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At least 80% of women experience cellulite in their lifetime. Given the variety of biological and lifestyle factors that contribute to the development of cellulite, this number is not surprising. By understanding what causes cellulite, women can combat it at the source and prevent its further development.

What Is Cellulite?

Cellulite is a chronic-degenerative dysfunction of the connective tissue. As discussed in the previous article in the series, the health of connective tissue is dependent on the exchange of fluids and molecules between the connective tissue and the circulatory and lymphatic systems. When lymphatic circulation is hindered, excess fluid remains in the body’s tissues and liquid is retained. Fluid retention signals the first step in the process of cellulite development. Stagnation of the fluid in the interstitial space of connective tissue causes an inflammatory alteration of adipose tissue in the dermal layer of skin that is pushed towards the skin’s surface, resulting in the orange peel texture of cellulite.

Primary Factors Causing Cellulite

There are many factors, both biological and lifestyle, that affect fluid retention in the body. Understanding these factors is the first step in treating cellulite. 

Biological Factors

Hormones play a critical role in regulating the body. The levels of the hormone estrogen in a woman’s body fluctuate throughout her life. During Premenstrual Syndrome, the estrogen levels in the body rise. When estrogen increases, the body responds by retaining fluid especially in the buttocks and thighs. During pregnancy, a woman’s body stores up to 50% more fluid. This fluid retention in combination with weight gain results in swelling of the thighs. During these periods of a woman’s life it is especially important to get regular physical activity. The activity promotes the removal of excess fluid that builds up in the body because of estrogen.

When women enter menopause between the ages of 45 and 50, their estrogen levels gradually decrease as menstruation stops. Metabolism slows down and women begin to gain weight and adipose tissue increases. Adopting a healthy diet, in addition to physical exercise, can mitigate the effects of a drop in estrogen levels at this stage in a woman’s life.

Lifestyle Factors

Sedentary lifestyles result in weakened muscles and poor circulation of lymphatic fluid through the body. Without adequate muscle tone to pump fluid, edema occurs and cellulite forms. A sluggish lymphatic system can be remedied with physical activity. 

The excessive consumption of salty food contributes to water retention in the interstitial space between cells. Alcohol consumption also prevents adequate transfer of fluid in the dermis which results in edema and swelling around collagen and adipose tissue. Furthermore, alcohol consumption damages the kidneys and liver which filter toxic compounds from the body. In the case of constipation, unnecessary stress is placed back on the liver and kidneys by allowing reabsorption of toxins as waste sits in the body.

Smoking damages the lungs and prevents inadequate oxygenation of the blood. By damaging blood vessels, smoking interferes with proper circulation which prevents fluid exchange within the interstitial space between cells. 

Clothing is an often-overlooked factor that affects cellulite generation. Tight clothing that compresses the body hinders blood circulation. It is best to avoid wearing excessively tight underwear, garters, leotards, girdles or stockings to allow for adequate blood flow. 

Traditional cellulite remediation methods involve treating surface dimpling with a variety of methods such as electrolipolysis, ultrasound therapy, laser therapy, low voltage electric current, mesotherapy and endermologie. While topically effective, these traditional therapies don't address hardened fat and other factors which can marginalize treatment results and result in cellulite returning prematurely.

Cryo T-Shock Therapy – and How Clients Can Help

The newest device in the U.S. market after success in Europe, the Pagani Cryo T-Shock, stands out from the crowd in its treatment approach. The treatment works by tackling cellulite from multiple angles. It reduces the number of fat cells which takes pressure off connective tissue, it increases blood and lymph flow within connective tissue, and softens the hardened connective tissue. Cellulite is a complicated issue and the treatment needs to work on multiple levels to reduce the effects of cellulite and help with long-term maintenance.

The T-Shock provides the surface results and also works towards reversing the internal cause of cellulite and resetting the tissue.Understanding that it is the retention of fluid within the dermis that causes cellulite formation helps make the time after treatment more effective. Once the therapy has removed adipose tissue and softened the connective tissue, the interstitial fluid can more easily pass from the affected area into the lymph system where it will be filtered from the body. This is a critical time to stay hydrated, exercise moderately and promote blood flow in the body to help deter cellulite from returning.

Cryo T-Shock therapy in conjunction with lifestyle changes can not only get rid of unsightly cellulite but also prevent its recurrence. Knowledge about the root cause of cellulite powers the Cryo T-Shock Therapy plan and guides the post-treatment plan for maintaining results. 


