The dimpled appearance often referred to as “dimples on the butt” is a common skin condition known as cellulite. This structural change in the skin’s surface is extremely prevalent, affecting up to 90% of post-pubertal women across all body types and weights. Cellulite is not caused by excess weight alone, but rather by the architecture of the underlying connective tissue and fat cells. Understanding that cellulite is rooted in the structure beneath the skin is key to setting realistic expectations for managing its appearance. Though completely eliminating the condition is challenging, various targeted strategies and treatments can significantly smooth the skin’s texture.
Understanding Cellulite: The Root Cause of Dimples
Cellulite primarily results from the interaction between fat cells and the fibrous connective tissue that anchors the skin to the muscle below. This tissue, called fibrous septae, organizes the subcutaneous fat layer into compartments. In women, these septae tend to run perpendicular to the skin’s surface, creating chambers where fat cells push upward, producing the characteristic dimpled texture. Men rarely experience cellulite because their septae are typically arranged in a criss-cross or oblique pattern, which provides stronger support.
Hormones, particularly estrogen, influence fat storage patterns and the integrity of the connective tissues, playing a role in cellulite development. Genetics also determines the skin’s structure, connective tissue strength, and circulatory efficiency, making some individuals more predisposed to the condition. Aging contributes to the problem as the skin thins and loses elasticity, making the underlying structural irregularities more visible.
Lifestyle Adjustments for Appearance Management
Changes in diet and exercise cannot alter the fundamental structure of the fibrous septae, but they can improve the overall appearance of cellulite. Building muscle mass, especially in the gluteal area, helps smooth the skin’s surface by firming the area. Targeted strength training exercises include squats, lunges, and glute bridges, which engage the muscles beneath the affected areas.
Maintaining a healthy body weight is helpful because reducing overall body fat can lessen the pressure exerted by fat cells against the connective tissue. However, people of all sizes can have cellulite, and weight loss alone may not fully resolve the dimpling. A balanced, anti-inflammatory diet coupled with consistent hydration supports skin elasticity and improves microcirculation, which can temporarily minimize visibility.
Over-the-Counter and Topical Solutions
Topical products are widely available for cellulite, but their effectiveness is temporary and marginal because they cannot penetrate deep enough to address the fibrous bands. Common ingredients include methylxanthines like caffeine, which promotes the breakdown of fat and stimulates microcirculation to reduce fluid retention. Caffeine is thought to mobilize triglycerides into free fatty acids that the lymphatic system can eliminate.
Retinoids, such as retinol, are also frequently included in topical formulations because they increase dermal thickness and collagen synthesis. This thickening of the skin’s outer layer can make the underlying dimpling less noticeable. Manual techniques, such as deep massage and dry brushing, can temporarily improve the skin’s appearance by boosting lymphatic drainage and circulation.
Professional and Minimally Invasive Treatment Options
For more significant and lasting improvement, professional procedures are necessary to physically or chemically alter the underlying fibrous septae. Subcision techniques, such as Cellfina, are minimally invasive procedures that mechanically sever the tough bands causing the dimples. This process releases the tension, allowing the skin to smooth out, and results can be long-lasting, often requiring only a single session for defined dimples.
A newer approach involves injectable treatments, such as Qwo (collagenase clostridium histolyticum-aaes), which uses enzymes to chemically break down the collagen-rich fibrous bands. This enzymatic remodeling releases the tension of the septae and stimulates the production of new collagen. Patients typically require three treatment sessions spaced about three weeks apart, though bruising at the injection site is a common side effect.
Energy-based treatments, like radiofrequency (RF) and laser therapies, use heat to target fat cells, stimulate collagen production, and sometimes help break down the septae. RF energy heats the deeper layers of the skin, tightening the tissue and encouraging the body to produce new collagen and elastin for a smoother contour. These non-invasive procedures often require a series of six to twelve sessions and have minimal downtime. Acoustic wave therapy, which utilizes sound waves, is often combined with RF to further stimulate collagen and improve circulation.