Cellulite: an evidence-based review.
BACKGROUND
Cellulite is a multifactorial condition that is present in 80-90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for cellulite.


OBJECTIVE
The objective of this review is to provide a systematic evaluation of the scientific evidence of the efficacy of treatments for cellulite reduction.


METHODS
This systematic review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses. Only original articles in English or German reporting data on the efficacy of cellulite treatments from in vivo human studies were considered. In total, 67 articles were analyzed for the following information: therapy, presence of a control group, randomization, blinding, sample size, description of statistical methods, results, and level of evidence.


RESULTS
Most of the evaluated studies, including laser- and light-based modalities, radiofrequency, and others had important methodological flaws; some did not use cellulite severity as an endpoint or did not provide sufficient statistical analyses. Of the 67 studies analyzed in this review, only 19 were placebo-controlled studies with randomization. Some evidence for potential benefit was only seen for acoustic wave therapy (AWT) and the 1440 nm Nd:YAG minimally invasive laser.


CONCLUSIONS
This article provides a systematic evaluation of the scientific evidence of the efficacy of treatment for cellulite reduction. No clear evidence of good efficacy could be identified in any of the evaluated cellulite treatments.
Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Germany. stefanie.luebberding@rosenparkresearch.de.
Stefanie
S
Luebberding
Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Germany.
Nils
N
Krueger
Sadick Dermatology, 911 Park Avenue, New York, NY, USA.
Neil S
NS
Sadick
D000273:Adipose Tissue / Q000378:metabolism*; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D012107:Research Design; D016896:Treatment Outcome