Collagen
05 August 2023
You are what you eat, so can you eat your way to better skin? This notion is the premise for beauty supplements; especially for collagen supplements and powders. The idea that collagen supplements are the elixirs of youth that allow a user to replenish collagen fibres in the skin to (hopefully) undo the signs of ageing is very attractive. Not surprisingly, collagen powders and supplements are immensely popular; with collagen hotpots, broths, soup, smoothies and even gummies trying to cash in on this trend.
Can collagen supplements give you younger, smoother and wrinkle-free skin? Do collagen supplements actually work? Here’s a deep dive into everything you need to know about collagen supplements and creams and how to delay signs of ageing in your skin.
Collagen is one of the most plentiful proteins in our body. It constitutes 25-30% of all proteins in the body1. Although collagen might be most famous for being a structural fibre of the skin; collagen can be found in many other parts of the body such as tendon, cartilage and joints. In the skin, collagen makes up 75% of the bulk of the skin2,3. Collagen fibres provide structural integrity to the skin; kind of like scaffolding in a building. Together with other proteins such as elastin and hyaluronic acid, these trio of proteins keep the skin plump, tight and moist.
Related blogpost:
How to Repair Your Skin Barrier
Collagen is continuously being produced by cells in our skin called fibroblasts to keep the skin plump and youthful. It is also naturally broken down by enzymes called matrix metalloproteinases in the skin.
As we get older, this balance of collagen production and loss gradually changes. Intrinsic ageing causes the collagen loss to exceed ongoing collagen synthesis; and the estimated collagen loss is approximately 1% every year throughout adult life4. Coupled with other ageing related changes to elastin fibres and hyaluronic acid in the skin; several structural and functional changes occur in the skin. Skin becomes thinner, less firm, less elastic and fine wrinkles appear5. Moisture loss from the skin also increases as we age due to depleting hyaluronic acid in the skin6,7.
Related blogposts:
Everything You Need to Know about Hyaluronic Acid
5 Cult Favourite Hyaluronic Acid Serums Reviewed
Lifestyle choices can negatively impact extrinsic ageing of the skin. Exposure to UV rays and air pollution; smoking and nutritional statuses can accelerate ageing in the skin8.
Growing awareness of factors that affect skin health and the perception that collagen supplements can augment collagen levels in the skin to delay signs of ageing has led to the boom of collagen supplements, not to mention collagen gummies, soups and hotpots. These collagen supplements claim to make one look younger, undo wrinkles and sagging, improve moisture levels, and reduce cellulite. Some of these companies claim to have studies and clinical trials to back up these claims. Like all studies; these need to be scrutinised to find out if they were biased and if they can be replicated in larger trials for doctors to make recommendations.
The current body of opinion among most doctors on whether collagen supplements/ powders can improve or delay signs of ageing in the skin- not convincing. The biochemistry and physiology do not add up. Here’s a deep dive into the world of collagen supplements, powders, gummies and soups- and the select circumstances that it may work.
Collagen supplements are oral supplements that contain large collagen protein molecules or smaller fragments called peptides and hydrolysed collagen. Collagen proteins, peptides and hydrolysed collagen are made up of even smaller units called amino acids- namely hydroxyproline, proline and glycine. Amino acids are the building blocks of peptides and proteins. The sequence of amino acids determine the properties of peptides and proteins. Unique to collagen peptides and proteins, is the presence of the amino acid hydroxyproline.
Collagen proteins, peptides and hydrolysed collagen
If you’ve looked up collagen supplements and powders before, you might be confused by the ingredient lists- collagen proteins, peptides and hydrolysed collagen. What are the differences between them? Which would be the most effective?
Put simply, collagen proteins are large molecules made up of smaller repeating units called peptides. In other words, many collagen peptides make up a large collagen protein molecule.
Another name for collagen peptides is hydrolysed collagen. In other words, the collagen protein has been hydrolysed or “chopped up” into smaller repeating peptides. Hydrolysed collagen is a popular choice among many nutraceutical companies for their collagen supplements and powders. The lower molecular weight of hydrolysed collagen is thought to allow hydrolysed collagen to be more easily absorbed by the gut and can be easily added as a booster to drinks and smoothies because they are more water soluble. (note from Dr Rachel Ho: more about these perceptions and claims will be scrutinised further in this blogpost.)
