Pilates guide

Pilates for cellulite: what cellulite is, what exercise can and can't change, what does help, the evidence, and a routine

Cellulite is the dimpled skin most women have on their thighs, bottom and hips: 80 to 90% of women after puberty, of every size. It's normal, not a disease. No study has tested Pilates on cellulite, and exercise alone hasn't removed it in any trial we found: in one, 12 weeks of daily glute strengthening left it unchanged. Pilates is still worth doing for strong legs and how you feel; it just isn't a cellulite treatment.

Our fascia and cellulite guide covers rolling, massage and fascia blasting, and our thigh fat guide covers fat loss. This guide explains what cellulite is and why women have it more than men, what exercise, weight loss and Pilates can and can't change, what dermatologists can offer and how long it lasts, how to tell cellulite from cellulitis and lipoedema, and a routine for your legs and glutes.

The short answer

Cellulite is normal

It affects 80 to 90% of women after puberty, at every size, and about 2% of men. It comes from fibrous bands that tie the skin down while fat pushes up between them; women's bands are fewer, run straight up and break more easily.

Sources 1, 2, 3

No study has tested Pilates on cellulite

We found none in the medical databases or trial registries. One preprint compared Pilates with massage but never measured cellulite.

Sources 4, 5

Exercise alone hasn't removed it in any trial

In a small trial with blinded assessors, 12 weeks of daily glute strengthening left the cellulite score unchanged. In other trials, only women who added a device (shock wave therapy, or a pressure suit while cycling) saw cellulite improve.

Sources 6, 7, 8

Weight loss helps many, not all

Most women's cellulite improved when they lost weight, but it got worse for some, more often those who started lighter and lost less. The bands stretch when weight goes on and don't shrink back.

Sources 9, 1

Pilates is for strength and how you feel

The American Academy of Dermatology says more muscle makes skin look smoother and firmer, but no trial has shown it, and the one blinded strength trial found no change. Pilates builds stronger legs and glutes, which is worth having whatever your skin looks like. This page promises no smoother skin and no particular shape.

Sources 10, 6

Nothing removes it for good

Reviews of cellulite treatments found none with clear, lasting evidence. Medical procedures that cut or release the bands last longest; an enzyme injection was stopped by its maker in 2022 because of bruising and skin discolouration.

Sources 11, 12, 13, 14, 15

Check first: hot skin, swollen legs and breast changes

Cellulite isn't cellulitis or lipoedema, and dimpling on the breast is a different sign. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.

Skin that turns painful, hot and swollen

  • Ask for an urgent GP appointment or get help from NHS 111 if your skin is painful, hot and swollen.
  • Call 999 or go to A&E if you have cellulitis with a very high temperature or you feel hot, cold or shivery, a fast heartbeat or fast breathing, purple patches on your skin, feeling dizzy or faint, confusion or disorientation, cold, clammy or pale skin, or unresponsiveness or loss of consciousness.

Source 16

A swollen, painful leg

Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, a journey of over 4 hours, pregnancy or a recent birth, cancer, a previous clot, or contraception or hormone replacement therapy (HRT) that contains oestrogen.

Source 17

Legs out of proportion, painful and quick to bruise

The NHS says to see a GP if you have symptoms of lipoedema: a build-up of fat, usually equal on both sides, that can make your bottom, thighs, lower legs and sometimes your arms look out of proportion with the rest of your body, with pain, tenderness or heaviness, and bruising easily. The skin may feel soft and cool and look dimpled, a bit like orange peel, which is easy to mistake for cellulite. Ask for an urgent GP appointment or get help from NHS 111 if your leg or legs become swollen, red, hot and painful and you have flu-like symptoms: it may be cellulitis.

Source 18

Dimpling on the breast

The NHS lists a change in the skin of your breast, such as dimpling that may look or feel like orange peel, among the symptoms of breast cancer in women, and says to see a GP if you have any changes in your breasts or nipples that are not normal for you. Many of these changes have other causes, but it's important to get them checked by a GP.

Source 19

What cellulite is

Normal, not a disease

The dimpled, uneven look of the skin, mostly on the thighs, buttocks and hips, in 80 to 90% of women after puberty, in all ethnic groups. It's rare in men (about 2%, usually with low male hormones or on hormone treatment). In 1978, the authors of the first cellulite grading scale wrote of "the essential normality and inevitability of it in women".

Sources 1, 20

The bands under the skin

Fat under the skin sits in pockets held by fibrous bands that tie the skin to deeper layers. On magnetic resonance imaging (MRI) scans, thick bands running straight down lay under 96.7% of dimples. In 20 body donors, men had more bands and theirs took more force to break (about 38 against 23 newtons). In women with cellulite, fat pushed further up into the skin, and scans found no extra water in the fat.

