Collagen is the most abundant protein in the human body, and the main component of connective tissue–the  scaffolding of bones, tendons, ligaments, cartilage, and skin upon which the body is built. As its name implies, connective tissue holds all the parts of the body in place. Collagen is particularly important in skin, but it is also abundant in muscles, blood vessels, eyeballs, the gut, intervertebral discs, and the dentin of teeth.

Collagen works with elastin and keratin to give skin its strength and elasticity. Gram for gram, the collagen in skin is stronger than steel. Combined with elastin, collagen also gives skin its flexibility, the ability to stretch and move with you and then bounce back into shape.

Collagen is also important in wound repair, the body’s ability to generate new skin. As part of the “dermal matrix,” collagen provides a structure on which this new skin can grow.

In other words, your body needs collagen!

Fortunately, your body knows how to make collagen, which it synthesizes from amino acids (the building blocks of proteins). The process also requires sulfur, vitamin C, zinc and copper.

Unfortunately, your body’s collagen production declines with age: an estimated one percent/year starting in our mid-thirties. Although men by nature have more collagen in their skin, women can lose up to 30% of their skin’s collagen production in the first five years post-menopause. This is one of the reasons supplemental estrogen is recommended for post-menopausal women.

The loss of collagen in the skin is what accounts for the difference between a baby’s plump, rounded cheek and the dry, thin, papery cheek of your grandmother. The loss of collagen can also weaken hair and nails, contribute to stiffer, less flexible tendons and ligaments, cause the shrinking and weakening of muscles, and even trigger gastrointestinal problems caused by thinning of the lining in the digestive tract.

All of which explains why there’s so much interest in collagen creams and supplements—the very natural desire to replace what our healthy, youthful bodies have lost.

The question remains, however:

Do oral collagen supplements or topical collagen treatments work?

Although a few studies have shown skin improvements resulting from oral collagen supplements, which are generally derived from animal proteins, I remain skeptical. To begin with, stomach acid breaks down the collagen proteins taken orally before they can reach the skin, or joints, or other parts of the body. In addition, collagen molecules are too large to be absorbed into the bloodstream. Although some supplement manufacturers claim to “shrink” the size of the collagen molecules so that they can be more readily absorbed; even if the collagen survives digestion, there is no way to direct it where you want it to go.

But there’s another option to increase or restore lost collagen. It’s what I recommend for my patients (and advice I follow myself):

Give your body the ingredients to make its own collagen!

The body makes collagen by combining amino acids that are found in protein-rich foods, like beef, chicken, fish, beans, eggs and dairy products. As noted, the process also requires sulfur, vitamin C, zinc, and copper and is supported by estrogen, at least in females. Glycosaminoglycans (GAGs) and hyaluronic acid are also important to constructing the dermal matrix that houses the collagen and elastin needed for a resilient epidermis. Lecithin is also important to include to repair and maintain cell walls.

…and protect your cells from further damage.

In addition to helping your body build collagen, amino acids also supply the precursors for your body’s production of antioxidants (in particular, glutathione), which is an essential molecule for protecting cells against oxidative damage (and for facilitating other metabolic and detoxification reactions). Glutathione, too, declines with age, making nutritional supplementation beneficial.

Sulfur is found in every living cell in the body and plays a key role in collagen synthesis and immunity [34]. Early studies have also indicated that sulfur-containing foods like garlic, onions, meat, and cruciferous vegetables can offer anti-inflammatory and detoxifying benefits. In addition, sulfur-rich foods like broccoli, Brussels sprouts, cabbage, and spinach are either high in glutathione or contribute to its production.

OK, but what can I eat?

The following is a short list of foods that supply essential nutrients that are rich in antioxidants, anti-inflammatory agents, and collagen-builders. They assist with the cellular renewal process and help the cells hold more water:

• Protein-rich foods like chicken, beef, fish, beans, eggs, and dairy products
• Blueberries, raspberries and strawberries
• Sulfur sources like broccoli, cabbage, spinach, and Brussels sprouts
• Lecithin from eggs, cauliflower, oranges, peanuts, and tomatoes

In addition, I recommend the following foods for their high vitamin and antioxidant content:

• Goji berries
• Pomegranates
• Vitamin A sources like carrots and mangoes
• Vitamin C sources like kiwis, mangoes, papayas and black currants
• B-carotene sources like carrots, pumpkin, kale and sweet potatoes
• Vitamin E sources like almonds, wheat germ, and dark leafy vegetables
• Omega-3, -6, and -9 found in flaxseeds, hemp seeds, cold-water fish, raw walnuts, and Brazil nuts

What about topical collagen treatments?

Collagen creams include products that contain collagen, protect existing collagen, or promote collagen production. Research shows that they are somewhat effective:

Creams that contain collagen generally are made of marine collagen or hydrolyzed collagen and, though they don’t increase the collagen content of your skin, they may temporarily plump the skin to minimize the look of wrinkles.

Creams formulated to help protect collagen often contain hyaluronic acid, which is a water-loving glycosaminoglycan (GAG) that can attract and hold up to one thousand times its weight in water. Keeping cells hydrated is essential to their proper functioning—including collagen production—and also keeps skin cells plump, moist, and flexible. In addition to ingesting GAGs and hyaluronic acid in the diet or by supplementation, it doesn’t hurt to apply these topically.

Creams that promote collagen production, often include retinol, which is the main skincare ingredient thought to help promote collagen production. It works by the same principle as exfoliation, or microdermabrasion: gentle irritation of the skin rouses its collagen-producing capabilities.

Preventing sun damage is essential to maintaining collagen. Collagen loss is accelerated by sun damage, as well as by smoking, pollution, and other environmental exposures. That’s why my #1 skincare product, ahead of all others, is sunscreen. I also remind patients to Eat your sunscreen by consuming foods like pomegranates, tomatoes, watermelon, and other red fruits—rich in lycopenes—along with foods that are high in beta-carotene (carrots, sweet potatoes, and other orange fruits, and dark, leafy greens like broccoli), healthy Omega-3 fats like cold-water fish and flaxseed, foods that are high in vitamin E, like almonds, and my personal favorite, dark chocolate. All of these have been shown protect skin against harmful UV rays and to increase the effectiveness of topical sunscreen products.

Other tips for keeping soft, smooth, supple skin:

Eat your water! Water is essential to cellular health. In fact, the common pathway to deterioration in all tissues is water loss. But because drinking your water tends to flush your system, rather than giving your cells time to capture and make use of the water, I recommend that you also “eat your water,” by consuming a diet high in water-rich foods, which are primarily fruits and vegetables.

Maintain your membranes. The other key to cellular hydration is maintaining strong cell membranes, so that you keep the water in the cells, where you want it. Lecithin (the reason to eat your egg yolks!) and B vitamins are the main nutrients I recommend for strong cell membranes, along with antioxidants to reduce free radical damage to cells.

Manage your stress.  Chronic Cultural Stress promotes chronic inflammation, which leads to “inflammaging,” the degenerative effects of inflammation over time. Virtually all of the disease conditions we associate with aging are linked to stress and inflammation. Stress management is not a luxury; it is essential.

Get your sleep. In addition to reducing stress, sleep is your body’s “rest and repair” cycle, the time it allocates for repairing and restoring the damage from the previous day. Skipping sleep is like deferring regularly scheduled maintenance on your car: it only leads to a bigger repair bill down the road.

Moisturize, moisturize, moisturize. In addition to keeping your parts together, skin is your body’s front line of defense against a dry and sometimes toxic environment. You can support the skin’s “barrier function” with a topical layer of moisture—another reason why “skincare if healthcare.”