Alpha lipoic acid (ALA) is a potent fat- and water-soluble antioxidant and anti-inflammatory. This makes it different from most other topical antioxidants, which are soluble only in either fat or water. ALA can penetrate skin cells easily through the lipid-rich cell membrane and continues to be effective once inside the cell due to its water solubility. ALA has a protective effect on vitamins E and C, thereby boosting their antioxidant abilities within the body. ALA is touted as a superior antioxidant compound. However, there is still very little data on the effects of alpha lipoic acid on human skin. Its primary function is as an anti-inflammatory. Alpha lipoic acid may be used to soften pigmented stretch marks and has been used for pigmentary disorders.
Aminophylline-See methylixanthines.

Basil
Derived from the flowering tops and leaves of the basil plant, this extract is used to relieve pain and muscular spasms, and to stimulate blood flow. It is also known for its restorative and anti-inflammatory properties.

Bioflavonoids
Bioflavonoids are a group of compounds consisting of potent plant derivatives. They have therapeutic anti-inflammatory attributes as well as strong antioxidant capabilities.

Borage Oil
Derived from the seed of borage, which grows abundantly in the Mediterranean region, Central Europe, and Asia, borage oil has an extremely high gamma linolenic acid (an essential fatty acid) content. GLA is vital for the synthesis of prostaglandin, a substance necessary for all manner of functions in the body. Borage oil has a very high content of essential unsaturated fatty acids, which are great skin conditioners and humectants that regulate the hydration of the skin. Although more study needs to be done, gamma linoleic acid may also have beneficial anti-inflammatory properties.

B Vitamins
There are eight B vitamins: folic acid, thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), cobalamin (B12), and biotin. The B complex group provides cumulative conditioning effects after extended and regular use. Niacin's topical form shows promise as an over-the-counter ingredient useful in anti-aging products.
One derivative of niacin, nicotinamide, has been shown to improve the ability of the epidermis to retain moisture. Topical nicotinamide was found to produce softer, smoother skin with less dryness and flakiness, as well as a reduction of fine lines. These benefits can be useful for patients with dermatitis, or dry and irritated skin. It is also useful as a treatment for aging skin, which frequently becomes dry and flaky. Niacinamide, another derivative of niacin, has been shown to be an effective skin-lightening agent. It also has anti-inflammatory properties, which makes it a potential treatment for acne and rosacea. B vitamins are beneficial in aiding metabolism of raw nutrients into new connective tissue and cell membranes.

Butcher's Broom
Butcher's broom is a plant native to the Mediterranean region. Its spines were once popular in the making of brooms, which is where it gets its unique name. Extracts from the roots of this plant seem to have the ability to strengthen and tone blood vessels, which is why it is a popular treatment for varicose veins and hemorrhoids in Europe.

Caffeine-See methylxanthines.

Carnitine (L-Carnitine)
Carnitine is a substance found naturally in the body that is used to transport fatty acids to your cells, where they are metabolized. It therefore serves the dual purpose of fat burning and cell strengthening.

Cat's-Claw
Cat's-claw is a large vine native to South and Central America. It gets its name from hooked thorns resembling claws that grow along the vine. It has been used as an anti-inflammatory by indigenous peoples for thousands of years and has recently been used successfully to stimulate the immune systems of cancer patients. Cat's-claw is also an antioxidant and has been found to increase blood flow throughout the body by dilating blood vessels.

Cayenne The active ingredient in cayenne is a pungent substance known as capsaicin. Capsaicin appears to alter the action of the bodily compound (called substance P) that transfers pain messages to the brain, reducing pain and inflammation by short-circuiting the pain message. Topically, it stimulates the treated area and is used to increase cell function and blood flow.

Cedarwood
This botanical is considered an antiseptic with tonic and antifungal properties. It is used to reduce oil and blemishes, as a natural astringent, as a treatment for eczema, psoriasis, inflammation, dandruff, hair loss, dry or oily hair, and to soften skin. As a lymphatic tonic, it is touted to aid in the removal of body fat and to stimulate the circulatory system.

