The causes of cellulite include changes in metabolism, physiology, dieting too hard or too much, sex-specific dimorphic skin architecture, alteration of connective tissue structure, hormonal factors, genetic factors, the microcirculatory system, the extracellular matrix, and subtle inflammatory alterations.
Hormones play a dominant role in the formation of cellulite. Estrogen may be the important hormone to initiate and aggravate cellulite. However, there has been no reliable clinical evidence to support such a claim. Other hormones, including insulin, the catecholamines adrenaline and noradrenaline, thyroid hormones, and prolactin, are all believed to participate in the development of cellulite.
There is a genetic element in individual susceptibility to cellulite. Researchers led by Enzo Emanuele have traced the genetic component of cellulite to particular polymorphisms in the angiotensin converting enzyme (ACE) and hypoxia-inducible factor 1A (HIF1a) genes.
Several factors have been shown to affect the development of cellulite. Sex, race, biotype, distribution of subcutaneous fat, and predisposition to lymphatic and circulatory insufficiency have all been shown to contribute to cellulite.
A high-stress lifestyle will cause an increase in the level of catecholamines, which have also been associated with the evolution of cellulite. Certain dieting practices can also diminish the level of these chemicals, and decreasing body fat typically results in the reduction in appearance of cellulite.