Why women have cellulite (and men don’t)

Do men get cellulite?

It is a common question I am asked at the clinic: “Do men have cellulite?'“ or “Why do men not get cellulite?”. And my answer has always been that women develop cellulite because they have weaker connective tissue and larger fat cells, due to the effect of female hormones.

Men, on the other hand, have much stronger connective tissue and much less subcutaneous fat, so they normally do not develop cellulite”.

Now a groundbreaking study published recently has shown that this is indeed the reason why women have cellulite and men don’t, explaining the exact mechanisms at play in women’s skin.

This study also confirms our approach to insist on high-power, deep-acting radio frequency to tighten the dermis and hypodermal structures and reduce fat accumulation and the use of concentrated actives that stimulate collagen synthesis and fat release (as opposed to the old fashioned way of focusing on temporary lymphatic drainage and mechanical massages, which literally trade water and achieve nothing in the end).

Men and cellulite

Why do men not get cellulite and women do: less collagen, more fat

The study on 20 men and 20 women aged 36-92 years’ old, has shown that women have 34% less collagen fibres and 57% larger fat lobules in the deep layer of their skin in relation to men. The combination of larger fat lobules pushing the skin upwards and less collagen anchors that offer little resistance to the upward pressure of fat, gives the appearance of cellulite.

As we will see below, the more fat / less collagen anatomy is due to estrogen and the collagen metabolism occurring during the monthly cycle.

“Cellulite is trapped toxins” and other old wives’ tales

This study also shows that the ‘cellulite is trapped toxins’ theory is yet another internet myth. Men are actually less careful with their diet, alcohol and smoking. So if someone had to have lots of cellulite because of high consumption of toxins, that would have to be men, not women. And don’t tell me that that chocolate before one’s period is ‘toxins’, because it isn’t.

This also shows why lymphatic massages, mechanical massages with a machine and body wraps, do not ‘work’ or only work very temporarily: because they just focus on a temporary reduction of water retention. But they do not address the fat accumulation / lack of collagen issue. These are the proverbial ‘elephants in the room’ when it comes to cellulite, according to this and several previous studies.

This toxin talk / poor circulation talk developed more than three decades ago, based on some basic and obsolete studies about cellulite, which have been superseded by more modern, fat better designed studies, including this one. Those studies basically said that cellulite does not exist (as if people are blind) and it’s only poor circulation, which accompanies cellulite but is not cellulite per se and is not the causal factor of it. The causal factor is +fat and -collagen.

Unfortunately, the public is usually 10-20 years behind the latest advances of science, as in everything to do with health, and people still try to do lymphatic massage, mechanical massage or detox body wraps to get rid of cellulite.

Age causes cellulite

The study also demonstrates why cellulite develops more with age. In the study, both older men and women have been found to have thinner dermis (middle skin layer).

Combine this with the gradual accumulation of superficial fat into the fat lobules we mentioned above and you have an increasing occurrence of cellulite with age.

Of course, you can see young girls with cellulite, in which case other risk factors are much stronger than the risk factor of thinner dermis, mentioned here.

Weight gain causes cellulite (duh!)

The scientists also found that the higher a woman’s body mass index (BMI), the bigger the superficial fat lobules are.

No surprises here. I know that some people will say that there are some slim women with loads of cellulite and some overweight women with little cellulite, but we are talking about exceptions and about one of the many factors among many here. Of course there will be exceptions, but the general rule applies: extra weight means more cellulite.

In fact, overweight /obese men also get cellulite, as their fat cells secrete estrogen, the secret sauce between plain fatness and cellulite appearance.

Men have more collagen, women have more fat

And there is even more: men have their superficial fat arranged in many smaller lobules with a lot more collagen anchors around them, which makes the upward protrusion of fat very difficult. Plus it makes skin tighter in men.

Women, on the other hand, have larger fat lobules with less collagen anchors around them to keep them in place and a weaker dermis. The combination means more cellulite and diminished skin tightness.

There is an explanation for all that. As fat cells increase in size they break down the connective tissue around it, in order to expand. This results in less collagen around the enlarged fat pouches.

