Why Collagen Declines — And Best Treatments That Actually Stimulate It
Discover expert skin science insights from our award-winning holistic aesthetic clinic in Altrincham. Written by Dr Caroline Warden an NHS GP, cosmetic dermatology specialist and leading aesthetic doctor in Hale, Cheshire
Collagen is the structural protein that keeps the skin firm, elastic and youthful. It forms a supportive scaffolding beneath the skin, giving it bounce, smoothness and resistance to wrinkles. But from our mid-20s onwards, collagen production begins to decline and by midlife, this decline becomes dramatically more noticeable.
At my doctor-led aesthetic clinic in Hale, many patients come in describing their skin as:
“thinner, crepier, less firm, tired or sagging.”
Almost always, declining collagen is the underlying cause.
This blog post explains why collagen naturally decreases, which lifestyle factors speed up the process, and most importantly the clinically proven aesthetic treatments that genuinely stimulate collagen from within.
What Is Collagen and Why Does It Matter?
Collagen is a fibrous protein that gives skin:
structure
elasticity
firmness
smoothness
the ability to heal
It works with elastin and hyaluronic acid to keep the skin youthful. When collagen declines, the skin becomes:
thinner
looser
more wrinkled
less resilient
more susceptible to damage
more hollow or saggy in certain areas
The first signs often appear around the eyes, mouth and jawline
Why Collagen Declines: The Science You Need to Know
Collagen decline is caused by a combination of intrinsic ageing (natural, internal) and extrinsic ageing (external factors).
1. Natural Ageing (Starts in Your 20s)
From the age of 25, collagen production decreases by around 1% per year. This rate increases around:
age 35
perimenopause
menopause
By the time you reach menopause, women lose up to 30% of collagen in the first five years due to hormonal shifts — primarily declining oestrogen.
2. Hormonal Changes (Especially Oestrogen Decline)
Oestrogen plays a major role in:
collagen production
elastin formation
hyaluronic acid levels
wound healing
skin thickness
hydration
When oestrogen drops (especially in perimenopause and menopause), collagen fibres weaken, leading to:
sagging
hollowing
crepiness
fine lines
laxity around the jawline and midface
3. UV and Sun Exposure
UV radiation breaks down collagen through free radical damage and activation of enzymes called MMPs (matrix metalloproteinases) which destroy collagen fibres.
Sun exposure contributes to:
premature ageing
deep lines
texture changes
pigmentation
loss of elasticity
It is the biggest external cause of collagen damage.
4. Stress & Cortisol Levels
Chronic stress elevates cortisol, which reduces collagen synthesis and increases inflammation. This accelerates:
fine lines
dullness
barrier damage
early signs of ageing
5. Poor Sleep
Collagen is produced during deep sleep. Poor sleep reduces the skin’s repair cycle and contributes to:
slower healing
reduced elasticity
puffy or tired-looking skin
6. Diet High in Sugar & Processed Foods
Sugar causes glycation, a process that hardens collagen fibres, making them brittle and less functional.
This leads to:
stiff, dull-looking skin
exaggerated lines
faster ageing
7. Smoking & Pollution
Both release free radicals that damage collagen structure and accelerate facial ageing, especially around the eyes and mouth.
8. Genetics
Some people naturally produce collagen more slowly or have weaker collagen fibres, influencing how they age.
What Collagen Decline Looks Like in Real Life
Signs your collagen is declining include:
fine lines and wrinkles
hollow temples or tear troughs
sagging cheeks or jawline
crepey skin
thinning of the skin
loss of volume around the mouth
dullness and rough texture
The good news? Collagen can be stimulated safely and
effectively with the right treatments.
Aesthetic Treatments That Actually Stimulate Collagen
Not every treatment that claims to “boost collagen” truly does. Here are the medically proven treatments I use in my Hale clinic that genuinely stimulate collagen production.
1. Microneedling With Exosomes: One of the Most Advanced Collagen Boosters
Microneedling creates precise micro-channels in the skin, triggering a controlled wound-healing response that increases:
collagen
elastin
hyaluronic acid
Adding exosomes significantly enhances results by delivering:
growth factors
peptides
anti-inflammatory cytokines
regenerative signals
Benefits:
✅ smoother skin
✅ improved firmness
✅ reduced fine lines
✅ refined pores
✅ improved acne scarring
✅ glowing complexion
Perfect for:
Ageing skin, acne scars, dullness, texture issues, early laxity.
2. Profhilo: Bioremodelling for Firmness and Elasticity
Profhilo is a high-concentration hyaluronic acid treatment that acts as a collagen stimulant rather than a filler.
It triggers:
collagen types I, III and IV
elastin
skin tightening
improved hydration
Benefits:
✅ firmer skin
✅ fewer fine lines
✅ glowing, hydrated complexion
✅ improved elasticity
Perfect for:
Midface laxity, crepey skin, early sagging, dullness.
3. Polynucleotides: Regenerative Collagen Stimulation
Polynucleotides (PNs) are one of the newest and most exciting regenerative treatments in aesthetics. They work by:
stimulating fibroblasts (collagen-producing cells)
repairing DNA damage
reducing inflammation
improving skin thickness
enhancing elasticity
Benefits:
✅ improved fine lines
✅ stronger skin barrier
✅ healthier, more resilient tissue
✅ reduced redness
Perfect for:
Delicate areas (eyes, mouth), sensitive skin, early ageing, post-inflammatory changes.
4. Dermal Fillers for Structural Collagen Support
Although fillers don’t directly stimulate collagen in the same way as microneedling or PNs, they restore structure and allow the skin to sit in a more youthful position.
