Maybe you have started getting worried about your facial skin and feel that it is aging. Perhaps you are troubled by thin skin or skin laxity or think you have ended up with sagging skin? Maybe you have also heard that collagen can make the skin younger and firmer. But what is collagen? What does collagen do in the skin and how can it stimulate skin renewal? And what can you do to increase the level of collagen in your skin? Here is all you need to know about collagen stimulation, collagen treatments and how to get firmer, thicker skin.


What is collagen?

Collagen is a strong, fibrous protein that is found throughout our bodies, including our bones, muscles and tendons. It is also found in the middle layer of the skin.1

Under a microscope, collagen looks like bands of rope bound together, or stacked logs.

What is collagen
Galderma aesthetic - What does collagen do in the skin

What does collagen do in the skin?

Collagen acts as our skin’s support structure or scaffolding that helps maintain the shape of the skin.1 In fact, a large part of our skin is composed of collagen.2

What does collagen do to our looks? A healthy supply of collagen gives us a youthful-looking complexion. This is why there is so much focus on collagen in the aesthetics world and why collagen is considered key for skin renewal.


When we age, what happens with the natural collagen in our skin?

As we age, our body’s natural collagen production decreases. The cells in our body that produce collagen, called fibroblasts, are no longer able to produce it as efficiently as they once did, and existing collagen becomes fragmented, bent and frayed.3

As the skin ages the natural collagen loss leads to thin skin and structurally weakened skin.4,5 Other typical signs that collagen loss can have in the aging face are sagging skin and loose skin.6,7

Galderma aesthetics - What does collagen do in the skin

External factors that can have a negative impact on collagen production

Collagen production doesn’t only decline due to aging. Collagen loss can also happen as a result of exposure to the sun’s ultraviolet (UV) radiation. In fact, studies show there can be a significant loss of collagen in chronically sun damaged skin, so it is important to reduce sun exposure and wear sunscreen whenever you are in the sun.8

Also, smoking is related to premature aging of the skin. One reason why is that cigarette smoke impairs your skin’s collagen production and can trigger the destruction of existing collagen in the skin.9

Furthermore, there is scientific evidence on the role of diet in skin aging, particularly when it comes to sugar and its effects on collagen. When we eat sugary foods, sugar molecules attach to collagen fibers in the skin and break them down through a process called glycation. This ultimately leads to a loss of the collagen’s strength and flexibility and is also known as “sugar sag.”10,11

In other words, the starting point of a skin renewal program, or if you are considering a skin renewal regimen, could be to take a closer look at your lifestyle and habits and, if necessary, make appropriate changes.


Read also: Why older fibroblasts are almost as good at producing collagen as younger fibroblasts

3 lifestyle choices to slow collagen loss

Minimize sun exposure and wear sunscreen

Quit smoking

Cut back on sugar

Other facial changes as we age

Apart from aging skin, with increased skin laxity and sagging skin, or structurally weakened and thin skin, there are other facial changes that come with age. Collagen loss, bone remodeling, and fat redistribution all contribute to changes that result in a less youthful appearance.12,13


More reading: Why a collagen treatment can address several signs of aging

Changes in bone structure


As we age, bone resorption increases. This means that our face will gradually lose some of its volume and definition. The effect is most noticeable at the temples and at the posterior part of the jaw. Also, our facial bones shift somewhat with age, for example the eye sockets descend slightly.



We also lose some of the facial fat as we age, which also leads to a loss of facial volume. Moreover, the fat compartments in the cheeks tend to descend toward the jawline. This can contribute to the appearance of sunken cheeks, as well as an undefined jawline. Most aesthetic treatments that aim at restoring a youthful look treat the above issues by providing skin renewal, structure and volume.

Loss of facial fat

What does collagen do for the skin if I apply a collagen cream?

