March 31, 2021 -- Collagen is the most plentiful protein in the human body. It's part of the scaffolding that keeps skin supple and supports the cartilage that acts like a shock absorber in the joints.
As you get older, this fibrous protein is much less abundant. "With time, there's a breakdown of collagen," says Nazanin Saedi, MD, associate professor and director of the Jefferson Laser Surgery and Cosmetic Dermatology Center in Philadelphia. "We have less than we did as children."
Our efforts to restore lost collagen and regain a more youthful skin tone and healthier joints have turned collagen supplements into a multibillion-dollar-a-year industry. Are these supplements a fountain of youth in a bottle, or are they nothing more than marketing hype?
Collagen for Skin
Our own natural collagen keeps our skin plump and youthful-looking. Could the kind that comes in a bottle do the same thing? "If you'd asked this question 3 or 4 years ago, people would have said 'This is absurd,'" Saedi says. "As more data are coming out and collagen supplements become increasingly popular, researchers are seeing that there is an improvement in skin quality."
Collagen activates cells called fibroblasts in the skin, which trigger the production of collagen, as well as elastin, a protein that makes skin more stretchy. In studies, people who took collagen for a few months did see some improvements in wrinkles and skin dryness.
But Saedi cautions that "the data are really weak." She says other dermatologic treatments have much more evidence to support that they boost collagen production, including Retin-A and laser resurfacing.
Collagen for Joints
Collagen makes up articular cartilage, the tissue that covers the ends of bones at the joints and allows them to move smoothly against one another. "Because cartilage deteriorates in osteoarthritis, it's been thought that if you could give a supplement like collagen, it would help you regrow cartilage," says Nancy E. Lane, MD, a distinguished professor of medicine, rheumatology, and aging at the University of California, Davis. "It does not."
There is very little evidence to show that collagen helps with arthritis. Many of the studies that have been done weren't well-designed. And the better-designed studies didn't confirm that these supplements reduced cartilage loss or eased pain from arthritis.
Collagen supplements won't hurt if you want to try them. "If it helps, fine," Lane says. "But it's not going to prevent the joint from deteriorating." You may get more benefit from physical therapy and exercises like walking and swimming to strengthen the muscles around the joint, as well as topical nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation.
Types of Collagen
Our bodies are made up of 16 types of collagen. Most of it is type I, II, or III. Type I is in the skin, tendons, and bones. Type II is in cartilage. Type III is in the skin and muscles.
Collagen supplements come in different forms, based on how they're prepared. These include gelatin, hydrolyzed, and denatured.
Gelatin is basically cooked -- heat-treated to break the larger proteins into smaller pieces. Hydrolyzed collagen is broken down even more, into smaller chains of amino acids -- the building blocks of protein. Undenatured collagen isn't broken down.
"Most of the research has been done with hydrolyzed collagen," Saedi says. "It can be absorbed by the body more easily."
The collagen used in supplements comes from animals, such as cows, pigs, and marine life like jellyfish, sponges, sharks, and other fish. Vegan collagen is also available, but Saedi doesn't recommend it. "I tell patients not to get the plant-based collagen products, because some of them don't contain real collagen." Plus, the majority of the research that's been done has used collagen from animals.
Is It Safe?
Collagen supplements are generally safe, Saedi says. Most of the side effects reported from their use are mild, including stomach upset and diarrhea.
The problem is that collagen, like other supplements, isn't regulated by the FDA. That means there can be big differences in quality and ingredients from bottle to bottle.
Should You Try Collagen?
If you're interested in trying collagen for your skin or joints, there's probably no harm in doing so. Just don't make the purchase expecting to see dramatic results. Chances are that any improvements you do see will be subtle, at best.
Anyone with arthritis should check with their rheumatologist before trying collagen "to manage their expectations,"Code Lane says.
If you do decide to buy collagen supplements, don't waste your money on the most expensive brand, Saedi says. Any product that's labeled "hydrolyzed" will do.