This prevents:
deep folds
shadowing
sagging
tiredness in the face
Strategic, subtle placement (cheeks, chin, jawline, temples) can dramatically improve facial ageing when done by a doctor.
5. Medical-Grade Skincare
Some ingredients have extensive clinical evidence for collagen stimulation:
Retinoids
The gold-standard for stimulating collagen.
Vitamin C (L-ascorbic acid)
Protects existing collagen and boosts new production.
Peptides
Signal fibroblasts to build new collagen.
SPF 50
Prevents collagen breakdown from UV.
When combined with in-clinic treatments, results are significantly enhanced.
Case Study: “Jayne”, Age 45 from Bowden — Boosting Collagen After Perimenopause
(Name changed for privacy.)
Jayne came to my Hale clinic feeling like her skin had aged rapidly over the past year. She noticed:
crepey texture under the eyes
sagging around the jawline
dull, tired-looking skin
increased lines around the mouth
loss of firmness in the cheeks
Assessment:
Jayne was in perimenopause, where declining oestrogen accelerates collagen loss dramatically.
Treatment Plan:
Microneedling with exosomes (3 treatments, spaced 4 weeks apart)
Two sessions of Profhilo for elasticity
Polynucleotides around the eyes and mouth
Medical-grade skincare including vitamin C and a gentle retinoid
SPF 50 every morning
Results after 3 months:
firmer, more lifted skin
improved texture and radiance
softer fine lines
stronger skin quality
brighter, healthier complexion
Jayne said:
“My face finally looks like it did five years ago. I feel fresh again.”
Frequently Asked Questions (FAQs)
1. Can collagen really be rebuilt?
Yes, treatments like microneedling, Profhilo, and polynucleotides stimulate fibroblasts to produce new collagen.
2. How long does it take to see results?
Collagen remodelling takes time — usually 6–12 weeks — but improvements continue for months.
3. Can skincare replace aesthetic treatments?
Skincare supports collagen, but in-clinic treatments stimulate collagen at a deeper level that skincare alone can’t reach.
4. What age should I start collagen treatments?
Most people begin in their late 20s or early 30s for prevention, but it’s never too late.
5. Are collagen supplements effective?
Evidence is mixed. They may support skin hydration but do not replace in-clinic collagen stimulation.
Want a personalised skincare plan?
Book now for a consultation
Dr Caroline Warden is an experienced NHS GP and aesthetic doctor. She has been a medical doctor for over 18 years. Her main Skin and Aesthetic Clinic is located in Hale, Cheshire but she also runs clinic in Disley, Stockport.
Whether you're new to aesthetic treatments or ready to refine your routine, her bespoke skin assessments are the best place to start. She’ll design a tailored plan based on your skin goals, lifestyle, and timeline.
Book your consultation at the clinic in Hale, Cheshire and experience aesthetic medicine.
You’ll be guided through your medical history, goals, and expectations so you can make an informed choice.
Our main Hale clinic is local To:
Alderley Edge, Altrincham, Bowdon, Bramhall, Hale Barns, Knutsford, Manchester, Mobberley, Sale, Timperley, Urmston, Wilmslow, Handforth, Poynton, Cheadle, Didsbury, Warrington
Our satellite Disley clinic on Thursday nights at Scott, Skin & Co, is local to:
New Mills, High Lane, Marple, Mellor, Whaley Bridge, Hayfield, Stockport
Further Reading: Scientific Research on Collagen Induction
1, Jaiswal S., et al. (2024). [*Microneedling in Dermatology: A Comprehensive Review.*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499218/)
A recent review summarising microneedling techniques, collagen stimulation mechanisms, and clinical applications for scarring and skin rejuvenation.
2, Singh A., et al. (2016). [*Microneedling: Advances and Widening Horizons.*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/)**
Explores the biological response triggered by microneedling, showing measurable increases in collagen I, III and elastin production after controlled injury.
3. Wang F., Garza L., et al. (2007). [*In Vivo Stimulation of De Novo Collagen Production Caused by Cross-Linked Hyaluronic Acid Dermal Filler Injections in Photodamaged Human Skin.*](https://jamanetwork.com/journals/jamadermatology/fullarticle/411242)**
Landmark study demonstrating that HA fillers don’t just add volume—they biologically stimulate new collagen formation within the dermis.
4. Sparavigna A., et al. (2016). [*Efficacy and Tolerability of a Microneedling Device for Skin Rejuvenation.*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044990/)**
Clinical trial confirming microneedling significantly improves firmness and texture with minimal downtime and excellent safety.
5. Alqam M., et al. (2022). [*Efficacy and Tolerance of a Microneedling Device for Wrinkles on the Neck.*](https://academic.oup.com/asj/article/42/10/1154/6565988)**
Published in *Aesthetic Surgery Journal*, this paper supports microneedling as a safe and effective collagen-inducing treatment even on delicate neck skin.
6.Ramaut L., Hoeksema H., Pirayesh A., et al. (2018). [*Microneedling: Where Do We Stand Now? A Systematic Review of the Literature.*](https://www.sciencedirect.com/science/article/abs/pii/S1748681517302504)**
A broad literature review covering histological and clinical evidence that microneedling triggers neocollagenesis and dermal remodelling.
7. Carver C., et al. (2024). [*Microneedling versus Microcoring: A Review of Percutaneous Collagen Induction Techniques.*](https://onlinelibrary.wiley.com/doi/10.1111/jocd.16175)**
Compares modern collagen-inducing methods, highlighting microneedling’s balance of safety, collagen stimulation, and minimal recovery time.
