Does Collagen Supplementation Actually Work? Aesthetic Doctors Share Their Views

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What are you born with in abundance, manufacture yourself, and then run out of it by age 40? The answer is collagen – a really hot topic in the beauty industry today. Determining whether collagen supplementation is worthwhile for aesthetic and medical reasons has created some controversy. Paola Chellew talks to three aesthetic doctors to get their professional point of view.

How do you take your coffee? I take mine with 10 000 mg of hydrolysed collagen every morning, without fail. That’s because, over three years ago, I developing excruciating pain in both of my wrists. This was definitely age-related and, as anti-inflammatories and painkillers were just going to numb my symptoms, I decided to start taking hydrolysed collagen as a supplement – with a firmly arched, sceptical brow. A few months later, the pain diminished and, as an added extra, my hair was thicker, and my skin and nails never looked better. And with results from clinical trials now starting to trickle in, we can finally settle the ongoing debate about whether or not collagen supplementation really works.

A question of collagen 

Collagen is the most plentiful protein in the human body, giving strength and structure to the bones, muscles, tendons, and the skin. The connective tissue binding all our cells together into a fantastic framework is mainly made up of collagen and elastin, giving us buoyancy and support.

Going back to my Greek

Collagen is found in all mammals, keeping us strong and healthy. The Greek root of the word, kolla, means glue – this is apt, as most collagen is found in the connective tissues between the bones – while gene means giving birth to something. The body gives birth to its own collagen, which plays an essential role in the healthy structure and function of our skin, bones, and connective tissue.

Babe, I’m gonna leave you…

As we age, collagen production slows down and gradually comes to a halt. The skin loses elasticity: it doesn’t seem to bounce back as it did before, and wrinkles set in. The lovely, spongy cartilage of joints starts thinning, and the result may be aches and pains associated with ageing. Muscles tend to weaken with age. Hair loses the volume it once had, and nails get brittle. 

Dr Alek Nikolic explains further:

“In the process of ageing, our body starts to produce less collagen at a declining rate of about 1.5% per year from the age of 25 onwards. The number and activity of skin cells (fibroblasts) that produce collagen decreases. Due to the fibroblasts becoming less active, the collagen matrix that provides the skin with firmness and structure starts to break down.”

Wake me up before you go-go

So that was the bad news…the good news is that we can stimulate collagen production in our skin by using topical retinoids (vitamin A derivatives), an antioxidant vitamin C serum in the morning, a good sunscreen, as well as investing in aesthetic treatments like chemical peels and microneedling. Cut smoking, booze, and sugar out of your life, and get moving physically with an activity you love. Make sure you incorporate muscle-strengthening exercises and stretch as much as possible. Avoid stress and encourage good sleeping habits.

Dr Natalie Cordeiro weighs in:

“I’m a great believer in addressing any skin or ageing concern using a multifaceted approach. If a patient shows signs of early ageing, I explain the factors that lead to ageing and how we can address them. Lower levels of mechanical stimulation and cellular fibroblast ageing (long-lived cells constantly undergoing damage) are two major contributing factors to ageing. 

“Mechanical stimulation of collagen can be achieved with somatologist treatments such as microneedling, peeling, or laser treatments. New on the market are biostimulator injectables that create new collagen, resulting in a lifting and tightening effect.” 

The Decider: Is collagen supplementation worth it?

Dr Alek’s take:

“Since sufficient collagen cannot be provided through the consumption of different kinds of food, the intake of hydrolysed collagen is essential at the correct dosage and absorption rate. Considering that we start losing collagen production from about 25 years of age, I feel that as we hit our thirties we should consider taking a daily hydrolysed collagen supplement. Both men and women will most definitely benefit from it. If you are receiving any aesthetic treatment, it is advisable to combine this with the right collagen supplement. Stimulating collagen externally through treatments and internally with a collagen supplement can work synergistically to obtain optimal results – not only in your appearance but in your health as well.”

Dr Debbie Norval concurs:

“All the collagen induction therapies, including the new injectable biostimulators, will benefit from the addition of hydrolysed collagen. You are literally helping the body to help itself! This is even more important in patients who smoke, as their collagen production is so impaired.” 

Close to the bone

Ageing also affects our bone density, particularly in menopausal women. Conditions such as osteoporosis can occur. Reasons include genetics, in addition to a lack of physical activity, poor nutrition, smoking, and drinking alcohol. 

For the purposes of this article, it is worthwhile to note that in a controlled study, “the findings… demonstrate that supplementation with 5 g of specific collagen peptides significantly increases bone mineral density of the lumbar spine and the femoral neck, as well as blood levels of the bone marker, P1NP, in postmenopausal women with age-related decline in bone marrow density.”¹

I still haven’t found what I’m looking for

Choosing a collagen supplement can be overwhelming, as businesses in the health industry have jumped on the brandwagon when it comes to marketing collagen. So, let’s break it down to simple facts. First, we need to understand what hydrolysed collagen signifies.

