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Reprinted with permission of Life Extension |
A Scientific Solution to Unsightly Cellulite
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By Laurie Barclay, MD
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Cellulite affects nearly
every woman as she gets older. The skin dimpling
and bumps typically seen on the thighs, hips,
and buttocks is a condition that women have
endured for centuries.
While purported “cures” for
cellulite abound, the billions of dollars spent
on specialized creams, diets, and massage
therapies have not overcome the problem. The
reason why these methods have failed is because
they have approached cellulite as purely a
cosmetic problem and neglected to address its
underlying causes.
Fortunately, major scientific
discoveries have uncovered the factors that
cause cellulite.
Dermatology experts have
taken these new data to develop powerful topical
agents that target cellulite by correcting the
underlying abnormalities involved in its
formation. These active botanicals have been
shown to help restore smooth and youthful body
contours to the hips and thighs.
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How Can You Tell if
You Have Cellulite?
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Pinch test: Using
your index finger and your thumb, pinch
the skin on your outer thigh, buttocks,
or abdomen, and look for dimpling.
Nurnberger-Mulle
scale: This scale classifies cellulite
into four stages:
- Stage 0: No
noticeable dimpling while standing
or lying, and the pinch test shows
folds and furrows, but no
mattress-like appearance.
- Stage 1: No
dimpling while standing or lying
down, but the pinch test shows
mattress-like appearance.
- Stage 2:
Spontaneous dimpling when standing,
but not when lying down.
- Stage 3:
Spontaneous dimpling when standing
and when lying down.
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How Females Develop
Cellulite
Why are women prone to
cellulite as soon as they begin menstruation,
whereas men are spared? Many experts believe
that the primary culprits are hormonal
influences on fat deposits over the buttocks,
thighs, and hips, as well as anatomical
differences in how this fat is stored.1,2
Although there are three
layers of fat under the skin, only the top layer
is involved in cellulite. Imagine that the skin
in this top layer is like a down quilt. The
stitches in the quilt represent columns of
collagen fibers that give the skin its
structure. Adding feathers into the compartments
between the stitches is analogous to how fat
globules accumulate between the skin’s collagen
columns. As more fat globules are added, the
compartments fill up, causing fat to bulge out
from the compartments resulting in the
characteristic dimpled appearance of cellulite.
Scientists have
discovered how changes in the connective tissue
structure in this top fat layer trigger the
formation of cellulite. Magnetic resonance
imaging studies have shown that women with
cellulite have pillar-like columns separating
the fat chambers, which are larger and deeper
than those in men.3
What makes women more
vulnerable to cellulite is that these large
vertical chambers can store an abundance of fat.
Collagen supporting tissue of men, on the other
hand, is more like a criss-cross net that is
organized into small diagonal chambers, which
hold only small amounts of fat.4
These longer supportive
columns in women are more easily weakened by
hormonal, structural, and vascular changes that
affect the skin’s support structure, allowing
fat to protrude deeply into the dermis (the
layer of skin beneath the outermost layer),
which gives rise to the characteristic lumpy
appearance of cellulite.1
Pregnancy and other
hormonal changes in women affect the formation
of cellulite, as do genetics and aging. These
factors adversely affect adipose tissue and the
supporting connective tissue.1
Hormones secreted in response to stress,
particularly cortisol, also encourage fat
deposition in problem areas.5
“The adipose
tissue in the thighs and buttocks [in women] is
special in that it is reserved for nutrition of
a fetus in bad times,” Peter T. Pugliese, MD,
founder of Circadia Skin Care Institute in
Reading, PA, tells Life Extension. “So this fat
does not move with normal dietary restriction or
with exercise.”
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What You Need to
Know: Combating Cellulite
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- 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.
- Life Extension
has identified seven compounds that
may be especially promising as a
multi-modal approach to correct the
underlying causes of cellulite.
- These candidates
for topical therapy of cellulite
include: glycyrrhetinic acid derived
from licorice root, which fights
stress-induced fat deposition
related to cortisol secretion; horse
chestnut, which improves circulation
and reduces capillary leakage; and
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.
- Four additional
nutrients have demonstrated profound
fat-reducing benefits. These
anti-fat ingredients, Phycoboreane™,
Rhodysterol™, Adiposlim™, and
Adipoless™, provide a key missing
link to resolving cellulite.
