For centuries, Chinese women have viewed collagen — a protein that binds tissues in fish and animals — as a fountain of youth, routinely consuming foods like pig’s feet, shark fins, and donkey skin in hopes of smoothing withered skin and preserving aging joints.
In the United States, collagen became best known in the 1980s as an expensive injectable filler to plump lips and soften lines. But only in recent years, as companies have come up with more appetizing ways to take it (including fruity chews, vanilla-flavored-coffee creamers, single-serving sachets, and easy-to-swallow capsules) has edible collagen begun to catch on here.
Instagram endorsements from celebrities like Kourtney Kardashian (who starts her day with a hot collagen beverage) haven’t hurt. And thanks to a small but growing body of evidence suggesting it can improve skin, ease arthritis symptoms, promote wound healing, and fend off muscle wasting, former skeptics in the medical field are also beginning to come around.
In 2020, in the United States alone, consumers are expected to spend $293 million on collagen supplements, up from just $50 million in 2014, according to market research firm Nutrition Business Journal. Globally, as collagen makes its way into more foods and beverages, topicals, and even the operating room, the market is projected to reach $6.5 billion by 2025.
The market size of collagen products in Thailand is more than 2 billion baht a year. There’s been a big growth in recent times, with Facebook full of collagen images; it’s almost become a must have fashion item. Dozens of brands are available via health food stores, drugstores, mail order and online shopping. Taken according to consumption of the recommended ‘dose’ the cost is likely to be around 300 THB a month.
But despite its popularity, questions remain about how well it works and how safe it is. “It’s definitely among the top three products people ask me about, and I believe it does hold promise in some diverse areas of medicine,” says Mark Moyad, MD, director of the complementary and alternative medicine program at the University of Michigan Medical Center. “It’s also one of the most wacky and controversial.”
Collagen is often called the body’s scaffolding. “It’s the glue that holds the body together,” says New York dermatologist Whitney Bowe. She says collagen makes up about 75% of the dry weight of your skin, providing volume that keeps skin looking plump and keeps lines at bay. It’s also rich in in the amino acids proline and glycine, which you need to maintain and repair your tendons, bones, and joints.
“As we get older, we break it down faster than we can replace it,” she says, noting that we begin to lose about 1% of our collagen per year in our mid-20s and lose as much as 30% during the first 5 years of menopause.
Injecting collagen has fallen out of favour in many medical skin care practices, since it doesn’t last as long as other fillers and tends to prompt allergic reactions. And when it’s put on the skin, it doesn’t absorb well, Bowe says.
When she learned a few years ago that people were eating it instead, she was skeptical. But she has since changed her mind. “Just in the last few years, there have been some impressive studies showing that ingestible collagen can indeed impact the appearance of skin,” says Bowe.
One 2014 study of 69 women ages 35 to 55 found that those who took 2.5 or 5 grams of collagen daily for 8 weeks showed a lot of improvement in skin elasticity, compared with those who didn’t take it. Another found that women who took 1 gram per day of a chicken-derived collagen supplement for 12 weeks had 76% less dryness, 12% fewer visible wrinkles, better blood flow in the skin, and a 6% higher collagen content.
And a 2019 review of eight studies including 805 patients concluded that “preliminary results are promising for the short and long-term use of oral collagen supplements for wound healing and skin aging.”
However many of the studies done so far on collagen are small and at least partially funded by industry.
The science is truly in its infancy, there’s a lot of conflict of interest, and not enough quality control but collagen holds promise.
As a protein source alone, collagen is an excellent one, packing in more protein per calorie than other sources while containing less sodium and sugar with evidence suggesting it may improve body composition, joint health, and healing rates.
One recent study of 53 elderly men with sarcopenia, a loss of muscle caused by aging, found that those who took 15 grams of collagen daily, in addition to lifting weights three times per week for 3 months, gained significantly more muscle and lost more fat than those who only lifted weights.
Collagen has also been shown to act as a powerful wound healer, able to stop bleeding, recruit immune and skin cells, and stimulate new blood vessel formation. One study of 89 long-term care residents with pressure ulcers found that those who took collagen supplements three times daily for 8 weeks saw their wounds heal twice as fast. Another, of eight patients who had a small surgical skin biopsy, found that daily topical collagen healed their wounds at least as well as sutures.
While research is mixed, a few studies have also shown that collagen supplements help with arthritis pain and sports-related joint pain.
All that said, some health professionals remain skeptical. Augusta, GA-based dermatologist Lauren Eckert Ploch says stomach acids break down collagen proteins you eat before they reach the skin intact, so she’s not convinced it helps at all. “The jury is still out.”
In one recent test of 14 popular collagen supplements, by the supplement testing company consumerlab.com, all products contained the levels of collagen they said they did, but one also contained high levels of cadmium, a toxic heavy metal.
Meanwhile, dermatologists and consumer groups have also expressed concerns that those ground-up hooves, hides, bones, and nerve tissues — particularly if they come from cows — could carry diseases including (BSE), or mad cow disease.
Andrea Wong, senior vice president for scientific and regulatory affairs for the industry trade group the Council for Responsible Nutrition, says that as ingredients go, collagen has an excellent track record.
“It has been around for ages, and there is a large body of evidence supporting its safe use,” she says. She notes that studies that see how well it works also look at side effects. In general, collagen has been shown to be safe, Wong said.
She notes that supplement companies are required to comply with federal “good manufacturing practices,” which prohibit unsafe levels of contaminants like heavy metals.
In 2016, the FDA prohibited the use of some cow parts in dietary supplements to “address the potential risk” of the presence of BSE. (Human consumption of BSE-infected meat has been linked to neurological disorders.)
The FDA exempted gelatin — a key collagen source — from the ban, “as long as it is manufactured using specified industry practices.”
Many of the concerns expressed about collagen supplements can be addressed by choosing wisely.
Look for companies that get their bones and tissues from cage-free, free-range, and antibiotic-free sources. Look for a trusted brand with a third-party label like NSF or USP. And check out the company’s website to see what it’s doing to keep heavy metals and other contaminants out of their products.
Consumers are advised have the attitude of ‘just prove to me that it’s clean and I’ll try it’. It can take up to 12 weeks for results to show; it might help, and it probably won’t harm, unless you are not being diligent about quality control.