Dr Debbie Norval explains:

“Hydrolysed collagen is not small enough to be dissolved. Rather, it’s small enough to be absorbed. It’s collagen that has been broken down into very small fragments through a process called hydrolysis. The fragments of collagen are tiny enough to pass through the intestinal barrier, yet are still large enough to be recognised as collagen in the bloodstream, where they are reconstituted into long chains of collagen protein. This collagen will then go where it is needed in the body.

“There are 28 types of collagen, and they all have different structures and functions. There are five types that are generally used in supplements, and they come from various sources.   

“For example, bovine (from cows) collagen contains Type I and III. Marine collagen contains Type I and II. 

“Type I collagen is the most abundant form of collagen found in the body and supports healthy skin, hair, ligaments, bone, and nails. Type III collagen, the second most common form of collagen found in the body, promotes and maintains blood vessels and muscles and improves gut health. Type II collagen helps support joints, cartilages, and bone problems, helping with pain management.”

What additives should one look out for that may be detrimental or even insignificant?

Dr Debbie shares:

“Certain collagen brands contain only pure collagen powder. Other brands have supplements added for various benefits, e.g. vitamin C, B vitamins, hyaluronic acid, magnesium, zinc, and silicone. These supplements help in the process of collagen synthesis. Some collagen supplements contain ingredients that brighten the skin, e.g. glutathione. Others are more focused on hair or immune support.

“If you are already taking multivitamins and supplements, you may prefer a plain collagen supplement so as not to duplicate. Alternatively, you might save on supplements and rely on the vitamins and minerals already added to your collagen. 

“Note that if you’re on a tight budget, the products with extra supplements will be a bit more expensive.

“Some are in syrup form, and others are tasteless or flavoured powders. There’s a collagen to suit everyone! If you’re careful with your sugar content, be aware that all collagen supplements contain calories, and some have more sugar than others.” 

Dr Alek’s guidelines:

1. Proven safety and efficacy certificates
2. FDA Approved
3. Scientifically and clinically proven through studies 
4. Pharmaceutically manufactured
5. Transparency of doses and ingredients on packaging
6. No less than 10 000 mg of hydrolysed collagen (proven to be the dosage at which the body starts to repair and heal)
7. 94% bioavailability (proven absorption) 

The vegan choice

Since we have established that collagen is sourced from animals, it’s important to be aware of the fact that vegan collagen products contain plant-based ingredients that help in your own collagen production. These may include copper and vitamin C, which are helpful in stimulating collagen production.²

Burden of proof

At first, when the collagen hype started, research was scant. Now, more and more trials have conclusive proof. 

Dr Alek elaborates:

“Many studies have proven over and over that collagen supplementation at the correct dosage of 10 g improves skin elasticity and skin hydration, allowing the dermal matrix of the skin to become denser. Studies also show that using collagen for inflammatory skin conditions such as eczema, psoriasis, as well as acne has been beneficial.”³

Dr Natalie Cordeiro adds:

“My husband rides off-road motorbikes and his joints take a huge strain, resulting in aches and pains. Collagen supplementation has decreased these symptoms significantly. Other than that, genetically, the females in my family have very fine hair. Hairdressers who have known us for years have commented on our increased volume of hair since taking collagen supplementation.”

Dr Natalie is adamant that once you see the signs and if you know that genetically you have factors that will speed up fibroblast degradation – (genetic testing will give you these answers) – then it is best to start early:

“If you follow a healthy lifestyle and have no genetic factors, then I advise patients to start before menopause or at the very least in peri-menopause. Studies show a very steep decline in collagen around menopause.⁴ Starting before hormonal blood levels start to decline makes the transition a lot smoother with regard to hair, skin, and nails.”

The Verdict: Never going to give you up

The science says it all – beyond a reasonable doubt. Evidence shows that hydrolysed collagen supplementation can support and strengthen the health of the skin, nails, hair, joints, and muscles. I’m going to continue taking it, and my wrists are thanking me for that. And if I knew I was going to be stranded on a desert island, I would definitely pack my collagen – along with my sunscreen. 

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References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441532/ (Specific Bioactive Collagen Peptides in Osteopenia and Osteoporosis: Long-Term Observation in Postmenopausal Women)
2. https://www.livescience.com/does-vegan-collagen-actually-work
3. https://pubmed.ncbi.nlm.nih.gov/26362110/ (The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network)
4. https://pubmed.ncbi.nlm.nih.gov/3120067/