Collagen vs Hyaluronic acid: what to choose and for whom

If you are facing a choice between collagen and hyaluronic acid, the most important question is what you need the supplement for: tendons after heavy training, knee pain or the condition of your skin. The answer determines the product, the dose and the way of taking it. Our editorial team has laid out the options across specific scenarios.

Define your goal

Collagen and hyaluronic acid have different evidence bases for different goals, so there is no universal answer to “which is better”. For tendons, ligaments and recovery after loading, collagen looks the more logical choice. For skin hydration both substances have some data, but not much.

The second question is whether you have a diagnosed problem. Acute pain, joint swelling, injury or restricted movement require examination by a doctor and possibly imaging. In such situations supplements can only be an addition, not a treatment.

Third is your nutrition. If you get little protein overall, then the first step should be a full-value diet, not collagen peptides. But if protein is sufficient, collagen can be a targeted addition for connective tissue.

Fourth are ethical and dietary restrictions. Collagen is always of animal origin, whereas hyaluronic acid for supplements is often obtained by microbial fermentation, so it may suit vegans.

For athletes: tendons, ligaments, joints

For athletes with intense loading the advantage is on the side of collagen. The study by Shaw and colleagues (2017) showed that 15 g of gelatin together with vitamin C, taken about an hour before a short jumping load, raised a marker of collagen synthesis in the blood. This is the basis for the practice of taking collagen before rehabilitation or “tendon” exercises.

In the study by Clark and colleagues (2008), athletes with activity-related joint pain took 10 g of collagen hydrolysate per day for 24 weeks and reported a reduction in pain compared with placebo. The effect was moderate, but for a supplement with a good safety profile this is a weighty argument.

There are also studies of collagen combined with strength training in older people: Zdzieblik and colleagues (2015) reported a greater gain in lean mass and strength in men with sarcopenia who received 15 g of collagen peptides. Such data should not be transferred directly to young athletes.

Oral hyaluronic acid has barely been studied for sports tendon injuries. It can be considered at most as an addition in knee pain, but not as a primary agent. Intra-articular injections are a separate medical topic, and decisions about them are made by an orthopaedist.

For skin: what to realistically expect

For skin, the marketing of both supplements runs well ahead of the science. Nevertheless, randomised trials exist. Proksch and colleagues (2014) reported an increase in skin elasticity in women after 8 weeks of taking 2.5–5 g of specific collagen peptides per day.

For oral hyaluronic acid there are also randomised works in which taking about 120 mg per day for 12 weeks was accompanied by a reduction in the severity of wrinkles and an improvement in skin hydration. Most such studies are small and were carried out with support from raw-material manufacturers.

A realistic expectation is small, gradual changes noticeable after 2–3 months of regular use, rather than a “filler effect”. No supplement will replace sun protection, quitting smoking and adequate sleep, which affect skin ageing far more strongly.

If the main goal is skin and the budget is limited, it is sensible to start with one supplement and assess the result, rather than buying several products at once.

Doses, forms and quality criteria

In studies, collagen was used in gram doses: from 2.5–5 g (skin) to 10–15 g (joints, tendons). A convenient form is a hydrolysate powder that dissolves in water or a smoothie. Undenatured type II collagen is a separate category with doses in tens of milligrams and a different proposed mechanism of action.

Hyaluronic acid is taken in much smaller doses — in studies usually in the range of 100–200 mg per day. Molecular mass varies between products, and manufacturers often state it on the label, but there is so far no clear evidence that a particular mass is superior for oral intake.

Among the quality criteria are a clearly stated raw-material source (bovine, porcine, fish collagen), the type of collagen, and the presence of independent tests for heavy metals and microbiological purity. For marine collagen the absence of a fish allergy is important.

Combination products and common mistakes

“Collagen + hyaluronic acid + vitamin C” products are popular, and from a safety standpoint there are no objections to them. The problem is different: in such mixtures the doses of the individual components are often too small. A single capsule cannot contain 10 g of collagen, so it is worth counting the real amount in the daily serving.

A common mistake is to treat collagen as a replacement for protein. Collagen is poor in essential amino acids, in particular leucine, and poorly stimulates muscle protein synthesis. For building muscle mass it is no alternative to whey or plant protein.

The second mistake is to expect a quick effect. Connective tissue is renewed slowly, so it is worth assessing the result no sooner than after several months of regular use.

The third is to ignore the cause of the pain. Pain in a tendon or joint is often linked to overload, technique or training planning; without correcting these factors a supplement will change little.

• count the dose per serving, not per package;
• do not replace complete protein with collagen;
• combine collagen intake with tendon exercises;
• for persistent pain — see a doctor, not buy a new supplement.

Editorial conclusions

For athletes with loading on tendons and joints, the first choice is collagen or gelatin in gram doses together with vitamin C and properly structured exercises.

For skin both supplements may be suitable, but expectations should be moderate; hyaluronic acid is a convenient option for vegans.

Combination products make sense only when the doses of the components match those that have been studied.

We also recommend reading “Collagen or Hyaluronic acid: what's the difference”, our review of vitamin C for connective tissue and a piece on the prevention of tendinopathies.

References

1. Shaw G, Lee-Barthel A, Ross ML, et al. Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. Am J Clin Nutr. 2017;105(1):136–143.
2. Clark KL, Sebastianelli W, Flechsenhar KR, et al. 24-Week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain. Curr Med Res Opin. 2008;24(5):1485–1496.
3. Zdzieblik D, Oesser S, Baumstark MW, et al. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr. 2015;114(8):1237–1245.
4. Proksch E, Segger D, Degwert J, et al. Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study. Skin Pharmacol Physiol. 2014;27(1):47–55.
5. Oe M, et al. Oral hyaluronan relieves wrinkles: a double-blinded, placebo-controlled study over a 12-week period. Clin Cosmet Investig Dermatol. 2017;10:267–273.
6. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–1589.