Facial creams that are sold over-the-counter (OTC) are not subject to the same requirements to prove their effectiveness before approval by authorities.14 If creams had a significant effect on skin renewal, like a mini face lift, far less consumers would be desperately searching for treatments to get rid of thin skin or sagging skin or skin tightening treatments.

When it comes to collagen creams, the outmost layer of the skin functions as a barrier and large molecules such as collagen can’t penetrate that barrier. So, what does collagen do in a cream to reduce sagging skin? The cream can be effective as a moisturizer but can’t promote collagen production or restore collagen loss.

Apart from collagen, certain ingredients in facial creams can have a positive effect on collagen production and skin renewal. For example, antioxidants such as vitamins, polyphenols, and flavonoids can reduce collagen degradation.15 So-called “cell regulators” such as retinols, peptides and growth factors can influence collagen production.15 So, if you are looking for a collagen cream, you should probably look for a cream that contains ingredients that have a positive effect on natural collagen production.

For those who are troubled by skin laxity or sagging skin, a facial cream is seldom enough to have the lifting effect or a skin tightening effect they are looking for. If you are not satisfied with the results from facial creams, you may want to explore other options.

What does collagen do for my skin if I eat collagen tablets or foods with collagen?

As mentioned above, your body – including the skin – can produce collagen. Also, a normal diet contains collagen. The digestive system breaks down the collagen proteins that we eat, whether we eat collagen tablets or foods with collagen.

If you are dieting however, or if you have excluded certain foods from your diet, you may end up with nutrient deficits that can have a negative effect, not only on your skin but also on your overall health. So, make sure your overall nutrient intake is adequate.

More reading: Find your way around the collagen tablets, creams and foods

What does collagen do for my skin if I use collagen injections or collagen fillers?

The effect of collagen injections, or collagen fillers, was actually investigated in a clinical study some years ago. The study evaluated the efficacy and safety of Sculptra® for correction of nasolabial fold wrinkles. Sculptra® is an injectable collagen stimulator based on poly-L-lactic acid, PLLA (read more about Sculptra® below). The study encompassed 233 patients. Half of the patients, 117, received collagen injections with human-derived collagen and the other half, 116, were treated with injectable PLLA (Sculptra®).16

The results were measured in several ways. Firstly, results were rated by the investigators (the healthcare practitioners doing the collagen treatments). According to the Investigator Global Evaluations, IGE, the overall improvement with injectable PLLA (SCULPTRA®) was 100% three weeks after the final treatment, and it remained above 86% at the end of the study at month 25. The IGE of the improvement with human-derived collagen treatments however declined from 94.0% at week three to 6.0% at month 13.16

Patients were also asked about their opinions. The overall Subject Global Evaluation scores for the injections of PLLA (Sculptra®) was 99% three weeks after the last treatment, 91% at month 13, and 81% at month 25. Among those treated with collagen injections of human-derived collagen, the overall Subject Global Evaluation scores declined from 96% three weeks after the collagen treatments to 15% at month 13.17

To sum up, what does collagen do for your skin if you inject it? The study showed that the effect of the collagen injections, or collagen fillers, declined much quicker than the effect of the collagen stimulator Sculptra®. So, if you are looking for skin renewal, collagen injections or collagen fillers are not the most effective treatment.

What is Sculptra? Read more below.

Collagen treatments for rebuilding collagen

Many collagen treatments for the skin are not about adding collagen but about rebuilding collagen naturally by stimulating the skin to produce more collagen. If you want a more visible effect on sagging skin or reduced skin laxity, you may want to explore some of these collagen treatments.

There are several aesthetic treatments for skin renewal and some of them have an effect on collagen production and can thus be considered collagen treatments. Below is a brief summary of the most common collagen treatments on the market.