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4362892/

  2. https://www.scientificamerican.com/article/is-cellulite-forever/

  3. https://americanpregnancy.org/pregnancy-concerns/swelling-during-pregnancy/

  4. https://www.healthline.com/health/alcohol-bloating#causes

  5. https://www.nhs.uk/smokefree/why-quit/smoking-health-problems


Understanding cellulite not as an inflammation of the cells but rather a chronic-degenerative dysfunction of connective tissue is the first step you must take before diagnosing the severity of your clients’ conditions and identifying the proper treatment measures. But what’s next? Though traditional treatment methods — including electrolipolysis, ultrasound therapy, laser therapy, low voltage electric current, mesotherapy and endermologie — abound in the market, the truth is that many of them are one dimensional and thus marginally effective at tackling the root issues at hand.  These traditional methods are only useful in treating topical symptoms and have no way of detecting cellulite below the surface that may be invisible to the naked eye.   As it turns out, the most effective technique to pinpoint cellulite in its earliest stages is the use of contact thermography, a diagnostic technology to accurately and precisely target cellulite in its earliest (non-visible) stages and disrupt its manifestation.


Contact thermography is a diagnostic tool that has been used in the medical and aesthetic fields since the 1970s. Originally employed for purpose of identifying breast pathologies, thermography has since been used in a variety of other medical fields — including rheumatology and angiology — and is now harnessed in the aesthetic space to help detect and classify cellulite on the legs and hardened fat on the abdomen and arms. Contact thermography involves microencapsulated liquid crystal plates that change color depending on the temperature of the area to which it is applied.

The technology itself is easy to use, painless, non-invasive and rapid: simply apply the flexible plate to a part of the body, hold it down for a few seconds and wait for the plate to generate a nuanced color-coded map that can reveal the thermovascular condition of the underlying tissues.  It can show the extent and severity of microcirculatory damage in both the cutaneous and underlying subcutaneous tissue. 

In this way, the tool can offer objective evidence about the progress of cellulite so that targeted and customized therapies can be implemented on a case-by-case basis.  Contact thermography can make it possible to:

  • detect cellulite from the earliest stages, even when there’s no visible surface evidence,

  • identify with greater precision which areas need to be treated,

  • devise the most suitable treatments for each case,

  • monitor progress by checking responses to treatments, and

  • keep track of cellulite for remedial treatments to keep it at bay.

    Thermographic plates are completely reusable, and can be repeated countless times without adverse effect.

    It’s important to note that a thermographic test and analysis should always be conducted prior to every single treatment session.  Without it, you may as well be throwing a dart at the issue and crossing your fingers for the best.  Results are best assessed prior to treatment (rather than after treatment) since any treatment intervention will affect the microcirculation of the area and thereby impact the image map the plate creates.

    When it comes to interpreting the results, specific color patterns and corroborating with the accompanying manual to assess whether cellulite is absent or in either the oedematous/fibrous/sclerotic stage.   

    The thermographic plates allow users to evaluate the extent and severity of the microcirculatory damage based on the alterations of skin temperature.  Temperature variations reveal the presence of cold areas (hypothermia due to circulatory causes), or of hot areas originated by capillary-venular stasis.

    The absence of spots means that there is no cellulite thanks to a good blood supply and the absence of oedema and toxin retention.


    The image will show spots of different color with blurred edges surrounded by haloes which indicate the presence of cold areas with a reduced blood supply. The skin feels rough to the touch and elasticity and tone may have decreased. If a hand is placed on the skin for a few seconds (pressing more firmly with the fingertips on the examined area), there will be a noticeable white halo confirming the presence of fluids in the subcutaneous layer.


    This image is usually characterized by numerous spots with sharply defined edges which indicate venous stasis and the presence of cold areas. The skin’s consistency is altered and the tissue starts to feel painful when pinched, plus there is a great decrease in elasticity and skin tone. The area may appear very compact or flaccid. The presence of adiposity usually accompanies this stage.


    In this case the situation is very similar to the previous one, but the color patches are much darker, black or brown, which indicates the presence of macro nodules, or very cold areas. The skin’s consistency is greatly altered, the tissue is painful simply when touched, there is a great decrease in skin elasticity and tone. The area may appear very compact or flaccid. The presence of adiposity usually accompanies this stage.


