Cellulite grades 1 to 3 explained: Which treatment at which severity

“Cellulite” is not a uniform phenomenon. What is only visible on one woman in certain lighting can be permanently pronounced on another. Cosmetics and aesthetics distinguish three severity grades, and depending on the grade, different treatment approaches are sensible.

The three cellulite grades according to Nürnberger-Müller

The classical classification by Nürnberger and Müller (1978) is still the standard today:

Grade 1: latent cellulite No visible dimples when standing or lying. Irregularities only become visible when the skin is pinched together (pinch test) or on muscle tension. Often from age 20 onwards.

Grade 2: moderate cellulite Dimples are visible when standing but disappear when lying down. Typically on thighs, buttocks, and sometimes upper arms. This stage is most common and affects many women between 30 and 50.

Grade 3: pronounced cellulite Dimples are visible even when lying down. Skin appears coarsely textured, sometimes with nodular densifications. Often accompanied by tension or tenderness in affected areas.

Which causes amplify which grades

• Genetic predisposition determines the baseline risk
• Hormonal factors (oestrogen, pregnancy, the pill) affect connective tissue
• Lifestyle (lack of exercise, smoking, alcohol, sugar-rich diet) amplifies all grades
• Water retention and weak microcirculation enlarge the visible dimples

Treatment approaches by severity

At grade 1 (latent)

Here it’s about prevention and preservation of tissue structure. What helps:

• Regular exercise, especially strength training for affected muscle groups
• Sufficient fluids and a protein-rich diet
• Skincare with circulation-promoting ingredients (e.g. caffeine, retinol)
• Mechanical microstimulation as a maintenance measure, 1 session every 2 to 4 weeks

At grade 2 (moderate)

Sport and creams are often no longer enough here. Sensible approaches:

• Regular connective tissue stimulation to specifically activate lymph flow and collagen build-up
• A course of 10 icoone® sessions 2 to 3 days apart is a typical starting point
• Combination with manual lymphatic drainage when water retention is simultaneously present
• Dietary adjustment: less salt, fewer fast carbs, more protein

At grade 3 (pronounced)

Non-invasive methods can improve the appearance but cannot achieve complete smoothing. Realistic options:

• Longer icoone® course with 15 to 20 sessions plus monthly maintenance
• For significant distress, medical evaluation of further treatment options in a specialist practice
• Lipoedema assessment: if there is significant pain and symmetrical distribution, a lipoedema diagnosis should be ruled out by a specialist

What sport does and doesn’t do

Strength training helps at all grades because trained muscles make skin appear smoother. Endurance training lowers body fat percentage. Both, however, do not change the connective tissue structure that causes cellulite: slim and athletic women can still have grade 2.

Mechanical microstimulation: What science says

Mechanical skin stimulation activates fibroblasts via so-called mechanotransduction. This leads to measurably increased production of collagen, elastin, and hyaluronic acid (Humbert et al., Clinical Interventions in Aging, 2015). This study was conducted with an LPG device but demonstrates the general principle on which icoone® is also based. Clinical studies specific to icoone® technology are documented at icoone.com/en/science.

Distinguishing lipoedema: When it’s not cellulite

If affected areas are painful, symmetrically distributed, and don’t respond to diet or sport, lipoedema should be medically evaluated. Lipoedema is a disease, not a cosmetic question: the GP or a phlebologist is the right contact here.

Pricing

Single session 60 min.: CHF 195 Recommended course (10 sessions): CHF 175.50 per session · original suit included · 0% instalment payment Intensive programme: from CHF 168 per session

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Also of interest: Lymphatic drainage as a complement

Sources

• Nürnberger F, Müller G. So-called cellulite: An invented disease. J Dermatol Surg Oncol 1978;4(3):221-229.
• Humbert P, et al. Mécano-Stimulation™ of the skin… Clinical Interventions in Aging 2015;10:387-403.
• icoone® scientific background: icoone.com/en/science

Individual results may vary. This content does not replace medical advice.

Frequently asked questions

Which cellulite grade do I have?

Grade 1: dimples only visible when pinching. Grade 2: dimples visible when standing, not when lying. Grade 3: dimples visible even when lying down. An accurate assessment is best done in person during a consultation.

Does sport help against cellulite?

Sport improves muscle tone and reduces body fat, which can visually improve cellulite. The underlying connective tissue structure, however, is not changed by sport. Even very athletic women can have grade 2 cellulite.

What is the difference between cellulite and lipoedema?

Cellulite is a cosmetic question and not painful. Lipoedema is a disease with painful, symmetrically distributed fat pads that don’t respond to diet. If lipoedema is suspected, medical evaluation by a GP or phlebologist should take place.

### Read more Cellulite: Why sport alone isn’t enough → · Skin tightening without surgery →

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