Centella Asiatica
Also called gotu kola and tiger's herb, this is an excellent vasodilator and blood vessel strengthener. It increases blood flow, thereby allowing for better absorption of nutrients. It is also often used as a diuretic, antioxidant, and anti-inflammatory, and facilitates the actions of the antioxidants vitamins C and E in areas where there is damage. In fact, this plant got the nickname tiger's herb because injured tigers often rub against it to heal their wounds.

Coenzyme Q10
Coenzyme Q10, also called ubiquinone, is a powerful antioxidant. It has been shown to increase resistance to disease and to strengthen the heart. Its primary function is to create a substance known as ATP in the body's cells. ATP is vital for energy. It also has great antioxidant abilities, which work especially well in the heart and blood vessels. This dynamic substance is also showing great promise in studies of the prevention of heart disease, cancer, and AIDS. It is also capable of boosting the antioxidant effect of vitamins C and E.

Copper Peptides
A peptide is an amino acid, which is a building block for collagen and elastin. Copper is a trace mineral that helps the body convert amino acids into this connective tissue. In theory, copper peptides should be an excellent source of collagen and elastin production, but sufficient study has yet to be done on this substance.

Dimethylaminoethanol (DMAE)
Topical formulas containing DMAE have been touted for their ability to improve skin firmness and lift sagging skin.

Esculin (Horse Chestnut)
Also called escin or aescin, this nutrient is derived from the seeds of the horse chestnut tree. Esculin is an excellent anti-inflammatory. More important, it has the ability to improve blood flow by filling in microscopic holes in the blood vessels. By reinforcing these veins, esculin also prevents future damage of the circulatory system.

Essential Fatty Acids (EFAs)
Essential fatty acids are so vital that they have been referred to as vitamin F. They have amazing hydrating abilities in topical creams, and when taken internally they help to build up the cell membranes and attract water to cells. Cold-water fish and ground flaxseeds are excellent food sources of EFAs.

Everlasting
This plant is a natural anti-inflammatory that is often used in aromatherapy oils and topical treatments for all kinds of skin disorders, including cellulite and stretch marks.

Fennel
Fennel is used as both a diuretic and an anti-inflammatory in some cellulite formulations. There has been too little study on it to determine how effective it is.

Ginger
Occasionally you find ginger used in a "cellulite soap" or a stretch mark scrub. While it does have antiseptic properties, its real help regarding cellulite is its anti-inflammatory benefits.

Ginkgo Biloba
Ginkgo increases the blood flow throughout the body, expanding the reach of any nutrients in the food you eat. It is also a potent antioxidant.

Goji Berries
Goji berries are virtually every method of fighting cellulite rolled into one delicious nugget. They are an excellent source of essential fatty acids, antioxidants, and anti-inflammatories, and they contain eighteen amino acids and twenty-one trace minerals.

Grapefruit
Grapefruit oil and extract have been used for muscle fatigue, stiffness, acne, fluid retention, and skin tightening, and as an antiseptic and astringent. They have also been touted for aiding hair growth and reducing cellulite. Grapefruit increases circulation, stimulates the lymphatic system, and may help to regulate body weight with regular use. It is also a good source of the antioxidant vitamin C.

Grape Seed
Grape-seed extract has the ability to inhibit the enzymes collagenase and elastase, which break down collagen and elastin. Preventing this damage from happening in the first place is much more effective than repairing it afterward. Grape-seed extract also contains a large amount of polyphenols, an antioxidant family that is particularly active in the skin.

Green Clay
Green clay is occasionally touted as a cellulite solution. Green clay contains many of the trace minerals that your body needs to metabolize nutrients into new tissue. In theory, these minerals should be effective when applied topically as well as when taken internally, but more study needs to be done on this before we can be sure.

Guarana
The guarana plant is native to the Amazon. It is helpful in cellulite treatments because of its ability to increase blood flow by dilating blood vessels. Studies are also finding that guarana has some antioxidant activity within the body.