    The stand-out prevention and treatment approach available today is the combined use of contact thermography and thermal shock.  Where contact thermography allows you to identify visible and invisible cellulite formation for your client and give you the specific location on the body where treatment needs to be applied, thermal shock (which alternates between heat and cold) is employed to kill fat cells (taking the pressure off the connective tissue) and increase blood and lymph flow (which alleviates inflammation and softens the connective tissue). This novel approach of heat and cold can increase microcirculation by up to 400%.  It is far more effective than administering cold alone.  Alternating between cooling and warming sequences in the same session: facilitates drainage; reduces edema; reduces fat layers, and: stimulates the connective tissue.  This drives oxygen flow to the targeted areas and improves the permeability of the skin as well as increases collagen production. The end result is that the appearance, texture and elasticity of the skin is improved and excess liquids/metabolic wastes are eliminated through a natural re-absorption of the lymphatic system.

    For more information about Contact Thermography reach out to Cryo Generation, exclusive North American distributor for IPS Systems Thermography which is marketed under the Adicell the Thermascan brands.

    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374708/

    2. https://sciforschenonline.org/journals/breast-cancer-research-advancements/JBCRA-1-107.php

    3. https://www.ips-srl.it/cellulite-contact-thermography/?lang=en


From light therapy to stem cell technology, cryotherapy to thermal shock, non-invasive, anti-aging technology abounds in today’s wellness marketplace. Some methods have been proven to be more effective than others. Yet while the benefits of cryoliposis have produced promising results it’s a one-dimensional treatment.   Researchers find that contrast therapy, or thermal shock, produces multiple benefits from killing fat cells to reversing the signs of aging than any other treatment. For estheticians and spa owners seeking science-backed tools not requiring medical oversight to help their clients see faster and more noticeable results in the mirror, here is what you should know about how thermal shock works and why researchers are so excited about this emerging anti-aging technology.


Where the application of cold alone — as in cryoliposis — has been shown to break down fat cells which can contribute to the unsightly appearance of cellulite, thermal shock goes a step further in eliminating the cells from the body through lymphatic drainage for more immediate and effective results. Using alternating cycles of hot and cold, thermal shock kills fat cells and reverses the signs of cellulite by increasing blood flow and circulation, stimulating the production of collagen, and improving overall skin elasticity.


By using extreme cold to constrict blood vessels, thermal shock treatments are able to break down fat cells without damaging other tissues.  By alternating cold with hot temperatures, the non-invasive therapy kills subcutaneous fat cells and then expels them from the body, gradually eliminating the signs of cellulite and promoting a smooth skin surface. In a case study of 92 women, aged 31 to 62 years old, 69 women saw a complete reduction in cellulite of the legs via thermal shock treatment across eight sessions.  19 women saw moderate improvement and only little or no improvement.  


Skin ages due to a reduction in collagen and elastin. By increasing oxygen and nutrient supply to the  tissue, thermal shock promotes a more youthful appearance.  When applied to the face and neck, consistently, this contrast therapy stimulates the production of collagen and improves skin elasticity, effectively smoothing out fine lines and wrinkles. Other benefits include: reducing puffiness around the eyes, give the impression of reduced pore size on the face and neck while lessening inflammation.  Not to mention that while skin vessels and capillaries undergo a period of vasoconstriction to break down toxins stored in skin layers; an alternating cycle of vasodilatation efficiently expels the toxins from the body. This process paves the way for healthy skin cells to emerge for a taut, more supple appearance of facial skin.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954866/

  1. https://www.researchgate.net/publication/236086574_Mental_state_and_quality_of_life_after_10_session_whole-body_cryotherapy

  2. https://www.tandfonline.com/doi/abs/10.1080/J148v25n03_02

  3. https://www.semanticscholar.org/paper/Complex-Effects-of-Hot-and-Cold-Procedures-on-Skin-Panovska-Dimitrova/e25c7f0c82046468e00beac3b1e08e3103e04135


Cellulite, from the French word cellule, which means “small cell,” is not only an unsightly condition that affects more than 80 percent of postpubertal women, but is a veritable pathology: an alteration of the topography of the skin that in medical literature is sometimes referred to as “edematous fibrosclerotic panniculopathy.” Visually, cellulite is often described as “dimpling” or having the texture of an “orange peel.” It mostly affects the upper side of the thighs (near the upper extremity of the femur) as well as the buttocks, the inside of the knees and inner thighs, the arms, and the upper part of the legs. For estheticians and spa owners who work with their clients on finding longer-term, lasting treatments for cellulite, it’s critical to first understand the complexities of cellulite before learning what works — and what doesn’t — about various treatment options on the market.