Plus, in women the monthly cycle gradually breaks down the connective tissue via enzymes called MMPs. The end result is cellulite.

Men have stronger collagen too

Moreover, the researchers have found that mens’ collagen anchors are also 65% stronger, further keeping skin tight and controlling the growth of fat cells, by means of compression action.

Make the collagen weaker and you have more uninhibited fat growth and therefore more cellulite. Keep collagen stronger and in a way you suffocate the growth of superficial fat cells and you have less cellulite.

Again testosterone in men and estrogen/monthly cycle in women cause the difference in connective tissue strength.

Women have more deep fat too

Plus the subcutaneous fat tissue under the skin (under the cellulite layer) is 49% larger in women than men, further undermining skin tightness and increasing excessive plumpness.

Now larger subcutaneous fat means more tension on the collagen anchors that connect the deep fascia around muscles and the skin. This leads to an appearance similar to cellulite, but with much larger peaks and troughs. This is no cellulite per se, but for all intents and purposes we can call it cellulite - which is also the term everyday people use.

More fat contained in larger “parcels” and less collagen leads to biomechanical instability

The authors of the study succinctly summarise these findings as follows: “Our results demonstrated that these structural factors lead to a significantly reduced biomechanical stability in females compared to males.”

The researchers add that ”Cellulite can be understood as dis-balance between containment and extrusion forces at the subdermal junction... Therapeutic options targeting cellulite should aim to strengthen the subdermal interface”.

How do you strengthen the “subdermal interface”?

And how does one improve this “biomechanical stability” to get rid of the dreaded cellulite?

Obviously you have to reduce the size of the fat lobules and increase skin collagen, which practically means more everyday movement, more exercise, less calorie intake and more collagen-boosting foods, such as vegetables, berries, herbs and lean protein. Avoiding hormonal contraception can also prevent further deterioration of connective tissue and enlargement of fat lobules.

You can find an extensive list of 60+ tips on how to get rid of cellulite naturally - it can be found at lipotherapeia.com/how-to-get-rid-of-cellulite (link at the bottom of the article).

Treatment-wise, the only treatment that boosts both collagen in the deep skin layers and releases fat from fat cells is high-power, deep-acting radio frequency, ideally combined with high power ultrasound, which is what we have been offering at the clinic for almost a decade now, and this study actually confirms our approach (link at the bottom of the article).


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But what causes women to have less collagen and more fat in the first place?

This study, despite the amazing insights it offers into the morphology of cellulite, does not explain why this morphology occurs in the first place.

The initial reason for the disparity between men and women has been described by other scientists in the past, although it is not too hard to imagine: women have estrogen and men have testosterone. This is the crucial difference.

Because other factors (inactivity, smoking, excess calorie consumption) affects men and women the same. The main differentiating factor is estrogen and the monthly secretion of collagen breaking compounds (MMPs), due to the monthly cycle, in women.

Estrogen, the contraceptive pill and cellulite in women, older/overweight men and transexuals

Estrogen also explains why women on hormonal contraception get much more cellulite than those not on it.

It also explains why overweight men or older men, who have more estrogen produced in their fat cells, also develop some cellulite.

And it explains why male to female transexuals do develop cellulite, if they consume excess calories / live a sedentary lifestyle.

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Pre-cellulite, estrogen and cellulite

Generally, everybody, man or woman, can get cellulite if both two following conditions are met: their body is loaded with enough estrogen; they ingest more calories than they spend and/or sit down too much.

The aptly named "pre-cellulite" fat pocket infrastructure exists on the skin of hips and thighs of both sexes. All it takes is

  • Estrogen to stimulate the proliferation (multiplication) of adipocytes (fat cells) in those areas (the fat tissue on the butt and thighs of all human beings - male or female - is very sensitive to oestrogen)

  • Excess calories (typically hydrogenated fat, saturated fat, sugar, alcohol and high glycaemic index starches) to fill up those multiplied fat cells with fat

  • A sedentary lifestyle makes things worse, by encouraging the skin to become loose and the blood and lymph vessels to become weaker, which in turns leads to water retention and consequent inflammation.