Chemical peels

Chemical peels

The purpose of chemical peels is to remove the top layers of the skin. This will start regeneration and repair mechanisms that will lead to skin renewal. Superficial peels only exfoliate the outmost layer of the skin whereas deep peels penetrate deeper. Several skin renewal effects have been reported from peels, among them an increase of collagen fiber content in the skin. There is a correlation between the depth of the peel and potential side effects, meaning that the deeper the peel, the greater is the risk of side effects such as hyperpigmentation and infections.15


IPL, Radiofrequency, Lasers, Fractionated Lasers

Chemical peels and ablative lasers have a traumatizing effect on the skin surface that can take some time for the body to repair. There are a number of treatments designed to stimulate skin renewal without disrupting the skin surface. The idea of all these treatments – IPL, Radiofrequency and Lasers – is to denaturalize collagen in the skin by heating it (denaturalize means that the structure of a protein is changed). This controlled tissue damage below the skin surface stimulates the skin to produce new collagen. As with all aesthetic treatments, there are certain side effects associated with these types of collagen treatments.15

IPL radio frequency
Ablative laser

Ablative laser treatments

Ablative laser treatments for skin renewal are based on the same principle as chemical peels. The idea is to remove the top layers of the skin, and the wound healing response in the skin will lead to skin renewal.18 Both chemical peels and laser treatments make the skin sensitive for some time.

Injectable skin renewal treatments that stimulate collagen production

Before and after with a Sculptra treatment

The idea of injectables for skin renewal and collagen production is to stimulate the fibroblasts in the skin to produce more collagen. The mechanism is not primarily based on causing a trauma, either to the skin surface or the deeper levels of the skin. Sculptra® is the original injectable collagen stimulator that activates the skin’s ability to produce collagen.19-23 Below is a summary of the mechanisms of Sculptra® and what results you can expect from a treatment with Sculptra®.

What is Sculptra®?

Sculptra® is an injectable collagen treatment that activates the skin’s ability to produce new, fresh collagen. Sculptra® is however not a collagen injector or collagen filler. As already mentioned above, collagen injections or collagen fillers don’t provide long-lasting results. Sculptra® was CE approved in 1999 for aesthetic use in the European market and is FDA approved in the United States.

Instead of collagen, Sculptra® contains microspheres of poly-L-lactic acid, PLLA. PLLA is a biodegradable substance that has been proven safe and has been used in medical implants and dissolvable sutures for more than 30 years.19,20 Biodegradable means that the PLLA can be broken down and eliminated by the body.

Sculptra is injected into the deeper layers of the skin. In the skin, the PLLA microspheres stimulate the skin’s own natural collagen production, helping to reinforce the skin’s inner structure and increase facial volume that has been lost.19,21,23

Read more: Look younger without looking like you’ve had work done


Moreover, in the 25-month study, wrinkles were analyzed by evaluators who didn’t know whether the patients had been treated with SCULPTRA® or with human-derived collagen. Evaluators could see improvements in the appearance of wrinkles up to 25 months after the last treatment among the patients treated with SCULPTRA®.26

What does a treatment program with Sculptra® look like?

Sculptra® is a collagen treatment that gradually leads to skin renewal. The number of treatment sessions and the number of injections per session vary from patient to patient. On average, three treatment sessions are needed over the course of a few months.

After each treatment, you may experience some temporary swelling that goes back after a few days, but don’t be disappointed if you look as you did before. Sculptra® works gradually and delivers full effect after an average of three treatment sessions over a few months.

Common side effects that have been reported from treatments with Sculptra® usually resolve spontaneously within 2 to 7 days, and include pain at the treatment area, redness, bruising, tenderness, itching, lumps, bleeding or swelling. If you are considering a treatment, make sure to contact a qualified healthcare practitioner who has received appropriate training with Sculptra®.

In the 25-month study, as many as 86% of those treated with Sculptra® continued to show improvement up to at least 25 months after the last treatment (the study ended after 25 months).16

When patients themselves were asked to rank the results, 80% rated Sculptra® as “good” to “excellent” 25 months after the last treatment.17

In the 12-month study, patients exhibited a significant increase of skin thickness. They were also very satisfied – 100% would recommend Sculptra® to a friend.27

Skin insights


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