Observation with tangential lighting is one of the most common methods used to measure cellulite due to its cost effectiveness, reproducibility, and relative ease. Such observation involves direct or photographic examination and visualization of the skin. Clinicians look for dimpling or puckering of the skin and palpate for subcutaneous nodules. This method is often best achieved in a dark room with tangential lighting where shadows can be created to view subtle dermal surface elevations and depressions [17].
For example, Rao, et al. took high-quality digital photographs with the Fuji S1 Twinflash camera system (Canfield Inc, Fairmont, New Jersey) in order to assess cellulite on the posterior and lateral thighs. Subjects stood against a black backdrop, and the Verilux Happy Lite system was shown at the level of the subject’s knees in order to enhance the quality of the image.