Promising a Cure for Those Dimples That Aren’t So Cute

The red pills come in a pink box and look big enough to banish cellulite from a horse, supposing horses get that kind of thing. The formulation--including extracts of seaweed, sweet clover, grape seed and gingko biloba--promises hope to any woman who’s ever stared despairingly at her back view in a mirror, in all its wobbly, dimpled glory.

The pill is Cellasene, and its manufacturer claims it can melt away the cellulite that so many women dread. It does so, they say, by improving blood flow to women’s thighs and buttocks, allowing trapped blobs of fat to be more easily metabolized by our bodies.

Given the way lots of women feel about this particular cosmetic condition, it’s no wonder that the drug’s U.S. distributor, Rexall Sundown Inc., expects business to be brisk. (One can almost understand--not quite--why an Australian woman, according to news reports, coughed up more than $1,000 for a 10-day supply, in the midst of a Cellasene shortage.) But can Cellasene--or a similar product from New Zealand, Cell-U-Thin Plus, that was also just launched in this country--really do us any good?

Many doctors are skeptical. Cellasene’s marketers “are hustling a pill with no value,” says Dr. Arthur Frank, medical director of the George Washington University weight management program in Washington, D.C. There’s no credible evidence, he says, that Cellasene or any other pill will do a thing for those dimples in your thighs.

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Cellasene’s inventor, Italian businessman Gianfranco Merizzi, begs to differ. Cellasene, he says, does work: His Milan-based company, Medestea Internazionale, has tested it with scientists at a nearby university.

“This is a serious approach to the problem of cellulite,” he says in a telephone interview from Dublin, Ireland, where a Cellasene launch is in full swing. “That’s a fact--not an opinion.”

Years of work went into developing the recipe, he says, starting in 1992, when he was judging a Miss Italy contest.

“There were a lot of young and beautiful girls,” he recalls. “When they heard I was president of a cosmetics company, they came to me and said, ‘We are young, but we have cellulite in the thighs.’ ”

Merizzi set out to help them. First, he experimented with thigh creams. But after concluding that the skin was a barrier to treatment, he turned his attention to a therapy that could be delivered in pill form.

What to deliver? Something to fight cellulite’s underlying cause, which, according to Merizzi, is “trapped fat.” The female hormone estrogen, he explains, causes poor blood flow in cellulite areas, so the fat can’t be metabolized.

If untreated, he adds, the cellulite passes through several stages and becomes irreversible.

“A lot of women develop cellulite at puberty, and in this case it’s very important to take care of it immediately,” he says.

Cellasene’s herbs were chosen to improve blood flow, he explains, allowing cellulite fat to be metabolized before it becomes irreversible.

But there’s a problem with all this, says Dr. Michael Rosenbaum, of Columbia-Presbyterian Medical Center. Merizzi’s theories, he says, don’t mesh with most doctors’ thinking about cellulite. Fat, he says, isn’t the main issue.

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Rosenbaum and colleagues recently put cellulite under the scientist’s scalpel--literally--when they cut thin slices of tissue from the thighs of a few stalwart male and female volunteers.

“Think of your thigh as a quilt,” he says. “Say you had a whole load of quilts and some of them were irregular with bumpy dimples, and some of them were smooth. What’s the difference between those quilts? Is it in the stuffing or the stitches?”

Rosenbaum and colleagues found no difference between the stuffing (or fat) of people with and without a cellulite problem. And they found no real difference in blood supply.

The difference, instead, was in the stitches: the elastic fibers of connective tissue that stretch through the fat, anchoring the skin to the muscles beneath. In men, that mesh of fibers was dense, like fishnet. In women, it was patterned more like a honeycomb. Fat in each cell of the comb could more easily bulge outward.

What’s more, the honeycomb pattern was more irregular in the tissue of women with cellulite.

Other doctors agree that connective tissue--not fat--causes dimpling, because the skin is tugged inward at points where strands join the skin. Genes, age and gender play their part in the dimpling’s severity.

There aren’t any miracle cures, says UCLA plastic surgeon Dr. Peter B. Fodor. Liposuction procedures, along with some severing of the connective fibers, can improve matters somewhat. So can a special massage treatment in which fibers are stretched and fat redistributed.

But Merizzi has proclaimed on national TV that Cellasene is indeed a cure for cellulite, citing three studies as proof. Women on Cellasene for eight weeks experienced loss of girth and fat around their thighs and hips, as well as increased blood flow to the areas of cellulite. Those studies have not been published in scientific journals in Europe or elsewhere.

The Cellasene studies did impress New York City plastic surgeon Dr. George Beraka, now a consultant for Merizzi’s company.

“At first I was skeptical, but to my amazement the data really show something,” Beraka says. He’s now doing his own study.

But other doctors say they’re unconvinced by unpublished studies. And Fodor, for one, doesn’t see how thigh circumference measures cellulite. Also, he asks, since the subjects didn’t lose weight, where did the extra heft go? A better measure, he says, would have been before-and-after photos.

To some doctors, too, there’s a niggling issue of safety. As herbal products, the pills aren’t subject to FDA regulation. Might some ingredients (iodine in the seaweed, or blood-thinning chemicals in the clover) potentially create problems, especially if users get over-exuberant with their intake? “People think that because something’s natural, it’s safe,” Frank says. “Well, what if I mixed up a potion of mushrooms I picked in the forest?”

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Merizzi insists that the product has undergone stringent safety testing. And the package carries warnings for people on blood-thinning medications or with thyroid conditions.

“My wife,” Beraka says, “is taking the pills. And I’m not concerned.”

Apparently anticipating a sales boom, Cellasene’s distributor says it will stock U.S. stores with plentiful supplies to avoid the type of shortages that occurred in Australia. But whether Cellasene or its New Zealand rival, Cell-U-Thin Plus, can help women fall in love with their thighs is questionable.

“I’m open-minded,” Fodor says. “In fact, I’m extremely anxious that something be developed for cellulite, so I could give it to my patients. But in the 22 years I’ve practiced plastic surgery, I have often seen miraculous cures surface in the media without first surfacing in the peer-reviewed scientific journals. I have yet to see any of those miraculous things turn out to be true.”