Ivy Extract
Ivy is a climbing plant with evergreen leaves that is widely used in bath and body products for its soothing and anti-inflammatory properties.

Juniper Berries
Juniper berries come from the plant commonly known as mistletoe. Juniper berries and extracts are high in vitamin C. They have been used to treat pain and inflammation from arthritis and varicose veins, and to increase circulation.

Lecithin
Lecithin is derived from egg yolks, soybeans, and corn, among other sources. When taken internally on a regular basis, it aids your body in repairing and strengthening its cell membranes. Topically, it has a softening and soothing effect on skin and is considered a natural antioxidant and emollient. Emollients make the skin feel softer and smoother, and reduce roughness, cracking, and irritation.

Lemongrass
Lemongrass is an ingredient in preparations to treat acne, cellulite, and other skin-related conditions. It has astringent, calmative, antiseptic, anti-infectious, and antifungal properties. It is good for the hair, face, and body. It can improve muscle tone and reduces excessive sweating and enlarged pores. Lemongrass stimulates hydration and lymphatic detoxification, strengthens connective tissue, and may tighten elastin.

Marine Extracts
Kelp derived from a marine plant, is used for its anti-inflammatory properties on the skin. It is rich in minerals and has been used to supply the thyroid gland with iodine in some instances. Kelp can also be used to hydrate the epidermis.
Nutrients in algae, such as iodine, can supposedly nourish the skin and protect elastin fibers.
Dried sea salts soften water and can be used for exfoliation. People travel from far and wide to bathe in hot springs, mineral baths, and the Dead Sea in Israel because of their unique mineral compositions. Natural mineral hot springs are also quite popular for their curative and relaxing benefits in Japan.

Methylxanthines
This is basically a family of diuretics that are often used to treat cellulite. When applied topically, these substances dehydrate the treated area. After repeated use, the area becomes smaller because of the loss of water. This decrease is only temporary-when use is discontinued, any water we ingest is reabsorbed into the area. While methylxanthines have no permanant effect on cellulite, they can temporarily minimize its appearance.
Methylxanthines include aminophylline, a synthetic diuretic; caffeine, present in kola nuts, coffee beans, tea, guarana, and more than sixty plant species; theophylline, derived from tea leaves; and theobromine, derived from the seeds of the coca plant, present in chocolate.

Mint Extract
Mint extract is occasionally used in cosmetic products for its aromatic and anti-inflammatory capabilities.

Oat Beta Glucan
Oat beta glucan is an ingredient used in topical creams. It firms the skin on contact, immediately improving the appearance of sagging or uneven skin.

Pine
Pine oil is derived from steam distillation of wood from pine trees. It has been used for its disinfectant, anti-inflammatory, and diuretic properties. It also stimulates circulation.

Pomegranate
Pomegranate is my favorite source of antioxidants. When applied topically to the skin, pomegranate extract has an effect on preventing skin cancer in laboratory mice. Pomegranate is likely the world's most prolific source of polyphenols. This is a very potent family of antioxidants that work primarily in the skin. They are found in grape seeds and green tea, but most abundantly in pomegranates. It is also very beneficial in increasing the protective abilities of sunscreens.

Retinoids (Retin-A, Retinol,
Retinyl Palmitate)
Topical use of retinoids over an extended period of time has the temporary effect of thickening and strengthening the dermis, making it more difficult for cellulite to push its way through. There is some evidence that retinoids also increase blood flow to the treated area.

Sweet Clover
Sweet clover stimulates blood flow and decreases inflammation in the vascular system. The clover plant produces abundant blossoms that are used in herbal oils and extracts.
Tea (Red, White, Black, Green)
Tea comes from leaves and leaf buds of plants cultivated principally in China, Japan, Ceylon, and other Asian countries. Tea is a mild stimulant, and its tonic properties are due to the caffeine content. Topically, it is used to reduce puffiness in areas affected by cellulite. Green tea also contains polyphenols, powerful antioxidants that function primarily in the skin. It is thought that these antioxidants may be able to inhibit cancer in some cases. For example, the topical administration of green tea has been shown to result in a reduction of tumors that occurred following UVB radiation.