Sources 3, 2, 21

Hormones and age

The female hormone oestrogen likely plays a big part, which fits cellulite appearing after puberty. Thinner skin with age isn't the main cause, since "Young adult female skin commonly presents with cellulite".

Sources 1, 22

Body fat

Severity tracks body fat: in 72 people scanned in 3D, "Cellulite severity was predicted by the percent fat" and the shape of the border between skin and fat. In 184 Brazilian girls aged 12 to 18, 77.7% had cellulite, and it was more common with a higher BMI (body mass index) and a family history. But women of every size have it.

Sources 23, 24, 1

How it's measured

Trials mostly grade photographs on a scale, such as the Cellulite Severity Scale, which scores 5 features from 0 to 3. A review found "only 2-dimensional and 3-dimensional digital photography have been adequately validated", so a casual before-and-after photo is a weak test: light, posture and skin temperature change how dimples look.

Sources 25, 26

Cellulite isn't cellulitis

Cellulitis is a skin infection, with skin that turns painful, hot and swollen, and it needs a doctor. The names are similar; the conditions aren't.

Source 16

Or lipoedema

Lipoedema is a build-up of fat in both legs, and sometimes the arms, that is often painful, tender or heavy and bruises easily, and usually spares the feet. An international consensus says "Lipedema is not an obesity-related comorbidity." Its skin can look dimpled too, which is one reason people mix the two up; our Pilates for lipoedema guide covers it.

Sources 18, 27, 28

What exercise and Pilates can and can't change

Every exercise and cellulite trial we found was small and short, and most tested a device with exercise as the comparison.

No study of PilatesStrong evidence

We found no trial or study that measured cellulite after Pilates, in English, Portuguese or Spanish medical databases or in trial registries. One preprint compared a Pilates group with women who had anti-cellulite massage once, and didn't measure cellulite.

Sources 4, 5

Strength exercise alone: no change in one blinded trialEmerging evidence

In a German double-blind trial, women did two glute exercises "Twice a day (in the morning and the evening)", 15 repetitions each leg, for 12 weeks, with either real or dummy shock wave sessions. With the dummy device, the Cellulite Severity Scale went from 10.0 to 10.1; with real shock wave, from 10.9 to 8.3. The trial was small, the number of women analysed isn't stated, and the device maker paid its publication charges.

Sources 6, 29

Aerobic exercise, diet and devicesEmerging evidence

In Portugal, 45 women were randomised and 42 finished: 6 aerobic sessions over 3 weeks, with or without shock wave therapy, or no treatment; only the shock wave group's cellulite eased more than the others. In 86 women with obesity, all diet groups lost weight, but only the group that cycled in a lower-body pressure suit improved how their cellulite looked. Treadmill training alone kept body fat from rising in 20 women; the cellulite benefit was reported for the group that added infrared light.

Sources 7, 8, 30

Weight loss helps many, not allEmerging evidence

"The majority of subjects had an improvement in cellulite with weight loss, but the condition worsened for others." Improvement went with a higher starting weight and more fat lost. Very large weight loss can loosen the skin and make cellulite more visible.

Sources 9, 1

Muscle under the skin: an expert view, not a trialMixed evidence

The American Academy of Dermatology says "Having more muscle makes your skin look smoother and firmer", and a 2024 clinical guide suggests lifestyle changes for mild cellulite. Neither is backed by a trial, and the one blinded strength trial found no change.

Sources 10, 31, 6

What does help, and for how long

These are medical or cosmetic treatments; a dermatologist can explain the options and their limits. Our fascia and cellulite guide covers massage, rolling and fascia blasting.

Treatments overall: no clear winnerStrong evidence

Of 67 studies of cellulite treatments, "No clear evidence of good efficacy could be identified". In 24 trials (2,084 people, with an average follow-up of 3.3 weeks), shock wave therapy, radiofrequency and an enzyme injection looked promising, but "none are definitively established". A 2023 review: "There is no effective treatment for cellulite".

Sources 11, 12, 1

Devices fadeEmerging evidence

Most device trials are of poor quality, and devices applied over the skin "produced real but decaying change", fading within 3 to 6 months.

Sources 32, 14

Treating the bands lasts longestEmerging evidence

Reviewers argue that targeting the bands is most likely to give lasting change. A procedure that cuts the bands with a needle or blade kept its benefit for 3 years in 45 women, in an open study with company-linked authors, and a sound-wave version helped most of 42 women after one visit.