Collagen sources
The next question on your mind would probably be- what is the source of collagen? Where do these collagen peptides and proteins come from?
Bad news for vegetarians: collagen supplements are from animal sources- namely from pigs (porcine collagen) or cows (bovine collagen). Collagen can be obtained from marine organisms too; and they are referred to as marine collagen.
Among the marine organisms from which collagen is extracted are some types of fishes, jellyfishes, sponges, sea urchins and octopuses. Marine collagen has a smaller molecular weight than collagen from animal sources; and is perceived to have better absorption after oral consumption. Contamination and inflammatory reactions are also lower with marine collagen compared to collagen or porcine and bovine origin9.
For vegetarians or vegans- there are NO plant based forms of collagen available. The sequence of amino acids that make up collagen in animals does not naturally occur in plants. A close inspection of plant based or vegetarian collagen supplements will reveal that instead, these products contain ingredients like vitamin C and zinc that encourage the body to increase its production of collagen.
Signs of ageing are often vilified; and the idea that collagen in the skin can be supplemented to “naturally” undo wrinkles, pigmentation, sagging and enlarged pores by ingesting pills and powders is certainly very enticing. The business of nutraceuticals and beauty supplements is booming; and collagen supplements is a big contributor to this. The nutrauceutical and health supplement is not regulated as tightly as medications and medical treatments- so a lot of the claims by manufacturers of collagen powders and supplements; as well as #sponsoredposts #sp by influencers are not subject to the scrutiny and rules that govern medications and medical treatments.
Some of the supposed benefits of collagen supplements and powders are:
• Reduced wrinkles
• Smoother skin
• Smaller pores
• Lifted skin
• Improved complexion and texture
• Increased hair growth
• Increased nail growth
• Reduced cellulite
For collagen supplements and powders to trigger collagen formation in the skin; a few conditions need to fulfilled, just like any other food, vitamins, medications or supplements that we consume
First of all they need to be absorbed by the gut, and then be delivered to the target organ (i.e. the skin) in some way that can then be reconstructed as collagen in the skin in order to allow noticeable benefits to be appreciated.
But here’s the tricky thing- collagen proteins are too large to pass through the gut membrane to enter the bloodstream. So what happens after a person ingests collagen supplements or hydrolysed collagen (or any protein, for that matter) is that the body’s digestive system of enzymes and acid juices break down the protein into smaller fragments- peptides and amino acids. Only amino acids and very small peptides called dipeptides (chain of 2 amino acid) and tripeptides (chain of 3 amino acids) can pass through the gut membrane to be absorbed into the bloodstream10. Any peptide or protein chain that contains 4 or more amino acids cannot be absorbed by the gut.
The smallest collagen unit that exists is called a collagen tripeptide (made up of 3 amino acids). Next, these collagen tripeptide and its smaller building blocks (i.e. amino acids) need to be delivered to the skin to be transformed as collagen in the skin. However, there is no way for these amino acids to be preferentially distributed to the skin, compared to other organs11. Our bodies naturally prioritises organs and tissues where functions are most important such as the heart and muscles. The skin has a lower priority, in comparison.
There is no way to control delivery of the ingested amino acids or collagen tripeptides to the skin. Organs and tissues with more vital functions that require collagen such as the bone, joints, tendons and cartilage are more likely to get the amino acids and collagen than the skin. Simply put, for collagen supplements or powders that are ingested to be transformed into collagen in the skin is a very long stretch. The science also applies to any collagen rich food that you may consume.
Based on the biology and physiology of our bodily digestive and absorptive processes- it may seem for collagen supplements and powders to reach the skin and get transformed as collagen fibres in the skin- is not as simplistic as makers of collagen powders and supplements make it seem like. The collagen that you are ingesting- may not end up in your skin!
The use of collagen supplements to improve collagen levels in the skin or address signs of ageing remains controversial as data from studies of collagen supplements is not robust. Manufacturers of collagen pills may point to statistics from company sponsored trials; and influencers may wax lyrical about how soft and plump their skin have become from taking collagen supplements- but large, randomised controlled trials for collagen supplements are just not available to convince doctors to make recommendations.
Literature on collagen supplements in peer reviewed journals is very limited. There are some studies, even small trials, that suggest that collagen supplements can improve skin texture, elasticity and hydration. However, some of these studies are equivocal or show that the improvements are not significant12,13. Some of these studies are also limited in power, lack controls and objective clinical end points12,13. With these limitations and the lack of consistency in the studies, making generalised statements about collagen supplements is also not possible.
