Aesthetic Surgery Journal Open Forum (ASJOF)Collagen Supplementation for Skin and Musculoskeletal Health: An Umbrella Review of Meta-Analyses on Elasticity, Hydration, and Structural Outcomes 

Collagen supplementation produces high-certainty improvements in skin elasticity and hydration and significant osteoarthritis symptom relief across 113 RCTs and nearly 8,000 participants. Benefits appear duration-dependent, with women losing roughly 30% of skin collagen in the first 5 years post-menopause representing a clear high-need population.

Clinical Considerations

• Skin elasticity improved significantly at high certainty (SMD 1.01) and hydration at high certainty (SMD 0.71) — the strongest evidence in the review
• Osteoarthritis pain and WOMAC total scores showed high-certainty reductions, with longer supplementation predicting greater functional improvement
• Cardiometabolic effects were mixed and dose-dependent; fat mass reduced modestly but lipids, glucose, and blood pressure showed no consistent benefit
• Most included meta-analyses rated low to critically low quality on AMSTAR-2, limiting conclusions on long-term outcomes

Patient Care Applications

• Counsel perimenopausal and postmenopausal patients that collagen supplementation has legitimate, high-certainty evidence for skin and joint benefits
• Set expectations that skin roughness and wrinkle depth show no significant improvement — collagen supports hydration and elasticity, not surface texture
• Recommend sustained use rather than short-term trials; benefits accumulate gradually and appear duration-dependent across outcomes
• Avoid positioning collagen as a cardiometabolic intervention until long-term morbidity data emerge

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