Sources 22, 13, 33

The enzyme injectionEmerging evidence

In two placebo-controlled trials of 843 women, collagenase injections made more women look at least a little better (37.1% against 17.8%, and 41.6% against 11.2%), but few looked clearly better (7.6% against 1.9%, and 5.6% against 0.5%). Bruising affected 89% in pooled studies, and one woman injected in the thighs tore both front thigh muscles. Its maker announced in December 2022 that it would stop making and selling the injection because of bruising and possible long-lasting skin discolouration; it remains approved by the US Food and Drug Administration (FDA).

Sources 34, 35, 36, 15

Creams and massageEmerging evidence

Six months of retinol cream barely changed "The lumpy-bumpy appearance of the skin" in 15 women, and in a 2026 caffeine cream trial the placebo legs improved too. Machine massage made no measurable difference in 52 women.

Sources 37, 38, 39

Legs and glutes on the mat

For strength, not to erase dimples: the side kick (8 to 10 each side), side-lying leg circles (8 each direction, each side), the inner thigh lift (10 to 12 each side), the shoulder bridge (3 to 5 kicks each leg) and the single-leg kick (6 to 8 each leg), all from the move pages' doses, and the single-leg glute bridge (6 to 8 each side, our Pilates glute workout). With pain on the outside of the hip, never lie on the sore side, as the side-lying move pages say.

Standing, then with load

Bodyweight squats (2 sets of 10 slow reps) and reverse lunges (8 each side), both our Pilates leg workout's; the wall side leg lift (10 to 12 each side, from the move page's dose), the option if lying on your side hurts; then goblet squats (3 sets of 8 to 12, our Pilates strength workout) and dumbbell Romanian deadlifts (3 sets of 8 to 12, our strength and balance workout) to add load.

Moving more

A brisk walk (20 minutes, our walk and Pilates workout) or marching on the spot (2 minutes to warm up, the same class) helps with overall fitness and fat, building toward the NHS's 150 minutes a week.

A routine for your legs, without promises

Our editorial starting point, following the NHS activity guidelines. It builds strength and fitness; no exercise has been shown to remove cellulite.

  1. Do our Pilates leg or glute class twice a week, making it harder as it gets easy.
  2. Add load on one or two days: squats, lunges and deadlifts with weights or a band.
  3. Walk briskly, cycle or swim on most days, building toward 150 minutes a week.
  4. Skip rollers, scrapers and fascia blasters if they bruise you: bruising isn't progress.
  5. See a GP for skin that is hot, red and swollen, legs that are painful and bruise easily, or breast changes.

Classes to follow

The leg and glute classes build strength, the walk and Pilates workout adds brisk walking, and the strength workout adds weights or a band. If your legs are painful and bruise easily, the Pilates for lipoedema class is gentler and padded.

Plans

For strength and fitness, not for cellulite.

Who should change what

Lipoedema or tender legs

Use our Pilates for lipoedema class: it pads the floor, keeps bands and balls off tender legs, and adds reps only when a session leaves you no more sore or bruised than usual.

Pain on the outside of the hip

Swap the side-lying moves for the wall side leg lift, as their move pages say.

Pregnancy

After the first trimester, keep time flat on your back short and prop yourself up, and skip face-down moves later in pregnancy, as the move pages say.

Skin that is hot, red and swollen

Stop and use the cellulitis advice near the top of this page before exercising.

When to stop, and when body worry becomes harmful

The skin, leg and breast signs are near the top of this page. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.

Chest pain or fainting while exercising: call 999

Call 999 if:

  • You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
  • The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
  • You have chest pain and feel sweaty, sick, light-headed or short of breath.
  • Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.

Sources 40, 41, 42

Breathlessness

Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.

Source 43

Stop the session if

You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.

Source 44

When eating, exercise or body worry becomes harmful

The NHS lists signs such as spending a lot of time worrying about your weight and body shape, exercising too much, and having very strict habits or routines around food. If that sounds like you, see a GP as soon as you can. You can also talk in confidence to the eating disorder charity Beat: 0808 801 0677 (England), 0808 801 0432 (Scotland), 0808 801 0433 (Wales) or 0808 801 0434 (Northern Ireland), 3pm to 8pm, Monday to Friday.

In a survey of 2,287 young adults, women who did yoga or Pilates had disordered eating as often as those who didn't, and men who did them reported more extreme weight-control behaviours (18.6% against 6.8%). Set goals for strength, control and how you feel, not calories burned.

Sources 45, 46, 47

Before you start

The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.

Source 44

Myths

"Pilates gets rid of cellulite"Strong evidence

No study has measured cellulite after Pilates, so there's no evidence either way.