Collagen supplements across different brands also vary in their type, source, concentration and combination of other nutraceuticals. Hence, outcomes across different formulations can vary. Until more clarity, standardised and more trials on collagen supplements are available, collagen powders for better skin remains a controversy.
The side effects of taking collagen supplements seems to be very negligible12,13.
There are no guidelines for collagen supplements and powders as the nutraceutical industry is not regulated. As collagen supplements and powders across brand vary in terms of quality, quantity, source and type of collagen used; generalisations cannot be made. If in doubt, please refer to the recommendations on the labels of the collagen supplement product.
Similarly, for published studies on collagen supplements- the duration of time required to see results from consuming oral collagen supplements ranged from 4 weeks to 90 days12-14.
• Type of collagen in ingredient list: Does it contain collagen proteins, peptides, or collagen hydrosylate/ hydrolysed collagen? Hydrolysed collagen has a smaller molecular size and is said to be more easily absorbed by the gut membrane; but the data on this from peer reviewed journals is lacking.
• Animal source of collagen (especially for users who may dietary restrictions): Is it derived from marine sources, cows or pigs? • Amount of collagen in the product
• Any additional ingredients- Vitamin C and copper are vitamins and minerals involved in the production of collagen in the skin; so these may also be helpful.
Meats are rich sources of collagen- both white meats (e.g. chicken, fish, shellfish) and red meats (lamb, beef, pork).
Other micronutrients such as vitamin C are also essential for the production of collagen. Rich sources of vitamin C include citrus fruit, berries, kiwifruit, and beetroot.
You can keep up with the Kardashians, but ageing- may be not. Just putting it out here that ageing is natural and physiological; we should not vilify the process of ageing or signs of ageing. Nonetheless, if you would like to adopt practices for healthier skin or delay signs of ageing- I’m all for it.
Some of the extrinsic factors that accelerate collagen loss in the skin are smoking, UV exposure and air pollution. Besides smoking cessation, simple skincare changes can make a difference to the health of the skin. A balanced diet with adequate proteins and micronutrients will also provide your skin with the necessary building blocks for collagen and other essential components of the skin.
UV exposure causes damages cell structures and collagen in the skin. The damage to the the skin causes signs of ageing such as hyperpigmentation and wrinkles15. Minimising UV damage to the skin through sunscreen use, limiting exposure to peak UV times and wearing sun-protective clothing are recommended16.
Related blogposts:
Sun Protective Clothing Explained
Air pollution have also been associated with signs of ageing by inducing oxidative stress on the skin15-19. Exposure to toxins in air pollution has been shown to induce wrinkles19. Applying antioxidants to the skin can help to reduce this oxidative stress to the skin. One of the most well studied antioxidants in skincare is vitamin C. You can learn about the many benefits of including this in your daily routine in Topical Vitamin C: One of the Best Ways to Protect Your Skin.
Active ingredients in skincare that can increase collagen production in the skin to improve fine lines and texture are retinoids, vitamin C and acids. You can learn more about these skincare ingredients in:
The Beginner’s Guide to Retinoids
5 Affordable & Popular Retinoid Serums Reviewed
Topical Vitamin C: One of the Best Ways to Protect Your Skin
Everything You Need to Know About Hyaluronic Acid
5 Cult Favourite Hyaluronic Acid Serums Reviewed
A Complete Guide to Acids in Skincare & Chemical Exfoliation
Collagen in skincare? The molecule is too large to be absorbed across the basement membranes to be meaningfully incorporated in to the dermis of the skin. At best, you might feel that your skin is smoother due to the emollient effect; but true collagen building results are unlikely to be felt. All the evidence and science behind collagen creams and skincare are covered in this blogpost Is Collagen Skincare a Scam?
If you find that skincare is moving too slowly, you can speak to your doctor to learn about your options to address signs of ageing such as enlarged pores, sagging skin and wrinkles. Some of these options are:
• Enlarged facial pores with Fractional CO2 lasers or Skinboosters with Microbotox. I’ve shared about my experience with Fractional CO2 laser for my pores here. You can also learn more about Skinboosters and microbotox in Skinboosters: All You Need to Know About It.
• Sagging in the skin can be treated with Face Threadlifts and Dermal Fillers as part of a Liquid Facelift. Learn more about all the non-surgical options in How to Treat Sagging Skin Without Surgery.
