Is cellulite hereditary?

Is cellulite hereditary or not? After 24+ years of theoretical research and hands-on application of cellulite reduction with more than 4000 women I can categorically say that cellulite is indeed genetic to a large extent. But cellulite it is also partially due to our unhealthy Western lifestyles (unhealthy nutrition, lack of physical activity, xenoestrogens, alcohol, smoking/vaping etc). So, in a nutshell, cellulite is as an average 50% due to genetics and 50% due to unhealthy lifestyle. Regardless of the cause, the solution remains the same: live as healthily as possible and perhaps have a course of 6-12 intensive treatments for fast results.
— Georgios Tzenichristos, LipoTherapeia | London

Cellulite: nature or nurture?

  • Cellulite and heredity | In summary

  • Is cellulite genetic?

  • Cellulite may be partially genetic but sometimes even the best genes cannot protect you

  • Cellulite may be partially hereditary but a wholesome lifestyle can protect you from “bad cellulite genes” for decades

  • But what do we know about the genetics that cause cellulite?

  • Most “good” and “bad” genes are switched on or off by our lifestyle

  • Genetics and cellulite | Study 1

  • Heredity and cellulite | Study 2

  • When it comes to cellulite, lifestyle is as important as genes

  • The same lifestyle that causes cellulite also causes most western degenerative diseases

  • A multilocus candidate approach identifies ACE and HIF1A as susceptibility genes for cellulite

  • Cellulite, smoking and angiotensin converting enzyme (ACE) gene insertion/deletion polymorphism

  • Have a skin tightening/cellulite treatment with London’s cellulite experts

  • The Cellulite School™: Get advanced training in cellulite reduction and skin tightening

In summary:

  • Cellulite has a significant genetic component, though lifestyle plays a major role in its development. Many slim and active women experience cellulite, while others with curvier figures or older age show little to none, indicating that genes influence its presence. However, even those with “good” genes can develop cellulite if they lead an unhealthy lifestyle, involving poor diet, lack of exercise, smoking or excessive alcohol. Conversely, those with a genetic predisposition can minimise or delay cellulite through a wholesome lifestyle.

  • Genetic factors associated with cellulite include predisposition to weight gain, poor circulation, connective tissue weakness, inflammation, and reduced antioxidant capacity. Importantly, genes can be “switched on” or “off” through lifestyle choices.

  • Two key studies examined specific genetic variations (SNPs). One found that women with the DD or ID variant of the ACE gene were significantly more likely to develop cellulite, particularly if they smoked. The second study showed a higher prevalence of cellulite in slim women with the ACE gene variation, while another variant in the HIF1A gene appeared to reduce cellulite risk.

  • Ultimately, while genes heavily influence cellulite, they are not destiny. A healthy lifestyle can prevent or reduce its appearance and delay other degenerative diseases linked to poor habits. Maintaining good nutrition, regular exercise, and avoiding harmful behaviours like smoking is essential—regardless of one’s genetic makeup.

Is cellulite genetic? Yes, partially, here's what research says.

These are common questions we hear at the clinic:

  • Is cellulite genetic?

  • Is there a hereditary component to cellulite?

And the answer, both from our clinical experience and from science, is that cellulite has a strong genetic component.

  • During the last 24 years at the clinic I have seen hundreds of slim women with a lot of cellulite or probably thousands of curvy women with little cellulite

  • I have also seen cellulite making its appearance even in the early teen years in some girls, when some women in their 60s seem to have little cellulite

  • And we have all seen very active women who are also very careful with their diet and still have some cellulite

These common examples show that cellulite definitely has a genetic component.

Cellulite may be partially genetic but sometimes even the best genes cannot protect you

Indeed, after several years of dietary abuse, smoking, drinking and/or sedentary living, weight gain and cellulite catch up on you.

I have seen at the clinic many ex-models, now in their 40s or 50s, who, despite the amazing body they had in their 20s and 30s, they now have a lot of cellulite and loose skin.

Plus we have the examples of top models, such as Cindy Crawford with cellulite or Elle “The Body” MacPherson with extreme skin laxity, despite all the expensive detox spa retreats, treatments and celebrity fitness gurus they have at their disposal.

Cellulite may be partially hereditary but a wholesome lifestyle can protect you from “bad cellulite genes” for decades

No matter how excellent your genes are, poor lifestyle choices catch up with you in the end. And vice versa, even with really “bad” genes you can stay cellulite free for a few decades with a super-healthy lifestyle.

The facts are that:

  • ‘Bad genes can actually cause cellulite and/or overweight very early in life, unless you are a ‘saint’, in terms of nutrition and exercise

  • And ‘good genes do protect you from cellulite/overweight and they can do so for decades but not forever, if you don’t care

This entire website is about how to prevent/reduce cellulite with lifestyle, treatments and topical actives, despite your genes.

But what do we know about the genetics that cause cellulite?

First off, any genetics that increase your chance of:

  • Putting on weight

  • Having loose connective tissue / hypermobility

  • Having poor circulation

  • Having higher levels of inflammation

  • Having higher tendency to develop fibrosis

  • Having lower antioxidant / anti-glycation capacity

…will also increase your chance of having cellulite and skin looseness - and earlier in life.