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These differences highlight
the fact that cellulite is not purely a cosmetic
problem, but involves a number of physiological
factors. “Cellulite is multifactorial but mostly
related to the underlying structure or framework
and relationship of adipose tissue to connective
tissue in women,” Adam M. Rotunda, MD, a
clinical instructor of dermatology at the David
Geffen School of Medicine, UCLA, tells Life
Extension.
Connective Tissue Structure
Abnormalities in Cellulite
Connective tissue structure
in women increases vulnerability to cellulite,
with the result that female skin becomes loose
and more wrinkled with age.
“Cellulite-affected skin demonstrates
biomechanical properties of increased laxity in
contrast to skin without cellulite,”
Gordon H. Sasaki, MD, FACS, a surgeon at the
Sasaki Advanced Aesthetic Medical Center in
Pasadena, CA, says.
Other factors
compromise the underlying connective tissue such
as the enzyme collagenase that is released
before a woman’s menstrual cycle. This enzyme
breaks down collagen, which is a key structural
protein within connective tissues.6
Fibrous tissue, similar to that seen with
scarring, may fill in the gaps caused by
degraded collagen. This results in the formation
of fibrotic stiff bands that can worsen the
appearance of cellulite.
“Cellulite is a disease of
the connective tissue initiated by cyclic
hormones of the menstrual cycle,” Dr. Pugliese
says. “The characteristic undulating surface one
sees with cellulite is the product of extensive
connective tissue destruction.”
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Cellulite: A Modern
Epidemic
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At one time,
cellulite was highly regarded as a
symbol of wealth (being able to afford
to eat rich foods), high social status
(leaving physical labor to the
servants), and attractiveness (as shown
in portraits of large women by Peter
Paul Rubens).
But since the
media has proclaimed, “You’ve come a
long way, baby!” thin has been in.
Cellulite, which affects the majority of
adult women,1,7,8
is now widely 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 dermis (the layer of skin beneath
the outermost layer) 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. “Formulators in
the spa world increasingly look to
herbal natural products for
demonstrations of efficacy, safety, and
function-ality of new ingredients and
their concentrations,” says Gordon H.
Sasaki, MD, FACS, an aesthetic plastic
surgeon at the Sasaki Advanced Aesthetic
Medical Center in Pasadena, CA, and
clinical professor of plastic surgery at
Loma Linda University Medical Center.
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Poor Circulation Aggravates
Cellulite
As well as connective tissue
abnormalities, poor circulation and lymphatic
drainage can also aggravate cellulite. Fat, or
adipose tissue, is relatively rich in blood
vessels. Decreased blood flow, swelling from
fluid accumulation (edema), and local
inflammation can aggravate the female propensity
to skin looseness and hasten the development of
cellulite through a domino effect.
When small blood
vessels become fragile, they leak excess fluid
that accumulates in the compartments between the
fat chambers. This effect increases pressure
within the tissues, resulting in poor lymphatic
drainage. As excess fluid is retained in dermal
tissues, fat globules cluster together and
inhibit venous return. This vascular damage
results in decreased collagen synthesis and an
inability to repair tissue damage, which weakens
the dermis. Over time, clumps of hardened
collagen contribute to the formation of fibrotic
collagen bands, which become deposited around
fat globules beneath the skin. The tightening of
these bands causes a vicious cycle that worsens
cellulite and impairs blood flow even more.6
These changes have been seen in ultrasound
imaging of skin affected by cellulite, which
reveals thinning of the dermis with fat pushing
upward.6
As a result of
compromised circulation and lymphatic drainage,
cellulite may appear and worsen in predisposed
areas.1
“One of the major
factors inducing cellulite is venous
insufficiency and congestion,”
Carl R. Thornfeldt, MD, FAAD, founder and CEO of
Episciences, Inc., tells Life Extension.
“Non-prescription and/or herbal therapies have
rarely been studied in this condition. Several
are reported to be effective in the literature,
but only horse chestnut [Aesculus hippocastanum]
and gotu kola [Centella asiatica] have
documented efficacy in reversing venous
insufficiency.” Leslie Baumann, MD, professor of
dermatology at the University of Miami, agrees
that,
“Horse chestnut and gotu kola seem to improve
circulation.”
“Increasing circulation may
help by increasing lymph flow,” Dr. Baumann
tells Life Extension. “Lymph builds
up and makes cellulite appear worse. By
increasing circulation this may increase lymph
flow and help the appearance of cellulite.”
