Evaluating cellulite

October 16, 2018

Researchers presenting at ASDS show that CR-PCSS and the PR-PCSS scales are reliable tools used to evaluate cellulite severity.

Cellulite is a common condition mostly affecting women. There are few ways to determine its severity, but now new research shows two additional severity scales can provide accurate assessments to pinpoint the best treatment options.

To date, physicians have had few validated scales to correctly analyze cellulite severity, including the Hexsel Cellulite Severity Scale. However, findings presented at the 2018 American Society for Dermatologic Surgery (ASDS) annual meeting point to the Clinician Reported Photonumeric Cellulite Scale (CR-PCSS) and the Patient Reported Photonumeric Cellulite Severity Scale (PR-PCSS) as reliable assessment options.

CR-PCSS and PR-PCSS both use a series of five photographs that rank increasing cellulite severity based on the number and depth of dimples on the left or right buttocks and the left or right posterolateral thighs. This noninterventional test-retest study used in-person assessments to evaluate the 5-point scale’s reliability.

To reach this goal, researchers enrolled 81 female patients over age 18 to participate. Of that group, 76 completed the CR-PCSS, and 75 completed the PR-PCSS. Six clinicians - three plastic surgeons and three dermatologists - evaluated participants after undergoing CR-PCSS online video and in-person training.

The participant group included both black and white women with skin types spanning the Fitzpatrick Scale. Of the group, 58 had cellulite on their buttocks and thighs. Fourteen had cellulite present on only their thighs, and three had cellulite on just their buttocks. One had a diagnosis of no cellulite.

Clinicians assessed participants on two consecutive days. Several methods were implemented to decrease clinician recall bias. There were no physical or verbal interactions, and patient evaluation order switched between assessments. Clinicians were also only allowed to observe the buttocks and thighs. Patients assessed their cellulite severity with the PR-PCSS, using either photographs or a mirror, on day 1 and, again, two weeks later. The longer interval was intended to reduce memory bias.

Results for CR-PCSS reliability showed a left buttock mean of 0.81 (SD 0.08) and 95% CI of 0.73, 0.90, and a right buttock mean of 0.81 (SD 0.09) and a 95% CI of 0.72, 0.90. The findings also revealed a left thigh mean of 0.78 (SD 0.11) and a 95% CI of 0.67, 0.90, and a right thigh mean of 0.79 (SD 0.11) and a 95% CI of 0.67, 0.90.

Overall, the researchers determined both the CR-PCSS and the PR-PCSS were reliable tools that could accurately evaluate cellulite severity in clinical, as well as real-world, settings.