Trace Minerals
Zinc, manganese, copper, selenium, magnesium, boron, chromium, molybdenum, silica, and vanadium are called trace minerals because our bodies need only a very small amount of them in order to function properly. All of the trace minerals are necessary for metabolism of nutrients. Without these, we would not be able to break down and utilize antioxidants and anti-inflammatories. Neither would we be able to convert lecithin and EFAs into our cell membranes, glucosamine into connective tissue, or amino acids into collagen and elastin. Trace minerals are a vital part of any cellulite treatment as well as overall health. Zinc soothes skin and also aids in the healing of wounds, burns, and scars. In the skin, zinc promotes cell division, cell repair, and cell growth.

Vitamin C (Ascorbic Acid,
Magnesium Ascorbyl Phosphate)
Vitamin C fights a three-pronged battle against cellulite and skin damage. First, it plays an important role in collagen synthesis, which has a firming effect on the skin. Vitamin C breaks down collagenase and elastinase, two naturally occurring substances in the body that attack collagen and elastin. Vitamin C is also a natural anti-inflammatory that helps in reversing some of the effects of sun damage. Finally, Vitamin C is a powerhouse antioxidant that has proved especially effective in battling free-radical damage within the skin.

Vitamin E
Vitamin E, both when applied topically and when taken internally, is a very potent fat-soluble antioxidant. This means that it can easily work its way into the fat-rich cell membranes in our bodies, protecting the cell walls from free-radical damage. Vitamin E is also an excellent hydrating and sealing agent when used in topical creams.

Anti-Dimple Treatments
Many popular treatments are purported to reduce cellulite and stretch marks. These range in invasiveness from gentle body wraps and massages to expensive surgical procedures.
What has not been measured is the impact that some of these therapies may have on your overall well-being and psyche, which is also of vital importance. For example, although lymphatic drainage may not be the definitive panacea for cottage cheese thighs, it may very well make you feel relaxed, invigorated, sleek, and sexy. This topic was discussed in detail in Chapter 7. I am a big believer in doing anything that feels good, gives you pleasure, and does you no harm. Being dimple-free and miserable is not a good trade-off. I want you to be smooth and happy with yourself too.

Body Spa Treatments
These are basically facials for your body. They can be wonderfully beneficial on many levels. For example, the Murad Spa in California (as well as many other spas around the world) offers our Firm and Tone Body Treatment. It begins with exfoliation of the problem area to help prepare it for a deep high-concentration infusion of firming, free-radical-fighting vitamin C. The procedure ends with a massage to relax your body while stimulating blood flow and metabolism. I am a firm believer that professional spa treatments are the ideal way to maximize any skin care regimen, whether your goal is to clear up acne, wrinkles, sun damage, or cellulite and stretch marks.

Body Wraps
Body wraps basically work by inducing sweating. They have a temporary diuretic effect in that they cause water loss in the body. Unfortunately, fat cells and connective tissue are not affected by sweating. Wraps work on other levels too, however. The body is usually swathed for up to an hour in herb-and seaweed-soaked cloths to increase circulation and firm the body's contours. You can expect to be wrapped from chest to toe (arms are optional) while lying on a thermal blanket to keep you warm. A technician then unwraps you and, as a final step, massages your body to further enhance circulation, sending oxygen to blocked tissues. Body wraps are not recommended for anyone who is dehydrated, so be wary if you drink excessive amounts of alcohol or caffeine. Because body wraps increase internal temperature, they are also not recommended for anyone with high blood pressure, or for pregnant women.
Seaweed, clay, and herbal wraps are exfoliating and they can improve the skin's appearance and texture. Depending on the herbs used, herbal wraps can be stimulating or soothing. The other action of body wraps is the diuretic effect of inducing sweating and temporarily reducing wasted water. However, as soon as you drink a glass or two of fluid or eat a regular meal, the fluid returns.
Body wraps can provide some localized edema loss, good exfoliation, some pampering relaxation, and the possible introduction of minerals. In theory, trace minerals should be effective when applied topically, but we need more evidence to be certain.