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Practical Treatment
Strategies
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A healthy lifestyle
is very effective in promoting
cardiovascular health, but diet and
exercise alone may not be enough to
adequately tackle cellulite. Dr. Rotunda
believes that, “Diet and exercise cannot
alter the histologic structure of the
perpendicular bands connecting the skin
to the underlying fascia and so cannot
eliminate cellulite entirely,” he says.
“However, lifestyle modifications may
assist to reduce the appearance of
cellulite by decreasing adipocyte
volume, thus placing less tension on
surrounding connective tissue, resulting
in decreased puckering, but this has not
been well documented.”
Dr. Wollina suggests
that wearing neoprene compression
shorts, as was done in some trials of
cellulite cream, may affect absorption
or penetration of active anti cellulite
compounds. “[Wearing support hose] will
reduce some of the strain on the
connective tissues and help prevent more
destruction of damaged collagen, but
second, it will place a force on the
thighs and buttocks that is
perpendicular to the long axis of the
body to counteract gravitational
stress,” Dr. Pugliese says. “In
addition, this force is able to
directionally stimulate the fibroblasts
to produce collagen… through
directionally sensitive cell receptors
called integrins.”
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Zeroing in on Anti Cellulite
Compounds
Ideally, an herbal
cream to combat cellulite should target the
three main causes of cellulite that have been
identified. These are excess fat deposition,
weakened connective tissue support structure,
and poor circulation.1,7,8
Life Extension has identified
seven compounds that may be especially promising
as a multi-modal approach to correct the
underlying causes of cellulite. Glycyrrhetinic
acid, for example, is a compound derived from
licorice root that targets fat storage in
response to stress. Horse chestnut and gotu kola
improve circulation, while also supporting
connective tissue integrity. All three compounds
have additional benefits that may improve the
appearance of cellulite-prone skin, including
antioxidant and anti-inflammatory activity. For
readers interested in technical descriptions of
these anti cellulite nutrients, please see the
information outlined in the boxes throughout
this article.
While the combination of
glycyrrhetinic acid, horse chestnut, and gotu
kola has demonstrated favorable anti cellulite
effects, scientists have discovered four
additional nutrients that have demonstrated
profound fat-reducing benefits. As you will
read, these anti-fat ingredients provide a key
missing link to resolving cellulite.
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How Licorice Root
Fights Stress-Related Fat Deposition
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Cortisol
secreted in response to stress leads to
fat storage beneath the skin,5
thereby aggravating cellulite.
Glycyrrhetinic acid, a compound derived
from licorice, fights this response5,13-15
making it a promising candidate for
cellulite therapy.
“The mechanism of
action of glycyrrhetinic acid is to
reduce fat. Cortisol is involved in the
distribution and deposition of fat,
which is regulated by an enzyme called
11-beta-hydroxysteroid dehydrogenase,
Decio Armanini, MD, professor of
endocrinology at the University of Padua
in Italy, tells Life Extension. “Glycyr-rhetinic
acid, the active principal of licorice
root, blocks 11-beta-hydroxysteroid
dehydrogenase type 1, thus reducing the
availability of cortisol at the level of
adipocytes.”
A groundbreaking
study by Dr. Armanini’s group15 showed a
promising effect of topical application
of a cream containing 2.5%
glycyrrhetinic acid in reducing the
thickness of thigh fat, as measured by
ultrasound. Eighteen healthy young
women, 20 to 33 years old and of normal
weight, were randomly assigned to apply
a cream containing glycyrrhetinic acid
cream or placebo to one thigh.
After one month
of treatment with glycyrrhetinic acid
cream, both the circumference and the
thickness of the superficial fat layer
were reduced compared with the opposite,
untreated thigh, and also compared with
the placebo group. Both comparisons were
statistically significant (P <0.005). In
women treated with glycyrrhetinic acid
cream, the thickness of the superficial
fat layer decreased by more than 10%,
from 16.8 to 14.7 mm.15
“Orally ingested
licorice and its active principal
glycyrrhetinic acid can produce
retention of sodium and water and
decreased serum potassium and
hypertension,” Dr. Armanini says. “[In
this study using topical glycyr-rhetinic
acid], no changes were observed in serum
potassium, blood pressure, plasma renin
activity, plasma aldosterone, or
cortisol.”
“The effect of
glycyrrhetinic acid is at the level of
fat cells. It could be effectively and
safely used in the reduction of unwanted
local fat accumulation,” Dr. Armanini
says. “We recommend the application of
this cream to our patients with
cellulite [related to] excessive topical
fat accumulation (two applications per
day). Its use is recommended [over] a
limited skin surface (where cellulite is
more evident as demonstrated in our
study).”
