Fat storage and breakdown are controlled by two sets of special receptors called alpha and beta receptors on the surface of each fat cell, or adipocyte. Regulated by the hormone epinephrine, beta-adrenergic receptors promote fat breakdown (lipolysis), where  alpha-adrenergic receptors prevent fat breakdown and promote fat storage. In the case of cellulite fat, the alpha receptors outnumber the beta receptors. Women also tend to have more fat-storage alpha receptors than fat-breakdown beta receptors in the hips and thighs  so that storage exceeds breakdown in these areas. This  helps cause swelling of the stored fat within cells. Stimulation of these receptors also leads to changes in a crucial fat-breakdown enzyme called hormone-sensitive lipase. This enzyme is located directly in the fat cell and is activated when beta receptors are stimulated, breaking down triglycerides in fat to release free fatty acids and glycerol into the bloodstream. Conversely, alpha-receptor stimulation inhibits this enzyme and promotes fat storage. Aerobic exercise improves the ability to mobilize and break apart triglycerides for energy use, whereas obesity makes the fat-breakdown enzyme hormone  sensitive lipase less sensitive to epinephrine.

Cellulite, which affects the majority of adult women  is now regarded as an unpleasant vestige of unhealthy eating and sedentary lifestyle. Scientists have discovered that cellulite arises from a number of age-related physiological changes. Gender differences in hormonally influenced fat deposition as well as effects of the stress hormone cortisol, connective tissue differences in skin between men and women, and poor circulation and lymphatic drainage all compromise skin integrity. As a result, the the layer of skin beneath the outermost layer (dermis)  weakens in cellulite prone areas, paving the way for swollen fat cells to protrude to the surface. Many currently available products marketed for cellulite treat this disorder as a purely cosmetic problem. However, products designed to treat cellulite need to also address the physiological basis of the condition.

• Cellulite is almost exclusively a condition that affects women, occurring in 85% to 98% of women after puberty, mostly over the thighs, buttocks, and hips.

• The causes of cellulite include the stress hormone cortisol, gender differences in fat storage, and metabolism in the top layer of fat and the structure of connective tissue in these areas, as well as fluid leakage from small capillaries in these areas.

• To be effective, a topical cream for cellulite would have to address all of these causes and its use would have to be continued to maintain benefit.

• Several compounds that may be especially promising as a  modal approach to correct the underlying causes of cellulite.

• The compounds for topical therapy of cellulite include:

1) Glycyrrhetinic acid derived from licorice root, which fights stress-induced fat deposition related to cortisol secretion

2) Horse chestnut, which improves circulation and reduces capillary leakage

3) Gotu kola, which stimulates collagen synthesis. These herbal extracts also contain compounds with potent antioxidant activity and anti-inflammatory activity, which may promote skin health, clarity, tone, and overall youthful appearance.

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