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The question

I've had cellulite on my upper thighs and buttocks as far back as when I was a teenager. But now, at 34, it has spread all the way down to my knees - not cute. I lost some weight, and I've started to run to be more active - I have a hard time drinking a lot of water though. Nothing seems to help my cellulite's appearance - what can you suggest?

The answer

Cellulite refers to the dimpled appearance of the skin, most commonly found on the hips, thighs and buttocks. With more than 90 per cent of women having some form of cellulite, it is extraordinarily common.

There is no known way to prevent getting cellulite, but maintaining a healthy weight, good hydration and strengthening muscles can help tone your skin and help to keep the appearance even. Specifically with diet, limiting excessive sugar (which gets converted to fat cells) and salt intake (which can cause fluid retention) may be helpful. Good hydration can help to flush toxins and help the skin appear more full and less lumpy.

Contrary to common belief, cellulite is not only related to excess weight gain but more likely due to genetic and hormonal causes and how fatty and connective tissue is distributed in the skin. Weight gain can make it more noticeable but cellulite is certainly not limited to those who may be overweight as it can be found in lean individuals as well.

Unfortunately at this time, there is no cure for cellulite. An abudance of products - creams, massage therapists, laser treatments - that claim to break down fat stores and reduce cellulite. While these offers may seem tempting, there is little evidence to show that they are effective in the long term. They may work for a few months, but without costly repeat treatments, the cellulite can return.

Liposuction is not recommended as a treatment for cellulite as while it may reshape the body, it does not make cellulite disappear.

It's great that you've become more active and that you've noticed changes in your weight - take great pride in that. These changes will be beneficial not only for your physical appearance but for your overall health and well-being.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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