Other research
by Dr. Armanini’s group suggests that
topical application of cream containing
glycyrrhetinic acid could be helpful for
acne and hirsutism (excessive facial or
body hair in women), perhaps because of
its antibacterial activity and its
ability to counteract the effects of
male hormones.16-18
As well as its
effects on fat deposition,
glycyrrhetinic acid also has known
anti-inflammatory effects,19,20
according to Dr. Thornfeldt. Fighting
inflammation could, in theory, help
break the vicious cycle of edema that
aggravates cellulite. In fact, an
extract of licorice root has been shown
to reduce inflammation and swelling in
the ear of laboratory mice, and even
protect against skin tumors caused by
toxic compounds.21
The
anti-inflammatory activity of licorice
root could theoretically protect the
connective tissue in skin by reducing
the expression of proinflammatory
cytokines and suppressing enzymes that
degrade collagen22
and other structural support proteins of
the skin.
“[Glycyrrhetinic
acid’s] apparent benefit in treating
signs of skin photoaging with topical
formulations suggests it will help
diminish visible cellulite by reversing
the atrophic skin and connective tissue
component of this condition,” Dr.
Thornfeldt says. “Formulating this
ingredient with horse chestnut for topical
application
would seem to be promising as a cellulite
therapy.”
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Enzymatic Breakdown of Body
Fat
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), whereas alpha-adrenergic receptors
prevent fat breakdown and promote fat storage.9,10
“In the case of cellulite fat, the alpha
receptors outnumber the beta receptors,” Dr.
Pugliese says. Women also tend to have more
fat-storage alpha receptors than fat-breakdown
beta receptors in the hips and thighs9
so that storage exceeds breakdown in these
areas, causing swelling of the stored fat within
cells.
Stimulation of these
receptors also leads to changes in a crucial
lipolytic (fat-breakdown) enzyme called
hormone-sensitive lipase.11
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.11
This may help explain why, to some degree,
exercise, which is associated with epinephrine
release by the sympathetic nervous system, is
helpful in improving the appearance of
cellulite, whereas obesity aggravates its
appearance.
Another enzyme called
lipoprotein lipase that is found in large
amounts in adipose tissue and in the liver acts
on triglycerides within lipoproteins, breaking
them down into free fatty acid molecules to be
either burned for energy or stored as fat.
Lipoprotein lipase is also responsible for the
uptake of fat into the adipocytes. Women tend to
have higher concentrations and activity of this
enzyme in the hips and thighs, favoring fat
storage in this region particularly if they are
not physically active.9
To overcome these adverse
enzymatic changes that make women vulnerable to
cellulite formation, scientists have identified
two unique marine extracts known as Phycoboreane™
and Rhodysterol™ that are showing promise for
their effects in promoting lipolysis and
liberating fat.
These compounds appear to
stimulate an enzyme called protein kinase A,
which in turn activates hormone-sensitive lipase
to break down fat, releasing fatty acids and
glycerol. These compounds also contain sulfated polysaccharides,
which can bind to fatty acids and facilitate
their elimination. Studies in all types of
cellulite are underway to determine the effects
of Phycoboreane™ and Rhodysterol™ on edema,
fibrosis, skin suppleness, and tonicity.
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How Gotu Kola
Stimulates Collagen Synthesis
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The herb gotu kola (Centella
asiatica) has a long history of use in
Ayurvedic medicine and is widely
believed to help retard the aging
process.
Like horse
chestnut, gotu kola is rich in
triterpene saponins with effects that
are beneficial in reducing cellulite. It
functions by stimulating collagen
production to strengthen the support
structure, reducing inflam-mation, and
improving blood vessel tone and
circulation, thereby reducing capillary
leakage.35
In the
laboratory, asiaticoside, a major active
component of gotu kola, has been shown
to stimulate synthesis of human collagen
type I,36
a deficiency of which appears to be
primarily related to skin aging.
In a study
described by Dr. Pavicic, gotu kola
extract given orally at a dose of 60 mg
for 90 days was effective in the
treatment of cellulite.37
Amazingly, gotu kola not only caused
shrinkage of fat cells over the buttocks
and thighs, but also reduced unsightly
fibrous tissue between fat cells.
“In this study
there was a significant reduction in the
diameter of adipocytes, especially in
the gluteofemoral region and a decrease
in inter-adipocyte fibrosis,” Dr.
