As a multifactorial process, cellulitis therapy will have to go through different treatments to get the best therapeutic result. Some methods are more aimed at reducing the underlying causes, improving cellular respiration (carboxytherapy). Others acting on fluid drainage (pressotherapy, mesotherapy). Others on tissue metabolism (radiofrequency, endodermic massage, ultrasound) and on adipocytolysis (cavitation). The treatment protocol is always individualized, trying to act on the most evident etiopathogenetic factors in each patient.

Cellulitis is a common problem affecting about 85% of women after puberty. It is favoured by various constitutional and lifestyle-related factors:

• genetic factors, due to the more or less marked tendency to accumulate adipose tissue
• incorrect nutrition, which can affect metabolism since childhood
• hormonal factors, due to excess of oestrogen that facilitate water retention
• medication intake, such as contraceptive pill
• stress and nervousness
• sedentary lifestyle and poor physical activity
• microcirculation problems

Cellulitis (more technically defined as PEFS - oedemato-fibro-sclerotic pannicolopathy) is ranked in four stages of severity:

1 - OEDEMA
The first stage is characterized by oedema, caused by the stasis of hypodermic fluid and the build-up of adipose tissue. Symptomatology is only characterized by the feeling of heaviness of the lower limbs. The skin begins to lose elasticity and the vessels present micro ectasia.

2 - FIBROSIS
The evolution of tissue oedema consists of reactive fibrosis around fat cells that, due to poor oxygenation, have poor metabolism and accumulations of toxins. The skin appears pale and has telangiectasia and orange-peel appearance.

3 - FIBROSCLEROSIS
Serious impairment of microcirculation with the reduction of oxygenation and tissue metabolic exchange. Presence of micronodules. The orange-peel appearance is evident. The palpation and the clamping of the tissues is very painful.

4 - MICRO-MACRONODULES
It is the evolution of the previous stage, in this case the micronodula converge to form macronodula. Skin is sensitive to touch.