reduce fat and inhibit scar-related proteins.
Many creams fail due to low concentrations of active ingredients, but high-purity, multi-ingredient formulations—combined with healthy nutrition and exercise for cellulite—can improve appearance, especially early on. For best results, a course of 6–12 deep-acting radiofrequency and ultrasound treatments, plus a quality cream used for at least three months, can reduce and prevent both cellulite and stretch marks. However, complete or permanent removal should not be expected.
Similarities and differences between cellulite and stretch marks
As many women instinctively know, cellulite and stretch marks are intimately connected.
There are many similarities, described below, and one major difference: stretch marks only involve connective tissue while cellulite involves adipose tissue, connective tissue and blood/lymphatic vessels.
Because of cellulite affecting three types of tissues, it is much more complicated than stretch marks.
Stretch marks, cellulite, dermis and hypodermis
Both stretch marks and cellulite are relatively deep structures:
Stretch marks occur in the dermis
Cellulite occurs deeper still, in the hypodermis
In both cases, silly epidermal approaches such as dry brushing, exfoliation and chemical peels do absolutely nothing (despite what silly consumer magazines, blogs and tiktok videos claim).
Microneedling may help stretch marks a bit - if it is quite deep - but it does nothing for cellulite.
Cellulite, stretch marks, estrogen and menstrual cycle
For starters, both problems typically occur in women of reproductive age, implying a connection with estrogen and the menstrual cycle, which together affect and often undermine collagen and elastin metabolism.
Early treatment and prevention are preferred for both cellulite and stretch marks
Both stretch marks and cellulite are notorious to treat and are reduced more easily when treatment starts early.
In the case of stretch marks, red/purple stretch marks (striae rubrae) have more chances to be reduced in size and to fade away when treated early.
White stretch marks (stria albae) are very difficult to treat, as they represent established skin tissue damage.
In the case of cellulite, treating it at the earliest stages (cellulite Stage 1), or better still preventing it while it is at the pre-cellulite stage, is much more effective than waiting until it becomes hard, puffy and painful, years or decades later.
How rapid expansion, stretch and consequent contraction of connective tissue results in cellulite and/or stretch marks
Both stretch marks and cellulite occur after connective tissue expansion.
In the case of stretch marks we have rapid skin expansion due to weight gain or due to sudden growth in teenagers.
In the case of cellulite we have rapid fat globule expansion which stretches:
The connective tissue sheath that is wrapped around fat globules (periadipose fascia)
The connective tissue strands (retinaculae cutis) that anchor the surface of the skin to the fascia underneath (also know erroneously as septae)
So in both cases, stretch marks and cellulite, we have sudden tissue stretching, which eventually leads to reactive shortening of connective tissue by specialised cells, the myofibroblasts.
In fact, the research paper referenced below states that cellulite is, to some extent at least, a vertical stretch mark issue.
Of course, hypodermal fat tissue accumulation is the elephant in the room, when it comes to cellulite and cellulite is not just a stretch mark / connective tissue problem.
Stretch marks, cellulite, collagen and elastin
In both stretch marks and cellulite, we have a disturbance in fibroblast collagen and elastin synthesis and breakdown, so both aesthetic conditions respond well to a stimulation of fibroblast function and to collagen remodelling efforts.
Again, in both cases, and for different reasons, more than plain fibroblast stimulation is needed, but it remains a good starting point for treatment.
In both cases, collagen remodelling is also important. Collagen remodelling refers to breaking down excessive/misoriented scar tissue collagen, which is also characterised by lack of elastin fibres, and replacing it with fresh functional collagen, rich in elastin.
This is easier said than done, in most cases, but it can gradually happen with deep-acting, high-power radiofrequency and deep-acting, high-power ultrasound cavitation, as well as several natural molecules which are known to do exactly that (more on that below).
How to treat cellulite and stretch marks
Of course, in addition to treatments and creams, cellulite also requires diet and exercise in order to “empty” the enlarged superficial fat cells.
Fat tissue aside, treatment for both stretch marks and cellulite is quite similar, because all the techniques and active molecules used for cellulite will also help with stretch marks too.
White stretch marks are visible and well-established scar tissue, so they will improve at a much slower pace than cellulite.
Red/purple stretch marks can improve much faster than either cellulite and white stretch marks.
Radiofrequency and ultrasound for cellulite and stretch marks
High-power, deep-acting radiofrequency is widely accepted to be the most effective and SAFE technology for skin tightening and collagen/elastin stimulation and thereby for both stretch marks and cellulite.
However, ultrasound is better for tissue remodelling than radiofrequency, so it is also very useful.
Laser treatment for stretch marks and cellulite
Certain laser treatments that penetrate into the dermis can help - partially, not fully - remove stretch marks.
However, all lasers are just too superficial for cellulite, as they cannot penetrate into the hypodermis.