Deep-Tissue Massage
Deep-tissue massage consists of slow strokes to create microtears in the superficial fascia. This makes tissue longer and smoother. The deep massage also loosens the connective tissue so that it moves more freely and no longer adheres to underlying structures. Deep massage followed by lymphatic drainage and appropriate stretching can also make the superficial fascia more flexible. The concurrent stimulation of the blood vessels can increase blood flow in the area, thereby increasing nutrition to the tissues.
Massage does not remove or decrease fat cells. It may improve the condition and appearance of the skin, reduce troublesome adhesions and scars, and increase the circulation of nutrients to tissues. When deep massage is too strong, it may also damage blood vessels, which defeats the benefits for cellulite reduction. Since areas with cellulite may already be sensitive, you can feel if too much pressure is applied. Deep massage provides relaxation and, if done properly, can stimulate the blood vessels and reduce stiffness.

A Sample Do-It-Yourself Massage
Begin by gently stroking with firm, moderate pressure, taking care not to press so hard that you break capillaries and bruise yourself. You can massage any time of the day, but it's best to wait at least two hours after eating. The most convenient time for most women is after a bath or shower-and preferably one that includes a brisk body rub with a loofah friction mitt. A bath is relaxing, and massage benefits you most when you are relaxed. Massaging areas of cellulite once or twice a day improves blood and lymph circulation and minimizes the appearance of the hard fatty lumps. Apply a moisturizing cream or oil to the area to be massaged, so that your hands can glide smoothly over the skin. Use your thumb and fingers to grip the skin and fatty layer beneath it. Then knead in small circular movements as though working with dough. Next, massage across the skin using the base of the palm of your hand, working in long, sweeping strokes toward the heart. Alternately, try a special handheld massager, which must be used with an oil or lotion to avoid excessive friction and broken capillaries.

Dermal Fillers
Fillers are an expensive and temporary method to improve the cosmetic appearance of dimpling. After a series of injections of human fat or another filling agent, the dimples may appear less obvious until the material eventually reabsorbs and the dimples return. This is a very costly and time-intensive procedure. To improve cellulite, any substance would have to be injected intradermally-into the skin and not below the skin-with a fine needle. For example, injectable hyaluronic acid gel may produce the effect of building GAGs. Injectable bovine (from cows) and human collagen may stimulate fibroblasts to strengthen the dermal layer. While these improve the appearance of uneven skin, the results wear off.

Electronic Anticellulite Devices
There are a few noninvasive, nonsurgical treatments for skin contour irregularities that are approved by the FDA for the "temporary reduction in the appearance of cellulite." One unit is a vacuum device that creates suction to temporarily immobilize and lift your fatty tissue, while dual rollers create deep, subdermal massage to the connective tissue. This stretches the connective tissue, increases blood and lymphatic flow, and exfoliates the skin.
These sessions take forty-five to ninety minutes and have been described as feeling like a rigorous massage. The typical treatment plans entail ten to twenty sessions, and once-a-month maintenance sessions, for an indefinite period of time. Once you stop having treatments, your skin texture and tone revert to their original state.
Treatments may leave you feeling invigorated, but long-term results have never been established either clinically or scientifically. These devices are also used as an adjunct to liposuction to smooth out potential imperfections that occur with large-volume fat reduction. They may cause bruising and damage to the dermis.

Iontophoresis
Iontophoresis devices are prescribed products that use electrical currents to feed mineral salts directly into your body. With the right nutrients, this method can potentially be used to treat cellulite. However, the only approved use for iontophoresis is for diagnosing cystic fibrosis.