Pavicic says. “Another study showed that
a cream containing gotu kola formulated
with other natural plant complexes
significantly improved the biomechanical
properties (extensibility and firmness)
of the skin. The effects of gotu kola
are attributed to triterpenoids that
favor lymphatic drainage and stimulate
synthesis of the extracellular matrix.”38
According to Dr.
Sasaki, “Gotu kola has been used to
treat cellulite topically because of its
purported effects in strengthening
tissues surrounding fat-storage cells,
tostimulate collagen in the weakened
walls of subdermal veins, and to reduce
the storage of subdermal moisture in the
legs.”
Gotu kola’s
ability to improve circulation in small
blood vessels is also well demonstrated
by a clinical, randomized study of the
herb in diabetic patients with
microangiopathy, a condition marked by
reduced blood flow through the
microcirculation.39
Thirty patients were treated for six
months with the total triterpenic
fraction of gotu kola asiatica,
60
mg twice daily. After six months of
treatment, these patients showed
significant improvements in
microcirculatory values measured with
Doppler ultrasound and decreased leakage
from capillaries, whereas control
patients had no changes.
“Gotu kola has been
used as a medicinal herb for thousands
of years in India, China, and Indonesia
to heal wounds, improve mental clarity,
and treat skin disorders such as leprosy
and psoriasis,” Dr. Sasaki says. “Today
American and Europeans use gotu kola for
disorders that cause connective tissue
swelling, such as scleroderma and
psoriatic arthritis, for depression, and
to improve memory and concentration.
Gotu kola is
rich in flavonoids with good antioxidant
activity needed for healthy skin. The
anti-inflammatory properties of gotu
kola suggest that it might also be
helpful for atopic dermatitis in
conditions of cold and dry weather.40
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The Two Most Exciting
Fat-Reducing Ingredients
Scientists in Europe
have developed two new breakthrough formulations
called Adiposlim™ and Adipoless™. Both of these
compounds work in synergy to help reduce
stubborn cellulite and prevent its formation.12
Adiposlim™ shrinks adipocytes by activating the
fat-burning beta receptors while simultaneously
turning off alpha receptors that inhibit fat
burning.12
It also boosts fat oxidation, ensuring fat is
burned as cellular energy, and inhibits the
enzyme lipoprotein lipase to prevent fat
storage.12
A clinical trial in
adults using Adiposlim™ on the thigh area showed
12% cellulite reduction after only one month,
compared with only 6% for a control group, as
well as visual cellulite improvement in 71% of
treated subjects.12
Adipoless™, meanwhile,
blocks the formation of blood vessels needed to
transform pre-adipocytes into fully formed fat
cells, thereby inhibiting the formation of new
fat.12
Doctors interviewed by Life
Extension emphasized the importance of reducing
fat storage in the regions of the body prone to
cellulite. According to Dr. Rotunda, once an
anti cellulite cream is discontinued, it is
conceivable any regional benefit at the site of
application would be lost unless fat cells are
destroyed or removed.
With the advent of these four
new topical fat-altering compounds (Adiposlim™,
Adipoless™, Phycoboreane™, and Rhodysterol™), a
sustainable anti cellulite program is now a
reality.
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How Horse Chestnut
Reduces Swelling, Improves Circulation
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Similarly to
licorice root, compounds contained in
horse chestnut (Aesculus hippocastanum)
appear to reduce swelling (edema),
combat inflammation,23
and improve sluggish circulation.24
The primary active
ingredient in horse chestnut is escin, a
member of the chemical class known as
triterpene saponins, which decrease
fluid leakage from small blood vessels,
quiet inflammation, and block the action
of thrombin, a compound that promotes
blood clotting. All of these effects
could be of benefit in fighting
cellulite.
“Escin purportedly is
able to promote increased blood
circulation through the veins by
increasing the tone in venous walls,
thereby enabling blood to flow
unrestricted,” Dr. Sasaki says. “This
effect has made horse chestnut a popular
topical and oral treatment for both
chronic venous insufficiency and
varicose veins.”