• Wrinkles in the upper face can be treated with Botox to relax the muscles. I’ve shared my results with Botox in Baby Botox & Preventative Botox. Safety issues and FAQs on Botox are covered in Is Botox Deadly?
• For fine wrinkles in the skin, injectables moisturisers such as Profhilo and Rejuran Healer are popular options. Learn more about them Is Profhilo the Future of Injectable Skincare? And Rejuran Healer: All You Need to Know About It.
Unless you have a deficiency of amino acids or collagen- taking collagen supplements or powders to improve the collagen the levels is unlikely to work. collagen proteins and peptides get broken into smaller units in the gut after consumption; and there is no preferential delivery of these units to the skin to be reassembled into collagen.
Despite anecdotes and marketing hype from the nutraceutical industry; evidence for collagen supplements improving the skin in large, quality trials are lacking. For small studies that seem to suggest that taking collagen supplements can improve the skin; there are conflicting studies that show no benefit.
There are evidence based ways to improve the collagen levels and the quality of the skin with other active ingredients and treatments compared to collagen supplements and creams. Until then, I’m going to be skipping this trend. Also, coming soon to Talking Point on Channel New Asia, I’ll be sharing more about collagen supplements and the host, Sharda, will be putting a collagen supplement to the test for a month. Stay tuned for this episode, it’ll be fun and educational!
References
1. Fibrous Protein Structures: Hierarchy, History and Heroes. Squire and Parry. Subcell Biochem. 2017;82:1-33
2. The Presence of Food-Derived Collagen Peptides in Human Body-Structure and Biological Activity. Sato. Food Funct. 2017;8:4325–4330.
3. Extracellular Matrix Regulation of Fibroblast Function: Redefining Our Perspective on Skin Aging Cole et al. J. Cell Commun. Signal. 2018;12:35–43.
4. The influence of age and sex on skin thickness, skin collagen and density. Shuster et al. Br J Dermatol. 1975 Dec;93(6):639-43.
5. Skin connective tissue and ageing. Calleja-Agius et al. Best Pract Res Clin Obstet Gynaecol. 2013 Oct;27(5):727-40.
6. Skin ageing. Calleja-Agius et al. Menopause Int. 2007 Jun;13(2):60-4.
7. Skin hydration: a review on its molecular mechanisms. Verdier-Sévrain and Bonté. J Cosmet Dermatol. 2007 Jun;6(2):75-82.
8. Improvement of dermal parameters in aged skin after oral use of a nutrient supplement. Addor et al. Clin Cosmet Investig Dermatol. 2018; 11: 195–201.
9. Enhancing Skin Health: By Oral Administration of Natural Compounds and Minerals with Implications to the Dermal Microbiome. Vollmer et al. Int J Mol Sci. 2018 Oct 7;19(10):3059.
10. Absorption of Amino Acids and Peptides. Vivo Physiology. Colorado State University. http://www.vivo.colostate.edu/hbooks/pathphys/digestion/smallgut/absorb_aacids.html
11. Nutraceuticals and skin appearance: Is there any evidence to support this growing trend? Spiro and Lockyer. Nutrition Bulletin. 2018 Mar; 7(1): 10-45.
12. Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis. Miranda et al. Int J Dermatol. 2021 Dec;60(12):1449-1461.
13. Oral collagen supplementation for skin aging: A fad or the future? Jhawar et al. J Cosmet Dermatol. 2020 Apr;19(4):910-912.
14. Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. Choi et al. J Drugs Dermatol. 2019 Jan 1;18(1):9-16.
15. Role of UV light in photodamage, skin aging, and skin cancer: importance of photoprotection. Gonzaga. Am J Clin Dermatol. 2009;10 Suppl 1:19-24.
16. Effects of air pollution on the skin: A review. Puri et al. Indian J Dermatol Venereol Leprol. Jul-Aug 2017;83(4):415-423.
17. Air pollution and skin diseases: Adverse effects of airborne particulate matter on various skin diseases. Kim et al. Life Sci. 2016 May 1;152:126-34.
18. Air pollution and skin disorders. Roberts. Int J Womens Dermatol. 2020 Nov 25;7(1):91-97.
19. Airborne particle exposure and extrinsic skin aging. Vierkötter. J Invest Dermatol. 2010 Dec;130(12):2719-26. 3.