Natural cream actives against both cellulite and stretch marks
The main natural active molecules that can help with tissue remodelling are:
EGCG from green tea
Curcumin from turmeric
The four triterpenes found in centella asiatica: asiatic acid, asiaticoside, madecassic acid, madecassoside
Quite a few other actives are known for their tissue healing/remodelling action but the ones above are the most widely researched.
Cellulite requires a fat reduction component too, so things like forskolin and caffeine are essential too.
In addition, both these ingredients (forskolin and caffeine) can also aid with stretch marks, as they are both known to inhibit the protein TGF-β1, which is the hallmark of scar tissue and myofibroblast proliferation.
All the above actives also boost microcirculation, which is an important component of tissue healing.
So in terms of skincare active ingredients the exact same actives that help with cellulite also help with stretch marks, with small differences.
Real cellulite / stretch mark creams
All these molecules, with the exception of caffeine, are quite expensive, and few manufacturers, if any, include them together in one product, due to cost. And almost none include them in high purity / high concentration form.
Hence the belief by the public that cellulite/stretch mark creams “do not work”. This is generally true, because most products contain almost - and sometimes literally - nothing (yes, NOTHING) in the way of relevant active ingredients in meaningful concentrations. Then they fill the gap with crafty marketing to sell those creams to the ignorant public.
However, a real, high-purity, high-concentration multi-ingredient formulation (plus healthy nutrition and exercise in the case of cellulite) can help reduce/prevent the appearance of both cellulite and stretch marks, especially at the earlier stages.
Treatments, if available they will help accelerate the whole process and offer more satisfactory results.
Of course, no miracles of immediate and/or permanent elimination of either cellulite or stretch marks should be expected (that’s for the gullible and the naive who believe in miracles and magic).
However, a course of 6-12 deep-acting, high-power radiofrequency and high-power ultrasound cavitation treatments, as well as a quality cream used for a period of 3 months or more, can both offer valuable help.
Cellulite: from standing fat herniation to hypodermal stretch marks
Research paper link: https://journals.lww.com/amjdermatopathology/pages/articleviewer.aspx?article=00007&issue=02000&type=abstract&year=2000
Abstract: There are glaring discrepancies in the microanatomical descriptions of cellulite in the literature. We revisited this common skin condition in women with a microscopic examination of 39 autopsy specimens. A control group consisted of 4 women and 11 men showing no evidence of cellulite. The lumpy aspect of the dermohypodermal interface appeared to represent a gender-linked characteristic of the thighs and buttocks without being a specific sign of cellulite. Incipient cellulite identified by the mattress phenomenon was related to the presence of focally enlarged fibrosclerotic strands partitioning the subcutis. Such strands possibly serve as a physiologic buttress against fat herniation limiting the outpouching of fat lobules on pinching the skin. These structures might represent a reactive process to sustained hypodermal pressure caused by fat accumulation. Full-blown cellulite likely represents subjugation of the hypertrophic response when connective tissue is overcome by progressive fat accumulation. Histologic aspects reminiscent of stretch marks are identified within the hypodermal strands, resulting in clinical skin dimpling.
Have a treatment in London with the cellulite experts
At LipoTherapeia we have specialised 100% in skin tightening and cellulite reduction for more than two decades and 20,000+ sessions.
This is all we study and practise every day and have researched and tried hands-on all the important skin tightening equipment and their manufacturers.
As strong, deep acting radiofrequency and deep-acting, high-power ultrasound cavitation are the technologies of choice for skin tightening and cellulite reduction, we have invested in the best RF/ultrasound technologies in the world.
(Of course, we keep looking for new technologies every day and if/when a better technology materialises we will be the first to provide it. However, we will never follow the latest ineffective gimmick, just because it’s good marketing to offer the latest hyped up - yet ineffective and/or unsafe treatment.)
Furthermore, over the last two decades we have developed advanced RF and cavitation treatment protocols in order to make the most of our technologies, for maximum results, naturally and safely.
And for even better, faster results, we now combine our RF/ultrasound treatments with high-power red/infrared light LED treatment.
Our radiofrequency/ultrasound/LED treatments are comfortable, pain-free, downtime-free, injection-free, 99.5%+ safe and always non-invasive.
(No unsafe and ineffective RF microneedling or HIFU and no safe but ineffective acoustic wave therapy, superficial RF (bipolar/tripolar/multipolar etc), low power RF/cavitation, electrical muscle stimulation, lymphatic massage, cupping, dry brushing and no ridiculous bum bum creams.)
Our focus is on honest, realistic, science-based treatment, combined with caring, professional service, with a smile.
We will be pleased to see you, assess your cellulite, skin laxity or fibrosis, listen to your story, discuss your case and offer you the best possible treatment.
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Why train with The Cellulite School™?
We all know that training in cellulite reduction and skin tightening is as basic as it gets. It is typically a 4-6 hour training, involving only basic instruction from the manufacturer on how operators can use the machine; lots of myths, erroneous information and misconceptions; and some basic health and safety on how to use the machine.
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