A rigorous
analysis of studies performed by the
prestigious UK Cochrane review group
showed that horse chestnut extract taken
orally improves chronic venous
insufficiency.25
Although the mechanism of action is not
fully understood, it may involve
blocking the activity of white blood
cells involved in producing an
inflammatory response.26
A randomized
trial in patients with chronic venous
insufficiency showed that horse chestnut
seed extract improves contractibility of
blood vessel walls, thereby improving
circulation, reducing leakage through
capillaries, and preventing edema
compared with a control group.27
In another randomized trial, treatment
with oral horse chestnut seed extract in
a dosage equivalent to 50 mg escin twice
daily was equivalent to compression
stocking therapy, which is a standard
treatment for chronic venous
insufficiency.28
Horse chestnut is
widely used in Europe for chronic venous
insufficiency. “It is considered by the
Council of Europe to be anti-edematous
and is approved by German Commission E
for venous congestion,” Dr. Thornfeldt
says.
In addition to
escin, horse chestnut contains an
arsenal of other compounds that may help
ward off cellulite, in part due to their
highly potent antioxidant activity.29
Horse chestnut
contains compounds that have been used
for years in the cosmetic industry to
treat varicose veins and spider veins.
Its primary active ingredient, escin,
blocks the enzyme hyaluronidase that
breaks down proteoglycans in the
supporting structure surrounding small
blood vessels, as well as in the
endothelium lining blood vessels,30
thus helping prevent vascular leakage.26
Additional
benefits of escin include blocking
inflammatory mediators such as
5-hydroxytryptamine and histamine and
decreasing the breakdown of
mucopolysaccharides that help support
capillary walls.31
A recent
exciting study has also revealed
encouraging benefits of horse chestnut
extract on reversing signs of facial
aging. This Japanese study has shown
that a horse chestnut extract
significantly reduces wrinkles around
the eyes, prompting the researchers to
refer to it as “a potent anti-aging
ingredient.”32
In this study, 40 healthy women applied
a gel containing 3% horse chestnut
extract to the skin around their eyes
three times daily for nine weeks, and
researchers rated wrinkle severity
according to serial photos.
After only six weeks,
women who applied horse chestnut extract
had significant decreases in the wrinkle
scores at the corners of the eyes or in
the lower eyelid skin compared with
controls. These improvements were
maintained at nine weeks.
Researchers are
now asking if there is a possible
interaction between cellulite and
premature skin aging.33
If so, would horse chestnut extract
benefit both conditions? The scientists
suggest that compounds in the horse
chestnut extract stimulate fibroblasts,32
which are connective tissue cells
involved in shaping tissue structures
within the skin, wound healing, and
blood vessel contraction. Although
fibroblasts are not muscle cells, horse
chestnut extract causes them to
contract, effectively toning the support
structures in skin.
“The results suggest
that an extract of horse chestnut can
generate contraction forces in
fibroblasts,” Dr. Pavicic says. “This
could be a very useful effect in the
treatment of cellulite.”
Because it has an
anticoagulant effect, horse chestnut
should not be taken orally in patients
who have bleeding disorders or who take
anticoagulant drugs, such as Coumadin®,
non-steroidal anti-inflammatory drugs,
or aspirin. In a few cases, topically
applied horse chestnut has been
associated with allergic skin reactions.
In Europe, gels
or creams containing 2% escin, applied
three to four times daily, are popular
for treating hemorrhoids, skin ulcers,
varicose veins, and bruises. A
randomized trial showed that this
therapy is effective in reducing
tenderness associated with bruising.34
For chronic venous insufficiency, the
suggested oral dosage of horse chestnut
extract is about 500-1,000 mg a day
(supplying 100-200 mg of the primary
active ingredient escin).
“It is unknown what
would be the optimal dose in cellulite
but it seems wise to start with a
comparable dosage,” Dr. Wollina says.
“There is evidence for anti-inflammatory
activity, increased capillary filtration
rate, and anti-edematous activity.
Insofar, horse chestnut extracts are
candidates for anti cellulite
treatment.”
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A Multi-Pronged Approach
Effective cellulite therapy
may ultimately require a multi-pronged approach:
mobilizing and reducing fat, preventing
breakdown of support structures within the skin
by promoting collagen synthesis, and preventing
capillary leakage, while inhibiting inflammation
and edema.
Glycyrrhetinic acid, horse
chestnut, gotu kola, Phycoboreane™, Rhodysterol™,
Adiposlim™, and Adipoless™ are well poised to
facilitate this strategy, ideally in combination
with healthy lifestyle changes and use of
adjunctive measures.
“Since cellulite is the
visible manifestation of multiple pathologic
processes, one cannot reasonably expect a single
agent to effectively treat this disease,” Dr.
Thornfeldt concludes.
If you have any questions on
the scientific content of this article, please
call a Life Extension Health Advisor at
1-800-226-2370.
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