Far-IR Emitted by Compression Stockings for Cellulitis Treatment

• Changes in ultra-sound images [ Time Frame: 0, 30, 60 and 90 days ] [ Designated as safety issue: No ]
  High resolution ultra-sound (DemaScan, Cortex Technology, Denmark)is used to measure dermis density and thickness and distance between dermis and fatty tissue in the most evident two areas with cellulitis(thighs and buttocks)
  
  

• Changes in Cellulitis clinical grade [ Time Frame: 0, 30, 60 and 90 days ] [ Designated as safety issue: No ]

  Main investigator evaluates the clinical aspect of cellulitis, i.e., the level of irregularity of skin surface, according to Nuremberg and Müller classification in four grades:

  0: no alterations I: alterations only visible by pinching the skin or contracting the muscles II: skin orange or padded aspect is visible when the woman stands up or by pinching the skin or contracting the muscles III: the same alterations of II associated to skin elevations and nodulations

  
  
• Subject evaluation [ Time Frame: day 90th ] [ Designated as safety issue: No ]
  Study subjects will give their opinion about modification on cellulitis appearance using a 5-point scale: much worse; worse; no change; better; much better
  
  
• Changes in Anthropometric measures [ Time Frame: 0, 30, 60 and 90 days ] [ Designated as safety issue: No ]
  The circumference of thighs, hip and waist are measured in standardized points
  
  
• Changes in Photographies [ Time Frame: 0, 30, 60 and 90 days ] [ Designated as safety issue: No ]
  By using the OMNIA device standardized photos are taken in three positions: front buttocks and side view of thighs
  
  
• Changes in Skin viscoelasticity [ Time Frame: 0, 30, 60 and 90 days ] [ Designated as safety issue: No ]
  Skin elasticity is measured by suction with the Cutometer device(Courage&Khazaka, Germany) in the most evident two areas with cellulitis(thighs and buttocks)
  
  
• Changes in DLQI scores [ Time Frame: 0 and 90 days ] [ Designated as safety issue: No ]
  The application of the quality of life generic questionnaire named Dermatology Life Quality Index or DLQI(Finlay, 1994), version DLQI-Brasil (Ferraz, 2006) will be used to evaluate the impact of cellulitis and its treatment on women´s life
  
  
• Occurence of adverse events [ Time Frame: 30, 60 and 90 days ] [ Designated as safety issue: Yes ]
  Report and/or observation of side effects,such as discomfort, difficulty to use the stockings or any distress will be registered
  
  
• Occurence of venous insufficiency signs [ Time Frame: 30, 60 and 90 days ] [ Designated as safety issue: Yes ]
  Symptoms and signals of venous insufficiency such as fatigue, swelling, burning will be evaluate by a five-point scale:0=none; 1 = slight; 2 = slight to moderate; 3 = moderate to severe; 4 = severe; 5 = unbearable
  
  
• Changes in Colour eco-doppler [ Time Frame: 0 and 90 days ] [ Designated as safety issue: Yes ]
  Superficial and deep venous systems will be evaluate before and at the end of the study by colour eco-doppler
  
  

Cellulitis is a sex-specific, anatomic and normal condition affecting women after puberty.The main clinical aspect is the irregularity on skin surface which is classified in 4 grades, 0 to III, according to Nurenberg classification, 1978.

It is a multifactorial condition, involving: herniation of subcutaneous fat into deep dermis; vertical fibrous septum from fatty tissue to dermis; alterations in microcirculation; hormonal and inflammatory factors Clinical evaluation is very difficult and the best methods are: high resolution ultrasound and magnetic resonance.

There is no effective management. Many devices have been introduced to treat that aesthetic condition which causes a great discomfort to women. There are few controlled studies with high level methodology and consistent conclusions.

The far-IR radiation can be obtained by low energy emitting devices and its main effects are the interaction with water and temperature increase. This method had already shown efficacy for circulation system disorders and wound healing by activation of TGF-beta and fibroblasts.

Our aim is to evaluate the benefits of far-IR for cellulitis control.