Collagen is the most abundant protein in our skin. It is what we call a structural protein, meaning that it plays a pivotal role in maintaining skin firmness and strength. Healthy collagen is important for healthy and beautiful skin. However, as we age, and with exposure to external factors such as UV rays, pollution, smoking, poor diet and stress, the collagen in our skin becomes damaged, which makes it less effective. And, with age, especially around menopause, natural production of collagen also diminishes, leading to visible signs of aging like wrinkles and sagging skin. While you can't completely reverse the aging process or restore collagen to its youthful levels, you can take steps to stimulate collagen production, and minimize further loss.
It is important to start with understanding the factors you have control over that can contribute to collagen decline. UV rays, in particular, accelerate collagen breakdown through a process known as photoaging. This is why I always say, regardless of season, sunscreen is a key component of any skincare routine. It can take 20 to 30 years for the damage to finally show on the surface of your skin, but it starts as young as in your teens and 20’s, which is why I always tell my younger patients: “nothing looks more beautiful in your 50’s than sun protection in your 20’s.”
Nutrition also plays a crucial role in collagen synthesis, and ensuring an adequate intake of certain vitamins and minerals can support the body's ability to produce collagen effectively. Some key vitamins and minerals that are essential for collagen synthesis include:
Vitamin C: A vital cofactor in the synthesis of collagen. It helps stabilize collagen molecules and promotes the conversion of proline and lysine into collagen. Sources: Citrus fruits, strawberries, bell peppers, broccoli, and kiwi.
Vitamin A: Supports the production of collagen and contributes to skin health. It helps regulate gene expression involved in the synthesis of collagen. Sources: Sweet potatoes, carrots, spinach, kale, and liver.
Vitamin E: An antioxidant that helps protect collagen from damage caused by free radicals.
Sources: Nuts, seeds, spinach, broccoli, and sunflower oil.
Vitamin K: Involved in the modification of certain proteins, including those that regulate calcium, which is important for collagen synthesis.
Sources: Leafy green vegetables, broccoli, Brussels sprouts, and cabbage.
B Vitamins (Biotin, B6, B12): Plays a role in collagen metabolism. Biotin, in particular, is important for the synthesis of collagen.
Sources: Biotin: Eggs, nuts, and sweet potatoes. B6 and B12: Meat, fish, poultry, and dairy products.
Zinc: A cofactor for collagen synthesis enzymes and is essential for the formation of stable collagen structures.
Sources: Meat, shellfish, legumes, seeds, and dairy products.
Copper: Involved in the cross-linking of collagen fibers, contributing to the strength and stability of collagen.
Sources: Seafood, nuts, seeds, whole grains, and legumes
Proline and Lysine (Amino Acids): Crucial building blocks for collagen synthesis.
Sources: Protein-rich foods such as meat, fish, dairy products, legumes, and nuts.
While getting nutrients through a balanced diet is the best way to promote collagen synthesis, collagen powder supplements have gained popularity for their potential, and at least theoretical benefits in promoting skin health, joint function, and overall well-being. However, not everyone may need or benefit from collagen supplements. It's important to note that while collagen supplements are generally considered safe for most people, more data is needed, as scientific evidence supporting certain claims is still evolving and often lacking. Remember, collagen is a protein, so if you have issues with your kidneys or are for any reason on a protein-restricted diet, it is important to consult with your doctor. It’s a good idea in general to review any supplement you are considering with your doctor.
Beyond diet and lifestyle changes, there are in-office treatments we use to help repair and restore collagen. Most importantly, combined treatments are always the best. We age in several dimensions; we need to address it that way. This means including skin care, devices such as lasers, neuromodulators (aka Botox, Dysport, Xeomin, Jeuveau and Daxxify), and dermal fillers for what I call subtly dramatic, authentic and natural results that help make every decade your most beautiful best. Here are a few of my favorites:
Dermal Fillers: There are several different options, but the two basic categories are hyaluronic acid-based fillers and semi-permanent fillers. Which product is used and how it is placed can make all the difference between looking natural and beautiful vs looking overfilled and pillow faced. The aesthetic physician needs to do a comprehensive full evaluation of your face as a single aesthetic unit, rather than simply trying to erase lines or fill holes:
- Hyaluronic Acid Fillers: These are non-permanent but often very long-lasting fillers containing hyaluronic acid (HA) can plump and contour the skin. We now have close to 15 different HA fillers and one thing to know is that they are all different and the better your doctor understands them, the better your results will be. There is an enzyme called hyaluronidase that can, at least theoretically, reverse and erase these fillers, but we are learning that some of the fillers last much longer than others, and some are not as easy to erase as others.
- Semi-permanent: Long-lasting fillers or collagen-stimulating injections using specific biostimulators like Sculptra, Radiesse or Bellafil. These have special properties and need to be done by advanced injectors since they cannot be reversed.
- Simplest: Non-ablative lasers promote collagen production with minimal downtime. These are treatments that don’t break or directly affect the outer layers of the skin. They often have little do no downtime, but they may have a great impact on the collagen layer of the skin, giving you a beautiful lifting and tightening effect. Usually, a series of treatments are needed for best results and, as with all treatments, occasional maintenance treatments are helpful to maintain the results and address further damage as it happens. In this category I consider treatments like microneedling with radiofrequency, Sofwave, Ultherapy and Thermage, Fotona, Clear and Brilliant and Fraxel.
- More Complex: Ablative lasers like Erbium and CO2 lasers remove layers of skin, stimulating collagen regeneration but requiring a longer recovery period. We often combine these with growth factors and exosomes to minimize the down time and to enhance the benefits.
Collagen is one of the most important elements of our skin. Protecting it from damage and helping to repair any damage that happens is a key component to youthful, healthy-looking skin.