Can cellulite be treated with low-energy extracorporeal shock wave therapy?

Figures & data

Figure 1 Schema representing the gender difference of the inner structure of skin and subcutaneous tissue. Modified from Müller and Nürnberger (1972).

Table 1 Grading of cellulite

Definition	Grade
• Smooth surface of skin while lying down and standing.	0
• Wrinkles upon pinch-test.
• Smooth surface of skin while lying down and standing.	1
• Mattress-phenomenon upon pinch-test.
• Smooth surface of skin while lying down.
• Mattress-phenomenon spontaneously while standing.	2
• Mattress-phenomenon spontaneously while standing and lying down.	3

Figure 2 Human resources: distributions of 21 female test persons. Left: histogram for age, middle: histogram for body mass index (BMI), right: histogram for grading of cellulite according to Table 1.

Figure 3 Collagenometry (Collagenoson^®) taking high-frequency high-resolution ultrasound measurements of the extra-cellular matrix of the skin before and after treatment with low energy defocused extracorporeal shock wave therapy (ESWT). Case of improvement-score of +2 (clear improvement). Both ultrasound samples taken from the treated area. Determination of improvement-score: dividing the dermis into the side to the epidermis and into the side to the sub-cutis and analyzing the change in the distributions of each side (−1: change to more irregular, 0: no change, 1: change to more regular).

Figure 4 Results: distributions of 21 female test persons. Upper left: histogram for improvement score (see Figure 3, −2 (

): clear worsening, −1 (□): worsening, 0 (▴): no change, +1 (▪): improvement, +2 (•): clear improvement) from collagenometry (Figure 3). Upper right: improvement score as function of age and cellulite-grade. Lower left: histogram for subjective opinion 0: no improvement, +: little improvement, ++: good improvement (smoothening of skin and more stretched). Lower right: histogram for low energy defocused ESWT tolerance −: negative tolerance (not suitable, some pain), 0: indifferent, +: tolerance positive tolerance (suitable, no pain).

MüllerGNürnbergerF1972Anatomical principles of the so-called “cellulite”Arch Dematol Forsch2441712

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