Water retention, excess superficial fat, inflammation and skin looseness are the hallmarks of cellulite.

All three of the above conditions (more estrogen, calorie imbalance, inactivity) have to be met for humans to develop cellulite. In the absence of high levels of estrogen, humans who overeat can only get "fat", especially on the stomach/waist area (as is the case with men) and maybe develop loose skin, but they do not develop cellulite.

Similarly, in the absence of excess calorie consumption or sedentary living, humans with high oestrogen levels can only get looser skin but they will not develop cellulite, or they will develop very little cellulite. Naturally, with both high levels of oestrogen and calorie surplus/inactivity most humans will develop a lot of cellulite.

High estrogen levels in men due to testosterone to oestrogen conversion

As I mentioned above, oestrogen is a precondition for a human to develop cellulite. Men normally have low estrogen levels, so if they overeat and/or live a sedentary lifestyle they typically become overweight and develop loose skin. However, some men have high estrogen levels, so those men if they overeat and/or do not move enough will develop cellulite. Men with high estrogen levels are typically either older or overweight/obese.

In older men, testosterone is more readily transformed into estrogen (via a process called aromatisation) than in younger men. This, combined with excess calorie consumption and a sedentary lifestyle will lead to the development of cellulite.

On the other hand, in overweight men it's fat cells that produce the estrogen needed for cellulite development. Fat cells are not inactive fat storage depots - they do secrete several hormones, one of which is estrogen. The more adipose cells a man's (or woman's) body has, they more estrogen is produced by those fat cells. As we saw above, this can lead to cellulite development, if combined with a calorie surplus and/or inactivity.

Estrogen, cellulite in men and gynaecomastia

The same things that lead to the creation of cellulite in men can also lead to the development of what is known as gynaecomastia, also known as "man breasts", "man boobs" or "moobs". Again, the culprit here is a combination of excess estrogen and excess calorie surplus. Estrogen stimulates the development of breast tissue, in both men and women, in the same way it stimulates the development of cellulite in both men and women.

Xenoestrogens phytoestrogens and cellulite in men

Some man-made chemicals, known as xenoestrogens, act as estrogen-like substances in the body and disrupt endocrine balance. Bisphenol A (BPA) and phthalates are known examples of xenoestrogens.

Some foods and drinks also contain high amounts of estrogen-like substances, called phytoestrogens. Soya and beer are well-known examples of phytoestrogen-containing foods.

All these estrogen-like substances can have an estrogenic effect on the body, and can possibly lead to cellulite creation, with phytoestrogens being more benign and xenoestrogens being quite nasty.

Transexuals and cellulite

There is one more case of high estrogen levels in men.

Those who undergo sex change (male to female transgender / transexuals) take high levels of oestrogen medication and testosterone blockers in order to transform their bodies into a more female form.

These high levels of estrogen can easily lead to cellulite creation, much faster than in obese and/or older men, due to the very high estrogen levels. So many transgender individuals do develop cellulite, after some years of estrogen intake, in exactly the same way as women do.

Photographs of famous transexual women can be seen in the press with clear signs of cellulite - sometimes even with excessive cellulite on their thighs and buttock areas. It is clear that by becoming a woman you face the same problems biological women face, unfortunately one of them being cellulite.

In summary: feminisation and cellulite

All in all, feminisation (due to old age, obesity or environmental chemicals), COMBINED WITH excess calorie consumption and inactivity, will inevitably lead to the development of cellulite.

Women, being more feminine (see estrogenic), are more prone to this esthetic condition, but men can also develop cellulite.

The solution to the problem of excess estrogen remains the same, for both men and women: eat healthy, non-processed, organic food, avoid plastics in your food supply and do loads of exercise. And for women, lose the contraceptive pill.

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How to tighten up your skin and get rid of cellulite

Check the most comprehenesive and strongest cellulite and skin tightening treatments in London:

You may also wish to check our highly concentrated cellulite creams:

This entire website is dedicated to cellulite reduction and skin tightening, but a good starting point is our 60+ tip guide on how to reduce cellulite and tighten up your skin: