Let’s talk collagen supplements. I’ve been meaning to write this blog post for months but have not found the time. So apologies for the delay, and here it is – dr Sarah xx
I’m going to confess, for a long time I considered collagen supplements to be complete bollocks.
How could taking collagen orally lead to there being more collagen in your skin? It would have to be absorbed through your gut, where it would get broken down into its basic protein constituents, travel through your blood, find its way to the dermis of your skin and then reconstruct itself back into collagen. Nah, why not just eat more protein? My cynical, scientific brain could not allow me to advocate spending money on something that appeared to make no sense.
But, the thing about being a cynical scientist is that you always remain open to new ideas and are willing to alter your opinion in the face of new evidence. And some months ago I read a paper that managed to change my mind.
Firstly, what actually is collagen?
Collagen is the main structural protein in our bodies, responsible for the mechanical support and shape of our bones, cartilage, tendons and of course the skin, where it makes up 75% of the total weight of our cutaneous tissue. As well as providing structure, collagen works as a team with elastin, hyaluronic acid and a molecule called reticulin to provide a support network for all the other cells of the skin – including our fibroblasts, keratinocytes and melanocytes.
Sadly, as we age, this support network becomes increasingly fragmented – our collagen fibres get shorter and less organised and we see an increase in enzymes (metalloproteinases) that actually work against us by degrading our collagen fibres and preventing the synthesis of new collagen from our fibroblasts. This is termed “intrinsic” ageing, and coupled with the “extrinsic” ageing caused by our environment and lifestyle choices, it all leads to functional and structural changes in the skin:
- volume reduction
- loss of elasticity
- decreased epidermal thickness
- increased wrinkles and fine liens
- decreased capacity to hold moisture in the skin
Being able to take collagen by mouth and have it reverse all these changes sounds like a golden ticket, right? But the evidence out there was previously a bit dodgy – some small studies were done; some showed improvements in all those signs of ageing listed above; some showed no benefit at all. So I was not convinced.
The paper that won me over was a systematic review – a statistical analysis of a number of studies looking at the role of oral hydrolysed collagen (HC) supplements in preventing skin aging in humans. It’s a very long paper with lots of maths (see below for the reference if you would like to read it!) where all the available studies are pooled together and analysed as a group. The researchers found 33 separate studies, 14 of which were excluded as they were not scientifically robust, leaving 19 studies to be analysed.
The results? The upshot is basically that oral collagen peptide supplements can achieve the following:
- improved skin hydration
- improved skin elasticity
- increased dermal density
- reduced facial wrinkles
- improved dermal collagen synthesis by fibroblasts
The beneficial effects were apparent at 60-90 days after starting the supplement and carried on for at least another 30 days after people stopped taking them.
How much do you need?
Daily intake of 2.5g (2500mg) of collagen peptides is needed to achieve results. There was one study included in the analysis that showed there was no additional benefit from taking 5g a day, but in that particular trial they were examining the skin quality of the inner arm, which is exposed to minimal environment damage and so ages relatively slower than other body areas, and therefore we can’t necessarily extrapolate that to the effects on facial/neck skin.
Since the meta-analysis that changed my mind, a few more studies have been published that have shown improvements in the skin with doses of hydrolysed collagen ranging from 500-5000mg per day. One of these trials was intentionally comparing 1g to 5g daily and found that whilst both doses led to an improvement in skin hydration, only the 5g dose improved elasticity.
So will any old collagen do?
Nope, this is where the size & structure of the collagen particles (peptides) matter. Your oral supplement has to contain bioactive collagen peptides – basically natural collagen that has already been broken down into smaller bits by enzyme before you eat it. This makes it easier for the very thing I was sceptical about to actually happen: once in the digestive system, these little bits of collagen are broken down further into tiny strands (dipeptides and tripeptides) that literally can get into the blood and land in the skin, where they group themselves into longer strands, join up and become structural collagen again.
There are a number of different proteins in most collagen supplements, with hydroxyproline, proline and glycine amino acids being the most common. Only hydroxyproline is a component of collagen, so what you are looking out for are prolylhydroxproline (Pro-Hyp) and hydroxyprolylglycine (Hyp-Gly). Most proteins are absorbed after digestion as amino acids, which are too big to make it all the way to the skin, but Pro-Hyp and Hyp-Gly are the ones that become tiny dipeptides in the gut, enabling them to travel all the way to the skin.
Does the source of the collagen matter?
Maybe, but only in terms of personal preference. There is no evidence to date that collagen from one source is more effective than any other; it is the concentration and the individual peptides that make it effective. Marine collagen is basically the scales of fish, which have a really high concentration of Pro-Hyp and Hyp-Gly, and is sourced as a byproduct of the fishing industry, using part of the fish that would otherwise be wasted. The other main source of collagen found in supplements in Australia is bovine, which means it comes from cows. Sadly for the vegans out there, no studies on skin effects have been done using plant-based collagen sources, so we still don’t know whether these would be effective.
Do we use collagen supplements at SkinBox?
Yes we do. I find them particularly useful as ongoing treatment for mature, dry skins and also for short-term use with laser resurfacing procedures, where we are intentionally flipping the skin into a regenerative mode – think of it as supplying extra building materials in order for the workforce to get the job done. Having spent a long time researching the commercially available options we settled on two different supplements that we recommend to our patients depending upon their needs:
GlowSo – bovine collagen in tablet form (plus kakadu plum, lutein, Zinc, VitC, Vit E, Biotin). 3 tablets daily is approximately 2.5g hydrolysed collagen. Daily cost = $2.48
MyCollagenLift – this is a medical-grade food supplement of marine collagen in powder form, with a heap of adjunctive other goodies in there (hyaluronic acid, organic silicon, ceramides, polyphenols, vitC, site, zinc, superoxide dismutase). 1 sachet per day gets you 5g of hydrolysed collagen. Daily cost – treatment phase (1 sachet per day) = $10 , maintenance phase (1/2 sachet a day) = $5
Of course, many other options are available out there. Read the ingredient panel, and remember you are looking out for hydrolysed collagen (specifically Pro-Hyp and Hyp-Gly) at a dose of at least 2500mg (2.5g) per day.