Cellulite is a localized metabolic disorder of the subcutaneous tissue. To better visualize the physiological intricacies of cellulite, it’s best to first understand the architecture of the skin. The outermost layer of the skin — the epidermis — provides a waterproof barrier for the layers underneath. Beneath the epidermis is the dermis (or corium), which contains hair follicles, sweat glands, blood vessels, nerve receptors and tough connective tissue. Beneath the corium is the hypodermis, or subcutaneous layer, which is made up of a matrix of adipose connective tissue (panniculus adiposus) and fat lobules (adipocytes) separated by a dense lattice of pre-collagen, collagen and elastin fibers. 

Adipose connective tissue is nourished by an intricate lymphatic and capillary network, which regulates the exchange of nutrients between your blood and tissues through fluids in the interstitial space (i.e., the space between tissue cells). Any disruption of alteration to the vessel network — including when the exchange of nutrients is slowed — can result in fluids and metabolic toxins actually accumulating in the collagen-mucopolysaccharide matrix of the interstitial space. This is known as edema. Edema is viewed as detrimental to tissue function because it prevents proper local circulation. This causes an increase in the number of connective cells and a consequent hardening of the tissue (sclerosis). Left unchecked, this can develop into a second phase where the nerve structures, collagen and elastin fibers of the dermis can also be affected, leading to the development of cellulite. This can proceed to a further degeneration where nodular visible formations develop on the epidermis, and can be hard and painful to the touch.


There are three main types of cellulite, which can be broken down into further stages or degrees. The type and stage of cellulite depends on the evolution of the symptoms it manifests.


Oedematous cellulite is associated with water retention and issues of circulation. Here, the skin actually appears swollen, paler, and with potential marbling in some areas. In the first stage, a slow-down of microcirculation leads to a build-up of fluids in the interstitial space between tissue cells, retaining fluids and increasing the volume of adipocytes. Though imperceivable, this is where cellulite begins. The resulting stagnation of liquids and toxins leads to the second stage, where prostaglandins, or inflammation mediators, are released, thereby triggering even more lymphatic obstruction and greater stagnation and volume in adipocytes. Toxins that accumulate and spill over into the tissues lead to widespread inflammation of adipose cells and the breakdown of collagen, which hardens and multiplies, leading to beginning stages of sclerosis. It’s important to note that, in this second stage, there are still no visible signs of cellulite formation on the epidermis and the affected areas are not painful to the touch. Identifying and targeting treatment on oedematous cellulite is one of the most effective treatment prerequisites.


In the third stage, or fibrous stage, the connective tissue continues to harden and even “strangles” adipose lobules, cutting them off from receiving proper fluid supply. The stress that tissues undergo during this stage result in the formation of micronodules, which are reminiscent of the “orange peel” or “mattress” texture on the skin.


Finally, in the fourth stage, collagen fibers embed the adipocytes in a sort of capsule, causing the connective tissue to withdraw. Hard micronodules develop and come into contact with the nerves, yielding pain when touched. In this stage of cellulite manifestation, circulation and the capillary network are altered and the skin is cold. This stage of development is the most difficult to treat. Indeed, there’s enormous benefit in identifying the stages and getting treatment as early as possible — once a person enters the fourth stage, a course of treatment must be extensive and repeated in order to take care of the connective tissue (by reducing inflammation and increasing circulation) and address any adipose tissue that needs to be reduced.


Thus, when we consider the true nature of cellulite, the name itself becomes somewhat of a misnomer. After all, cellulite has less to do with cellular inflammation as it does a chronic-degenerative dysfunction of the connective tissue. Furthermore, the notion that cellulite is solely associated with fat or adiposity is a myth. These are distinct phenomena that may manifest simultaneously but are otherwise not dependent upon one another. Most women collect pockets of excess fat in areas of cellulite as the condition progresses from the oedematous stage to the fibrous and/or sclerotic stages. The stagnation of the area — along with improper diet or a sedentary lifestyle — can lead to the enlargement of fat cells. That said, cellulite should not be confused with obesity, where a gain in adipose tissue mass results from an increase in adipocyte cell size and number. Cellulite is largely indiscriminate in that it affects nearly all postpubertal women, overweight or not (slender and wiry women aren’t exempt). A woman can even have an ideal ratio of body weight to height and still develop evident manifestations of cellulite. To remedy the issue, then, it’s important to get treatments that tackle the connective tissue and reduce fat simultaneously. Many traditional treatment methods are effective but only superficially so — they do not target the underlying issues that originate cellulite.