Source 4

"The right exercise gets rid of cellulite"Emerging evidence

In one small blinded trial, 12 weeks of daily glute strengthening left the cellulite score unchanged, and in other trials only groups that added a device improved.

Sources 6, 7, 8

"Cellulite means you're unhealthy or overweight"Strong evidence

Most women have it, at every size. It depends on the bands under the skin and on hormones; severity tracks body fat, but it isn't a disease.

Sources 1, 20, 23

"Cellulite is trapped water or toxins, so drink water or detox"Emerging evidence

Scans found no extra water in the fat of women with cellulite. One snapshot study linked drinking less water with cellulite in teenagers, which can't show that drinking more treats it, and no trial has tested water or detox.

Sources 21, 24

"Pilates stretches the fascia and softens the bands"Emerging evidence

No study shows exercise or stretching changes the bands. Reviewers say only treatments that target the bands give lasting change, and our fascia and cellulite guide explains why rolling and blasting can't reach them.

Sources 4, 22

"A before-and-after photo proves it works"Emerging evidence

Light, posture and skin temperature change how dimples look, and only standardised photography has been validated for grading cellulite.

Source 26

"Losing weight always gets rid of cellulite"Emerging evidence

It improved for most women who lost weight in one study and got worse for some.

Source 9

"Cellulite creams work"Mixed evidence

Retinol barely changed the lumpy look, and in a 2026 caffeine cream trial the placebo legs improved too.

Sources 37, 38

"Reformer Pilates is better for cellulite"Strong evidence

No trial of any kind of Pilates has measured cellulite.

Source 4

Questions people ask

Does Pilates help cellulite?

No study has tested it. In a small blinded trial, 12 weeks of daily glute strengthening didn't change cellulite, so Pilates is worth doing for strength and fitness, not to erase dimples.

Can Pilates get rid of cellulite?

No exercise has been shown to remove it. Nothing removes it for good: reviews of cellulite treatments found none with clear, lasting evidence.

What are the best Pilates exercises for cellulite?

There aren't any proven ones. The side kick, bridges and leg kicks, plus squats and lunges, build leg and glute strength, and our Pilates leg and glute classes put them together.

Is cellulite normal?

Yes: 80 to 90% of women have it after puberty, at every size. It comes from how fibrous bands hold the fat under the skin, which differs between women and men.

Does losing weight get rid of cellulite?

It improved for most women who lost weight in one study and got worse for some, more often those who started lighter and lost less. The bands stretch when you gain weight but don't shrink back.

Is reformer Pilates good for cellulite?

No study has measured cellulite after reformer or mat Pilates. Either builds strength, which is a good reason to do it.

Why do Pilates before and after photos look so different?

Lighting, posture, skin temperature and angle all change how dimples look, and only standardised photography has been validated for grading cellulite. A casual photo can't tell you much.

What actually reduces cellulite?

Treatments aimed at the bands under the skin give the longest-lasting results, but they are medical procedures with modest results and side effects such as bruising. Shock wave therapy and radiofrequency help a little for a short time, and creams do little. A dermatologist can explain the options.

Is cellulite the same as cellulitis?

No. Cellulitis is a skin infection: skin that is painful, hot and swollen needs an urgent GP appointment or NHS 111, and 999 with signs such as a very high temperature, a fast heartbeat or confusion.

Is it cellulite or lipoedema?

Lipoedema is fat in both legs, and sometimes the arms, out of proportion with the rest of the body, often painful, heavy and quick to bruise; its skin can look dimpled too. See a GP if that sounds like you.

Does drinking water help cellulite?

Scans found no extra water in the fat of women with cellulite, and no trial has tested drinking more water. Drink to thirst for your health, not for your skin's dimples.

Does yoga help cellulite?

No study has looked. Like Pilates, it's good for you, but it isn't a cellulite treatment.

