The Truth About Lipedema vs. Cellulite: Key Differences Medical Experts Want Every Woman to Know
Plus learn why the two may be confused with a third condition
It’s a common case of mistaken identity: If a woman sees a doctor about dimply fat deposits in her legs, she might be told it’s just cellulite when in fact it’s lipedema. The two conditions are often confused with each other, but when it comes to lipedema vs. cellulite, they’re actually quite different.
Complicating matters, a third condition is sometimes blamed: “Patients are sometimes referred to us because their doctors have told them they have lymphedema,” says Kuldeep Singh, MD, associate chief of vascular surgery and director of limb salvage surgery at Staten Island University Hospital in New York. “Very infrequently are they told they have lipedema.”
Lipedema vs. cellulite: What’s the difference?
Lipedema is a chronic medical condition involving the abnormal accumulation of fat, usually in the legs. It’s symmetrical, meaning it affects both thighs and sometimes both calves, but not the feet. “It’s not a rare condition but it gets misdiagnosed,” says Natalie Hone, MD, FAAD, a dermatologist at Memorial Hermann Health System in Houston. “There isn’t a definitive diagnostic test.” Instead, it has to be evaluated by a physician.
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Someone who has lipedema may bruise easily and have visible spider veins under the skin in the affected areas. “The area can feel tender to the touch,” says Dr. Singh, who specializes in treating lipedema and lymphedema. If it’s severe, it can cause pain and difficulty with walking or dressing. (Learn more about one woman’s painful journey with lipedema here.)
By contrast, lymphedema is a condition that involves a buildup of fluid in soft tissues in the body when the lymphatic system is damaged or blocked. It can have a genetic basis or be due to an infection or medical treatment (such as radiation for cancer).
Cellulite is less problematic than lipedema
Meanwhile, cellulite is considered a cosmetic condition. With cellulite, an accumulation of normal fat cells appears on the thighs, hips or buttocks, giving the skin an uneven, lumpy or dimpled appearance, Dr. Hone says. Cellulite can occur on one or both sides of the body, but the affected areas aren’t tender or painful.
What increases the risk of lipedema vs. cellulite?
Lipedema affects more women than men, and there can be a genetic basis for it, Dr. Singh says. Because it occurs more often in women, it’s believed that hormones and inflammation also play a role. Why? It usually begins or worsens during puberty, pregnancy or menopause. Other than that, “it’s very difficult to determine who will get it,” Dr. Singh adds.
Contrary to popular belief, these abnormal deposits of fat in the legs are not related to diet or exercise, Dr. Hone notes.
On the other hand, cellulite affects up to 90 percent of women and 10 percent of men after puberty. It’s believed to have hormonal, metabolic and inflammatory aspects. With cellulite, there can also be architectural changes under the skin, whereby “fibrous tissue encases fatty tissue in a honeycomb pattern,” Dr. Hone explains. This is what creates that familiar dimpled appearance or “orange peel” skin.
How lipedema is treated
There are a few techniques to help manage lipedema. Here’s what can help:
Regular exercise and dietary changes
Light to moderate exercise and an anti-inflammatory diet can help with lipedema management, though it won’t cure it. “Aquatic activity is especially helpful because the water pressure helps promote lymphatic drainage,” Dr. Hone says.
Unlike treatment for overweight and obesity, lipedema doesn’t respond well to dietary changes and exercise alone. Indeed, a small 2023 study in the International Journal of Environmental Research and Public Health found that women with lipedema who wore compression leggings daily and participated in an exercise program three times per week had a decrease in the severity of their symptoms (especially bruising and pain), compared to those who only exercised.
Compression therapy
Compression socks, stockings or other devices help increase blood circulation in the legs. “Low-level compression therapy rarely reverses lipedema, but it can help prevent progression and complications,” Dr. Hone says.
Do natural supplements work?
Unfortunately, there aren’t any topical remedies known to help with lipedema. And the jury is out on supplements. In theory, however, the use of fat-burning supplements that contain green tea, caffeine, chromium, carnitine and conjugated linoleic acid, could work together with a healthy diet and physical exercise to reduce fat deposit in patients with lipedema, according to a 2022 review in the Journal of Preventive Medicine and Hygiene.
When surgery is an option
If lipedema is affecting your mobility and quality of life, a doctor may be able to recommend other interventions. In some instances, surgical techniques such as liposuction or excisional lipectomy, in which the fatty tissue is surgically removed, may be an option. A study in Plastic and Reconstructive Surgery Global Open found that lipedema reduction surgery led to an improvement in quality of life for 84 percent of the 148 participating women, and an improvement in pain for 86 percent of them.
How cellulite is treated
Compared to lipedema, there are more treatments to reduce or improve the appearance of cellulite.
Diet, exercise and home remedies
Regular aerobic exercise and a healthy diet—including drinking adequate amounts of water—may help, Dr. Hone says. And topical agents, such as those containing retinoids or caffeine, can “stimulate circulation and production of collagen and dissolve fatty tissue,” Dr. Hone says.
Also, on the DIY side of the equation, increasing circulation with various forms of massage or the regular application of moisturizers may help improve the appearance of cellulite, she adds.
In-office procedures
If home fixes don’t help sufficiently, see your doctor to explore other treatment options. Acoustic wave therapy, which uses sound waves to break up cellulite, and radiofrequency, which uses heat to treat cellulite, can reduce the appearance of cellulite.
A minimally invasive laser treatment called Cellulaze may also improve the appearance of cellulite. There’s a medical procedure called Cellfina, in which a doctor inserts a needle under the skin to break up the bands of fibrous tissue that make cellulite visible, and a new treatment called Sofwave, which uses ultrasound technology to improve the appearance of cellulite.
Keep in mind: These machine-driven treatments aren’t usually covered by insurance, Dr. Singh says. This is partly because cellulite is considered a cosmetic condition rather than a medical one.
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