Lipedema vs cellulite: how to tell them apart
Cellulite is dimpled skin that 80% to 90% of women have after puberty, and it does not hurt. Lipedema is a medical condition: painful fat that builds up on both legs, the hips and sometimes the arms, spares the hands and feet, and does not go away with dieting. Lipedema needs a physician. Karisma does not treat it.
Published · Written by Kay Woodson · Results vary.
Lipedema vs cellulite at a glance
Cleveland Clinic's descriptions side by side. Only a healthcare provider can diagnose lipedema.
| Cellulite | Lipedema | |
|---|---|---|
| What it is | Fat pushing against the connective tissue under the skin, which dimples the surface | A long-term condition with abnormal fat buildup in the lower body |
| How common | 80% to 90% of women who have gone through puberty | One global estimate puts it at 11% of women. Rare in men |
| Does it hurt? | No | Yes, from mild to severe, constant or only under pressure |
| Where | Wherever fat presses against the connective tissue under the skin | Both sides of the body: buttocks, thighs, calves, sometimes the upper arms |
| Hands and feet | Not listed as a sign | Not affected |
| Bruising | Not listed as a sign | Skin bruises easily |
| Diet and exercise | Exercise builds muscle, which flattens how it looks | Dieting usually does not remove it the way it removes other fat |
| Who to see | A spa or a doctor, for appearance only | A healthcare provider, for a diagnosis |
Cleveland Clinic, "Lipedema" (last updated June 1, 2023) and "Cellulite" (last updated October 28, 2021).
Why are the two so easy to confuse?
Because lipedema can dimple too. Cleveland Clinic describes four stages. In stage 1, the skin looks normal, though you may feel small, pebble-like bumps underneath. By stage 2, the surface is uneven and dimpled, which is exactly what most people call cellulite. Stage 3 brings large folds of fat and skin, and in stage 4 lipedema and lymphedema occur together.
It is also often mistaken for being overweight. The clue is in how it behaves: the fat is painful, it sits on both sides in the same pattern, it stops at the ankles and wrists, and it holds on through diets that shrink the rest of the body.
Which signs should you show a physician?
Any one of these, on legs or arms that also look dimpled, is a reason to see a doctor before a spa:
- Pain or tenderness in the fat, at rest or when pressed
- Bruising that appears easily, without a clear knock
- Fat that builds up evenly on both legs, or both arms, and stops at the ankles or wrists
- Legs that stay the same size while diet and exercise slim the rest of you
- Swelling in the legs, or legs that have changed shape over the years
Cleveland Clinic notes there is no single test. A provider examines you, takes your history, and may order blood tests or imaging to rule out other causes.
What helps lipedema, and what helps cellulite?
Rows marked "not offered" are not available at Karisma.
| Option | For | Who provides it |
|---|---|---|
| Compression stockings | Lipedema | Prescribed or fitted through your healthcare provider. Not offered |
| Lymphatic drainage massage | Lipedema, as part of a medical plan | A therapist your provider recommends. Not offered at Karisma |
| Swimming, biking, walking | Lipedema: mobility and swelling | You, with your provider's guidance |
| Liposuction | Lipedema: Cleveland Clinic says it can remove fat and help pain and mobility | A surgeon. Not offered |
| Exercise | Cellulite: more muscle flattens how it looks | You |
| LPG Endermologie | Cellulite: FDA-cleared to temporarily reduce its appearance | Karisma, $160 first visit, then $150 |
What Endermologie can and cannot do
LPG Endermologie, the body treatment Kay Woodson offers, is FDA-cleared to "temporarily reduce the appearance of cellulite," a clearance dated January 18, 2000 (510(k) K990445). That is the whole claim. It is not cleared, sold or offered at Karisma as a treatment for lipedema, lymphedema or any medical condition, and it does not remove fat.
If the table above sounds like your legs, see a physician first. If you already have a lipedema diagnosis and want to ask about body work, bring your physician's written guidance to a consultation and let Kay decide with you whether any session is appropriate. For cellulite alone, the cellulite treatment page sets out the studio's options and prices.
Questions about lipedema and cellulite
How can I tell if I have lipedema or cellulite?
Pain, easy bruising, matching fat on both legs that stops at the ankles, and fat that does not shrink with dieting all point toward lipedema. Cellulite does not hurt. Only a healthcare provider can diagnose lipedema.
Can cellulite treatment help lipedema?
Cellulite treatments aim at the look of the skin. Lipedema is a condition of the fat itself and is treated through a physician, with options such as compression, lymphatic drainage massage, exercise and liposuction.
Who diagnoses lipedema?
A healthcare provider, through a physical exam and your medical history. There is no single test, so blood tests or imaging may be used to rule out other conditions.
Does losing weight help lipedema?
Cleveland Clinic says dieting usually does not get rid of lipedema fat the way it does other fat, though a heart-healthy diet may help slow it, especially started early.
- Lipedema, Cleveland Clinic, last updated June 1, 2023, checked October 29, 2026
- Cellulite, Cleveland Clinic, last updated October 28, 2021, checked October 29, 2026
- FDA 510(k) K990445, LPG Therapeutic Massager, decision January 18, 2000