Cellulite. It’s something most of us will see pop up on our lower bodies as time passes. Even women who aren’t overweight at all will look in the mirror one day and notice that lumpy, cottage cheese look on their thighs, rear or even abdomen.

Put most simply, cellulite is fat. It takes that dimpled form we find so unattractive due to the aging process. First, connective fibers under the skin’s surface tend to lose elasticity as the years pass. As they become less able to stretch and give, they stiffen and pull down on the skin at various points. While this is happening, fat cells may also be plumping up and pushing out. For the final blow, skin itself loses its strong, supple qualities and is less able to cover fat deposits smoothly and keep them in check.

If you’re getting the idea that you shouldn’t blame yourself too much if you have cellulite, you’re right. In fact, you may have more if you’re overweight, but chances are you have some cellulite even if you’re slim and trim. Not only that, differences in tissue structures cause women to develop cellulite much more than men do.

So do you feel better about your cellulite now you know what it is and why you have it? Maybe not. Maybe you’re wondering how to get rid of it.

Unfortunately, there’s no easy answer. In fact, there is a dizzying array of possible treatments. It can be very difficult for a layperson to figure out which ones might actually reduce cellulite versus those that mainly work to reduce the bank account.

First, know that nearly all doctors agree that creams don’t work. They may cause a temporary tingling sensation and possible swelling that fools you into thinking something is happening. Save your money.

Liposuction in its various forms is the tried and true way to get rid of fat, including cellulite. It’s also surgery, meaning it will likely cost you more than other treatments in terms of money and downtime. And while the fat cells sucked out from under the skin are gone forever, you may still have some cellulite left that liposuction can’t reach.

Another option is Lipolysis (the most popular iteration today is called Smart Lipo). In this procedure, a laser inserted under the skin heats and liquefies fat, while a tube suctions it away. An additional benefit is that the heat may cause skin to contract over the treated area. Unfortunately, because lipolysis is best for small areas, it’s generally not considered a good option for many cellulite deposits.

In a continuing quest to develop non-invasive ways to get rid of cellulite, equipment manufacturers seem to produce new treatments with enticing names annually. There are several different twists on laser, light, radio freguency therapy available now (examples include VelaSmooth, SmoothShapes and others). Waves penetrate the skin and liquefy fat, then mechanical rollers, massagers and/or suction helps move the liquefied fat into the lymph system where it is gradually drained from the body. Some women see improvement with these treatments; unfortunately, the majority of patients characterize their treatment as a “waste of money.”

A treatment that’s currently popular called Endermologie uses the same Mechanical massage action without an accompanying laser or light treatment. Some patients report satisfaction, but almost all say you have to continue treatment or the results will be temporary.

Infrared light and radio frequency therapies without add-ons are sometimes marketed as options for improving the appearance of cellulite (treatments such as Thermage and Titan). The way these procedures work is to cause the skin to tighten up by penetrating the outer layer and essentially causing damage to deeper layers. Collagen is produced during the healing process, enabling the skin to become more taut and cover the cellulite better. Fat cells aren’t directly affected.

Then there’s Mesotherapy (Lipodissolve is one brand), injections of chemicals that are said to dissolve fat. It’s not an FDA-approved treatment, it’s painful and many doctors discourage patients from even considering this option.

If you’re still confused you’re not alone. And you may continue to feel confused for the foreseeable future. After all, “new and improved” treatments are sure to keep showing up. Google “acoustic wave therapy” and you’ll hear about one of the newer options.

Experts agree that the best way to reduce cellulite is to eat properly and exercise, dropping any extra pounds you may be carrying. If you’re determined to try one of these treatments, you’ll have a better chance of success if you add your own efforts to the process.

As to which treatment to choose? If you’re not up for liposuction still considered the gold standard, do as much independent research on these other options as possible. Seek input from patients who have tried these methods, not practitioners who have sunk thousands of dollars into new equipment. And go forward with your eyes open, knowing that, liposuction aside, most reviews of most of these treatments are unfavorable.