Short answer: Repeated manipulation of connective tissue!!
Cellulite is caused when the fibrous bands of connective tissue that anchor the skin to muscles break down, allowing fat cells to push up into the skin layer. The more fat cells you have, for example, due to weight gain, the more likely it is for those fat cells to push to the top layer. Also, the older you get the less turgid and firm your skin is due to the body producing less collagen-- collagen firms and smoothes out the skin. So even skinny people get cellulite as they age. This creates the uneven, bumpy texture that gives cellulite its cottage cheese-like appearance.
So what are the doctors saying? Well, there are many studies. But the only one that I care about is the one that says this:
"....[L]ymphatic drainage massage, [is] a type of massage that uses light pressure to help the lymphatic system drain fluids, debris, and toxins; and connective tissue manipulation (CTM) had on cellulite. CTM is a type of massage to improve circulation that applies pressure to the ligaments, tendons, and tissues that connect muscle to skin. All three techniques were effective in decreasing fat and the circumference of the thigh where the massage was performed."
(Study available here: https://pubmed.ncbi.nlm.nih.gov/19627407/)
So massaging the skin does help with reducing the appearance of cellulite, then? Yes, massages at home with various massage tools can help-- dry brushing, cupping, gua sha instruments all aid in lymphatic drainage. However, this is temporary -- which just means it has to be a lasting part of your self-care routine-- especially as you get older. And the more effective result seems to be going to a professional who uses a mechanical lymphatic drainage device.
So here are 5 Selfcare tips for reducing your cellulite
1. Move your body. Exercise to encourage blood flow, proper circulation, reduce fat cells, and use a foam roller with a vibration feature to manipulate the connective tissues beneath your skin. See a vibrating foam roller here.
2. Dry brush. Use a brush with firm and smooth massage spikes in between the bristles. This improves circulation and redistributes fat cells. You must do this routinely and repeatedly. If you stop, the cellulite comes back. You never complain about brushing your teeth, right? So why complain about dry brushing which is only a twice per week activity? See dry brushing tools here.
3. Cupping and massages. See a professional. Dry cupping can encourage the drainage of fluid, toxins, and other chemical byproducts from the body, which may improve the way cellulite looks.
4. Take collagen powder or pills, as this plumps up the skin and gives it more turgidity and thickness-- making for smoother, less lumpy, and papery thin skin.
5.See a professional who uses a mechanical/electronic device that manipulates the connective tissues. This drains excess body fluids and redistributes fat.