Drug delivery systems integrated with conventional and advanced treatment approaches toward cellulite reduction

Cellulite is a multifactorial condition induced by topographic alteration of skin giving rise to 'orange peel' appearance. It is a universal aesthetic problem affecting 85% of post pubertal females. The present article provides an exclusive overview of all aspects related to cellulite, including its clinical manifestation, etiology, pathophysiology, evaluation and classification. Approaches for reducing cellulite appearance are innumerable. Conventional therapeutic strategies and modern practices such as physical, mechanical methods - including subcision and mesotherapy- and pharmacological agents, oral and topical routes, are reviewed. Novel delivery systems based on nanocarriers incorporating anti-cellulite agents developed in the past decade have been enumerated and analyzed for their efficacy in delivering drugs to target sites. Two main carrier based systems have been reviewed; lipid and polymer based carriers. Methylxanthines, specifically caffeine, has been critically evaluated due to its lipolytic effect of fat cells through inhibition of phosphodiesterase enzymes. The main challenge of this active moiety is its inability to penetrate the closely packed lipophilic stratum corneum. Its incorporation in such delivery systems have shown promising results in its bioavailability and efficacy. However, despite the utilization of nanocarriers in achieving targeted drug delivery has been demonstrated, yet its application in this indication has emerged recently and is limited. It is anticipated that this is a golden opportunistic research area to be exploited and developed.