Most “good” and “bad” genes are switched on or off by our lifestyle

Of course, as we said above:

  • You can have excellent genes and still develop cellulite because of poor lifestyle

  • And you can have very poor genes and still maintain a great figure and smooth thighs with an excellent lifestyle

This is because it is not just about the genes you have but also whether you switch those genes on (with the unhealthy “Western civilisation” lifestyle) or off (with a wholesome, natural lifestyle).

But generally speaking, poor genetics mean more cellulite. And better genetics mean less cellulite.

In addition to this general statement, there are two studies (both with a control arm) that looked specifically at the influence of specific SNPs (single nucleotide polymorphisms) in our genetic code that can significantly increase your chance of cellulite.

Genetics and cellulite | Study 1

In one study, 123 women with moderate/severe cellulite (~34 y.o.) were compared to 109 women (~33 y.o.) with no cellulite, and it was found that:

  • Women who smoke, but DON‘T have a genetic predisposition, have equal probability to develop moderate/severe cellulite as women who don’t smoke. This is an example of lifestyle (smoking) having no influence (by the age of 33) in cellulite. I am sure if the scientists looked at women of older ages (say 50s or 60s) they would find a huge impact. In my clinic I see that the older the age and more severe the cellulite.

  • Women who don’t smoke, but DO carry a genetic predisposition, have 2x more probability of developing moderate/severe cellulite. So just the genetic predisposition itself is enough to double your chance of developing moderate/severe cellulite, regardless of poor lifestyle choices (smoking, in this case). However, the most important finding is the following:

  • Women who smoke and DO carry a genetic predisposition have 13.5x higher chances of developing moderate/severe cellulite. This is a clear example of making the most of bad genes with bad lifestyle.

So if you have the DD or ID polymorphism of the ACE* gene (rs1799752/rs4343), you most probably will develop cellulite at some time. If you also smoke, it is almost certain that you will develop cellulite, especially after the age of 40.

(* The ACE gene controls blood pressure via expression of the ACE enzyme. With the DD polymorphism you have higher ACE levels and higher chances of heart disease.)

I am sure if the researchers looked at other lifestyle factors, i.e. poor nutritional habits, inactivity etc, they would report similar findings.

Heredity and cellulite | Study 2

In the other study, this time looking at 200 slim women with cellulite and 200 slim women without cellulite, it was found that:

  • The ACE gene ID type (rs1799752/rs4343) was also associated with higher prevalence of cellulite (1.8x higher). And that is in slim women. In more curvy women this result would most probably be even more pronounced.

  • The HIF1A* gene polymorphism rs11549465 decreases the odds of developing cellulite by 40%. That’s good news for those who have this SNP, which by the way also protects you from developing type 1 and type 2 diabetes.

(* The HIF-1 transcriptional complex controls the response to low tissue oxygen levels/hypoxia. Hypoxia is very common in adipose tissue with cellulite/poor circulation and can lead to fibrosis.)

When it comes to cellulite, lifestyle is as important as genes

What does this practically mean?

  • If you are generally slim and can eat what you want without developing cellulite, do not become complacent. Good genes can only protect you for so long.

  • If you tend to put on weight/develop cellulite easily, all is not lost: take great care of your nutrition, exercise a lot, avoid smoking etc and you can minimise/avoid cellulite for decades.

The same lifestyle that causes cellulite also causes most western degenerative diseases

On the other hand, if you do tend to put on weight/develop cellulite easily AND lead a very unhealthy lifestyle at the same time (perhaps because you don’t care about external appearance) then it is still very important to change your lifestyle to avoid multiple health conditions.

This is because the same genes / lifestyle choices that cause cellulite also cause cancer, heart disease, diseases and other ‘Western lifestyle’ diseases.

Yes, do “Love your cellulite” if you must, but also do your best to stay healthy, even if you don’t care about your external appearance.

A multilocus candidate approach identifies ACE and HIF1A as susceptibility genes for cellulite

  • Research paper link: https://pubmed.ncbi.nlm.nih.gov/20059631/

  • Abstract: Cellulite is a common complex cosmetic problem for many post-adolescent women characterised by relief alterations of the skin surface, which give the skin an orange-peel appearance. Although genetic factors have been suggested to play a role in the development of cellulite, the genetic background of this condition remains unclear. We therefore conducted a multi-locus genetic study examining the potential associations of candidate gene variants in oestrogen receptors, endothelial function/adipose tissue hypoxia, lipid metabolism, extracellular matrix homeostasis, inflammation and adipose tissue biology, with the risk of cellulite. Using a case-control study of 200 lean women with cellulite and 200 age- and BMI-matched controls (grade 0 according to Nurnberger-Muller scale), we examined the association of cellulite with 25 polymorphisms in 15 candidate genes. Two of the 25 polymorphisms were significantly associated with cellulite at the P < 0.01 level. After allowance for age, body mass index, the prevalence of contraceptive use and smoking in logistic regression analysis, the multivariable-adjusted odds ratios for cellulite were 1.19 (95% CI: 1.10-1.51; P < 0.01) for ACE rs1799752 and 0.61 (95% CI: 0.45-0.88, P < 0.01) for HIF1A rs11549465. This study, which demonstrates an independent role of ACE and HIF1A in predisposing to cellulite, may provide novel information on the pathophysiology of this common cosmetic problem, and offer a topic for research for novel beautification interventions.

Cellulite, smoking and angiotensin converting enzyme (ACE) gene insertion/deletion polymorphism

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