To learn more about cellulite, please visit the second piece in our Cellulite Series: Cellulite: Treat the Cause Not The Symptom.


  1. https://www.medicalnewstoday.com/articles/149465

  2. https://www.webmd.com/skin-problems-and-treatments/picture-of-the-skin#1 

  3. https://www.ncbi.nlm.nih.gov/books/NBK53445/

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232550/


Estheticians, massage therapists and spa owners are constantly looking for new ways to offer clients cutting-edge beauty and wellness technology. Thermal shock provides a novel approach to cryotherapy weight loss, body contouring and whole-body health. Localized cryotherapy is a form of accelerated icing where the body is exposed to cold temperatures for five to thirty minutes. The benefits of this form of cryotherapy range from improved skin tone through collagen stimulation, reduced inflammation and a reduction in fat cells. However, researchers are now finding that contrast therapy — or thermal shock, which employs both quick cycles of heat and cold — may actually be more effective for one’s health and physical appearance, especially in the case of fat loss.

The application of heat and cold speeds lymphatic drainage to clear skin and tissues resulting in a dramatic reduction in fat cells. Not to mention thermal shock has been proven to reduce fine lines, relieve muscle trauma and more. To learn how thermal shock, and specifically the Cryo T-Shock system, can make a difference in your body (and your clients’ bodies), here are the top five benefits of the treatment.

1. Fat Loss
Thermal shock reduces fat cells typically resistant to diet and exercise alone. By applying heat to relax fat cells through vasodilation, then administering an extended period of cold, fat cells die and drain through the lymphatic system. In a study of 68 women, 50 experienced “very good” results with a reduction in excess fat on the abdomen.

2. Reduction in Cellulite

Appearance Thermal shock is a non-invasive procedure that impacts the causes of cellulite including protrusion of fat into the lower dermis. Using mechanical energy and micro-massage, thermal shock eliminates excess liquids through lymphatic drainage resulting in a smoother skin surface. In a case study of 43 women, 30 study participants saw a reduction in cellulite of the gluteus via thermal shock treatment across eight sessions.

3. A Youthful Facial Appearance

When used around the face and neck, thermal shock triggers the production of collagen which smooths out facial lines and wrinkles and reduces puffiness around the eyes. Dead cells get released from the body while healthy skin cells activate resulting in a more youthful appearance. Before and after photos show the results of anti-aging facials using thermal shock, which can tighten loose skin and even reinvigorate elastin-depleted skin.

4. Toned and Tightened Skin

Similar to collagen production, thermal shock also effectively improves skin elasticity thanks to significantly increased micro circulation triggered by the application of hot and cold procedures. Ideal for restoring loose, aging skin, thermal shock promotes a more toned and tightened appearance.

5. Pain Relief and Injury Recovery

In mere minutes, thermal shock has been shown to stimulate the natural process of pain reduction and activate anti-inflammatory processes. In a case study of 98 patients with muscle and tendon disorders, 72.5 percent reported a total reduction in pain and improved movement capability with 100 percent of participants reporting a positive perception of treatment.

The Cryo T-Shock system, designed by Milan-based Pagani, is a one-of-a-kind anti-aging, body contouring and measuring device which uses thermographic imaging technology to visually demonstrate the type and density of fat and cellulite and validate post-treatment effectiveness. It utilizes a high-quality 150-watt Peltier cell that is capable of generating and subtracting heat transdermally, and is currently the only device on the market that is able to administer such rapid exchanges from hot to cold within the same applicator head. Its programming functions and easy-to-use drop-down menu with 58 beauty protocols organized by need and anatomy make it a wonderful and versatile product to offer to your clients. Contact Cryo Generation to learn more.

Erica Garza is an author and essayist from Los Angeles. Her writing has appeared in TIME, Health, Glamour, Good Housekeeping, Women's Health and VICE.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954866/

  2. https://www.ncbi.nlm.nih.gov/pubmed/20524715

  3. https://www.researchgate.net/publication/236086574_Mental_state_and_quality_of_life_after_10_session_whole-body_cryotherapy

  4. https://static1.squarespace.com/static/5d50a88ed8aca200012ea7f1/t/5e21c15212540e1f1c85a5b7/1579270483290/CRYOTSHOCKEVIDENCES.pdf

  5. https://www.semanticscholar.org/paper/Complex-Effects-of-Hot-and-Cold-Procedures-on-Skin-Panovska-Dimitrova/e25c7f0c82046468e00beac3b1e08e3103e04135

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