What Causes Cellulite, and Is It the Same as Lipoedema?

Cellulite is caused by fat pushing up between the bands of connective tissue that hold your skin in place, while those bands pull the skin down, which creates dimpling on the surface. Lipoedema is a different, medical condition where fat builds up in the legs and sometimes the arms, and it is often painful. They can look alike, but they are not the same.

What Is Happening Under the Skin

Picture the layer just beneath your skin as a quilted mattress. The stitching is made of fibrous bands, called septae, that run from the skin down to the muscle. The padding in each pocket is fat. When the pockets are fuller or the stitching is tight, the surface puckers. That puckering is cellulite.

Doctors sometimes grade cellulite by whether it only shows when you pinch the skin, shows when you are standing, or shows all the time.

Why Women Get Cellulite More Than Men

In women, the septae mostly run straight up and down, which lets fat push upwards between them. In men they tend to run at angles in a criss cross pattern, which holds fat more firmly. Female hormones, particularly oestrogen, also influence where fat is stored and how connective tissue behaves, which is why cellulite often appears or changes around puberty, pregnancy and menopause.

What Makes Cellulite More Visible

• Genetics. If your mother has noticeable cellulite, you are more likely to.
• Age. Skin gets thinner and makes less collagen, so it hides less of what is underneath.
• Weight changes. Gaining fat fills the pockets. Losing weight quickly can leave skin looser.
• Low muscle tone. Less muscle beneath means less support.
• Lifestyle. Smoking and sun damage both break down collagen.

For what you can actually do about it, read how to get rid of cellulite: what works and what doesn’t.

Cellulite vs Lipoedema

	Cellulite	Lipoedema
What it is	A cosmetic change in the skin surface	A long term medical condition affecting fat tissue
Where	Thighs, bum, hips, sometimes tummy and arms	Both legs evenly, sometimes arms, feet usually unaffected
Pain	Not painful	Often painful, tender or heavy, bruises easily
Diet and exercise	Can make it less visible	Affected fat does not usually reduce
Who to see	A clinic, if you want it to look smoother	Your GP first

The NHS describes lipoedema as abnormal fat build up in the legs and sometimes arms, which can feel soft, cool and dimpled, may be painful and bruise easily, and is not caused by being overweight. You can read more on the NHS lipoedema page.

Can Clinic Treatments Help?

For cellulite, yes, to a degree. Radiofrequency treatments such as SmartSculpt Pro aim to firm the skin and reduce the fat beneath it, which can make dimpling look smoother over a course of sessions. They are not a treatment for lipoedema, and if we think you may have it we will suggest you speak to your GP first. See our cellulite treatment page for details.

Frequently Asked Questions

What is the main cause of cellulite?

Cellulite forms when fat pushes up between the bands of connective tissue that anchor the skin, while those bands pull down. The way these bands are arranged in women, plus hormones and genetics, are the main reasons it is so common.

Is cellulite a sign of being overweight?

No. Slim and very active people get cellulite too. Extra weight can make it more visible, but it is not the cause on its own.

How do I know if I have lipoedema or cellulite?

Lipoedema usually means fat has built up evenly on both legs, sometimes the arms, while the feet are not affected. The area often feels painful or tender and bruises easily. Cellulite is not painful. If you think you might have lipoedema, see your GP.

Can men get cellulite?

Yes, but far less often, because the connective tissue in male skin is arranged in a criss cross pattern that holds fat in place more firmly.

Does cellulite get worse with age?

It often looks more noticeable with age, because skin becomes thinner and makes less collagen, so it shows more of the unevenness beneath.