It's one good reason to hate summer for many women. But as Sabine Henning reports from Bremen, once it's there, cellulite is probably there to stay.

Cellulite is a problem for many women, especially in the bikini season. The bad news is: it cannot be completely cured by medicine or therapy, experts say. But a balanced diet and plenty of sport can help. More than 80 per cent of women over 20 years of age suffer from cellulitis, the diffuse inflammation of the connective tissues that looks like dents in the skin, particularly on the bottom, hips, thighs and stomach. It affects women more than men because their connective tissue has a looser network. This allows the skin to stretch, for instance in pregnancy, but with increasing age, it means the skin loses stability and causes waves in the skin. Are there any cures? Anti-cellulite creams have only a limited effect, says Gisela Reinecke, spokeswoman for the German cosmetics industry group VKE. They do help to remove water from skin tissue and thereby tighten the skin, but they need to be applied twice a day for at least three months before showing any effect. Three years ago, the German consumer organisation Stiftung Warentest tested three anti-cellulite gels and an anti-cellulite fluid over a two-month period and concluded they had no effect on cellulite at all. They also tested two anti-cellulite massage machines and found them to be worthless. Ointments containing hormones could be more effective, says Bernd Kleine-Gunk, chief gynaecologist at the Euromed Clinic in Fuerth. "The male hormones cause a cross networking of the skin tissue," he said. Ointments are most effective when combined with lymph drainage in which the skin tissue is drained by massage. This therapy can show positive effects within two or three weeks, he said. But it remains effective only so long as patients continue the therapy, and is not without side effects. The hormones in the cream can enter the blood stream, and the skin pores on the affected area become larger and oily and cause hair growth. Patients who choose this therapy should seek out doctors who specialise in hormone cosmetic or aesthetic endocrinology. But the therapy can be expensive: one month's dosage costs around 60 to 70 euros, says Kleine-Gunk. The therapy is more effective when accompanied by regular sport and a weight loss programme. Exercise therapy Panos Pantas, business manager of the Meridian Academy in Hamburg, which trains fitness trainers, confirms that regular sport strengthens the skin tissue. Aerobics, walking, jogging or cycling could help fight cellulites, he said. He advises 60 minutes sport three days a week along with a muscle-toning programme using gymnastics, training with light weights or elastic bands. People will see the effects within six to eight weeks, he promises. But sport can only help alleviate cellulitis, it cannot cure it, he says. Isabell Keller of the German Nutrition Society DGE says cellulitis can also be alleviated with a low fat and wholefood diet. Fresh fruit and vegetables should be part of the daily menu. Some people also believe silicon supplements in the form of tablets, gel or powder can fight cellulite, but expert opinion is divided. The mineral is believed to increase the toning of the tissue and make the skin more elastic. But its effect has not been scientifically proven, warns Kleine- Gunk and other gynaecologists. August 2002 DPA