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Reilly et al. Plast Aesthet Res 2021;8:2 I http://dx.doi.org/10.20517/2347-9264.2020.153 Page 15 of 24

Figure 11. Advanced Lipid peroxidation End products (ALE) form when polyunsaturated fatty acids are oxidised, forming lipid radical
species which can lead to production of reactive substances such as MDA (Malondialdehyde) or 4-HNE (4-hydroxy-2-nonenal), which
react with lysine residues in the collagen backbone, leading to cumulative damage over prolonged periods of time. (By permission of
MINERVA Research Labs Ltd - London)

and society needed to adapt or adjust. Supporting both of these concepts has been a desire to minimise the
visible signs of skin ageing.

Stimulation of collagen production and/or inhibition of collagen degradation can be achieved in several
ways, including the use of surgical aesthetic treatments, topical treatments, or use of oral supplements
(often referred to as “nutricosmeceuticals”). In a report published by the European Union, the critical
importance of nutrition in active and healthy ageing has been clearly described for both macronutrients
[84]
and micronutrients . The link between nutrition and skin ageing has also been reviewed in detail by
[85]
Schagen et al. . Of 11 intervention pathways/strategies mentioned in this review, 7 are directly related to
collagen content in the skin, underlining the importance of this protein to skin integrity and ageing.

Supplement drinks containing hydrolysed bioactive collagen peptides, in combination with vitamins,
minerals and botanical antioxidants are frequently used in nutricosmeceutical products to improve skin
elasticity, hydration and visible signs of fine lines and wrinkles [86-89] . Furthermore, studies have reported
[90]
benefits for nail growth and reduction of the symptoms associated with broken, brittle or split nails .