Sources

  1. Gabriel 2023 · Cellulite: current understanding and treatment (review, Aesthet Surg J Open Forum; read in full)
  2. Rudolph 2019 · The tissue under the skin of the buttock in 20 body donors (anatomy study, Plast Reconstr Surg)
  3. Hexsel 2009 · Dimples and the bands under them on MRI in 30 women (imaging study, Dermatol Surg)
  4. PubMed · Our search for Pilates or exercise trials measuring cellulite (2 November 2026; Europe PMC and ClinicalTrials.gov also searched)
  5. Dzimbova 2022 · Pilates, anti-cellulite massage and body composition (preprint, not peer reviewed, Research Square)
  6. Knobloch 2013 · Glute exercises with real or dummy shock wave therapy for cellulite (double-blind randomised trial, Dermatol Ther; read in full; the device maker paid its publication charges)
  7. Troia 2021 · Aerobic exercise with or without shock wave therapy for cellulite in 45 women (randomised trial, J Cosmet Dermatol)
  8. Löberbauer-Purer 2012 · Diet, cycling and a lower-body pressure device in 86 women with obesity (randomised trial, Eur J Appl Physiol)
  9. Smalls 2006 · Weight loss and cellulite (study, Plast Reconstr Surg)
  10. American Academy of Dermatology · Cellulite treatments: what really works? (no date shown)
  11. Luebberding 2015 · Cellulite treatments: 67 studies (evidence-based review, Am J Clin Dermatol)
  12. Lim 2025 · Cellulite treatments: 24 randomised trials, 2,084 people (systematic review, Aesthetic Plast Surg)
  13. Kaminer 2017 · Device subcision for cellulite, followed for 3 years in 45 women (open study, Dermatol Surg)
  14. Nagshabandi 2026 · How long body contouring and cellulite treatments last (short review, JPRAS Open)
  15. Endo · Announcement that it would stop making and selling its collagenase cellulite injection (company press release, December 2022; read in full)
  16. NHS · Cellulitis
  17. NHS · DVT (deep vein thrombosis)
  18. NHS · Lipoedema (past its review date: reviewed July 2023, review due July 2026)
  19. NHS · Symptoms of breast cancer in women
  20. Nürnberger 1978 · So-called cellulite (descriptive study, J Dermatol Surg Oncol)
  21. Querleux 2002 · Fat under the skin on MRI and spectroscopy, by sex and cellulite (imaging study, Skin Res Technol)
  22. Bass 2020 · The causes of cellulite (review, Dermatol Surg; read in full)
  23. Smalls 2005 · Measuring cellulite in 3D in 72 people (study, J Cosmet Sci)
  24. Soares 2022 · Cellulite in 184 Brazilian girls aged 12 to 18 (cross-sectional study, Int J Dermatol)
  25. Hexsel 2009 · A photo-based cellulite severity scale (validation study, J Eur Acad Dermatol Venereol)
  26. Young 2021 · Cellulite severity scales and imaging (review, Aesthet Surg J)
  27. Kruppa 2026 · Lipedema World Alliance consensus on definition and management (Delphi consensus, Nat Commun; read in full)
  28. Herbst 2021 · Standard of care for lipedema in the United States (guideline, Phlebology; read in full)
  29. Knobloch 2010 · Shock wave therapy for cellulite: the trial plan (protocol, BMC Womens Health; read in full)
  30. Paolillo 2011 · Treadmill training with or without infrared light for cellulite in 20 women (trial, J Cosmet Laser Ther)
  31. Menon 2024 · A clinical guide to treating cellulite (review, Aesthetic Plast Surg)
  32. Longano 2024 · Electrical, light and ultrasound devices for cellulite: 32 studies (systematic review, Lasers Med Sci)
  33. Tanzi 2024 · Acoustic subcision for cellulite in 42 women (clinical trial, Dermatol Surg; read in full)
  34. Kaufman-Janette 2021 · Collagenase injections for cellulite in 843 women (two phase 3 placebo-controlled randomised trials, Dermatol Surg; read in full)
  35. Foppiani 2024 · Collagenase or subcision for cellulite: 14 studies (systematic review and meta-analysis, Plast Reconstr Surg Glob Open; read in full)
  36. Grekin 2023 · New considerations with collagenase for cellulite, including a muscle tear (letter with a case, Aesthet Surg J Open Forum; read in full)
  37. Piérard-Franchimont 2000 · Retinol cream for cellulite in 15 women (randomised placebo-controlled trial, Am J Clin Dermatol)
  38. Ponto 2026 · A caffeine cream for cellulite in 24 women (double-blind randomised trial, Pharmaceutics; read in full)
  39. Collis 1999 · Machine massage or aminophylline cream for cellulite in 52 women (randomised trial, Plast Reconstr Surg)
  40. NHS · Chest pain (past its review date: reviewed August 2023, review due August 2026)
  41. NHS · Heart attack
  42. NHS · Fainting
  43. NHS · Shortness of breath
  44. NHS · Pilates video for beginners, with its safety advice
  45. NHS · Eating disorders: overview
  46. Beat · Support now: helplines for England, Scotland, Wales and Northern Ireland
  47. Neumark-Sztainer 2011 · Yoga and Pilates, body image and disordered eating in 2,287 young adults (population survey, Int J Eat Disord)

Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.