Ask An Expert: Annee de Mamiel, Facialist & Acupuncturist

Your skin health needs an inner and outer approach in midlife. A-list favourite Annee shares her hormonal expertise, including the most common skin symptoms and how HRT can help.

With a BSC in Anatomy & Physiology, a BSC in Acupuncture and a Diploma in Oriental Aromatherapy, Annee is an unusual – and highly skilled – beauty professional. Her approach blends Western science with evidence-based Eastern medicine, to target daily stressors in a holistic way.

If you’re lucky enough to experience a facial with Annee herself at London’s Nomad Hotel (we have, and it was an entrancing experience), or have tried her products at home, you’ll know that she has created something special in beauty. Her multi-layered approach tackles both the symptoms of stress as well as the root causes.

The results? Your mind and body feel more balanced and your skin glows.

Annee’s products are all created with natural formulas. Each one is handmade in the lab of de Mamiel in the British countryside and is powered by Annee’s extensive expertise, clinical practice and skin health know-how. No surprise that the awards and accolades have rolled in. De Mamiel was one of the first beauty brands in net-a-porter’s 2014 Beauty Edit and it has won a Vogue 100 award.

As a midlife woman herself, Annee understands inside and out what this time of life is like. We asked her to share her expertise and insight on beauty in the menopause years. As well as recommending key products from her range, she explains the hormonal changes that are happening at this time of life and how they are reflected on your skin.

Get ready for a detailed and fascinating deep dive into menopause beauty, with a woman who knows it intimately.

What are the hormonal changes affecting skin in the perimenopause and menopause years?

There is a decrease in oestrogen levels, while androgens like testosterone, remain the same. This leads to changes like hormonal acne.

Other changes that menopause brings can also impact our skin and are related to hormones and our levels of cortisol and adrenalin. This can impact our ability to cope with stress and result in mood swings, anxiety, lack of sleep and depression which in turn increase cortisol levels and a negative impact on our skin.

READ MORE What are the 34 menopause symptoms?

Do symptoms improve as women move from perimenopause into menopause, or are the hormonal changes permanent?

Perimenopause is very different from menopause: at this stage periods might become irregular, but you still have oestrogen. During perimenopause, you’re getting hot flashes, so you might find that your skin gets red. You might also have breakouts, and skin that was previously balanced might start to get dry or oily patches. Sometimes women experience rosacea at this point.

READ MORE What is the difference between perimenopause and menopause?

In menopause, oestrogen levels drop and we see accelerated aged-related changes in the skin. Your skin is likely to get quite dry.

What is the connection between oestrogen and the skin?

There is a relationship between collagen production, skin thickness and oestrogen levels. This means that a decrease of oestrogen leads to a thinning of both the epidermis and dermis. This results in thinner skin.

Collagen and elastin levels decrease leading to increased wrinkles and sagginess.

The cumulative impact of these changes leads to dryness and itchiness, wrinkles and fragility, which increases the risk of skin trauma.

There is also a natural slowdown of cellular turnover, and decrease in humectants in the skin exacerbates the dryness.

Can HRT help?

HRT definitely helps if it is something you choose to do, as you are increasing oestrogen levels. Addressing levels of stress and cortisol will also help as there is a crossover of symptoms like excessive dryness, thinning, redness.

READ MORE HRT, is it safe? Everything you need to know.

Is this a time when women need to review their existing skincare routines?

Absolutely, especially if it’s not something you are used to doing. It is quite easy to fall into a routine and not get the most of your skincare.

What are the most common symptoms for skin and hair changes?

Loss of collagen.

This is a protein that gives your skin its firmness and elasticity. As we age, collagen production starts to slow down. As much as 30% of collagen is lost in the first five years after menopause, which is associated with oestrogen deficiency. This leads to an increase in wrinkling and sagging.


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Skin looseness and wrinkling.
Elastin, our elastic fibres and glycosaminoglycans (GAGs) decrease due to the drop in oestrogen levels. This is what makes your skin plump and bouncy, so we see facial wrinkles and creases progressively deepen.

Thinning of the skin.
This is because the dermis and epidermis start to become thinner with age. The thinning of the dermis occurs due to the loss of collagen, GAGs and water. This makes it more prone to bruising and tearing.  

Skin dryness.
This dryness can seem unquenchable! Oestrogen is essential for skin hydration because it increases the skin’s production of GAGs and oil, improves the barrier function and increases water retention. 

Pruritus (skin itching).
Pruritus or skin itching is common further into menopause, and it is caused by extreme dryness of the skin. The condition is menopause-related, as the skin tends to become much drier with the drop in oestrogen levels.

Hormonal acne can stay post menopause, even if it is something you have never previously experienced. This is due to the depletion of oestrogen but androgens levels remaining the same.

You want to be as gentle as you can with acne. Take care to use non-drying products, because most acne products can be drying. Acne is inflammatory so something soothing or with salicylic acid, Zinc, Vitamin A also help. If acne is persistent and painful cysts and nothing else works, maybe a trip to the dermatologist so it doesn’t get you down. You may need an androgen blocker.

Delayed wound healing.
As the skin becomes more thin and fragile, it becomes more susceptible to bruises and tears. Oestrogen deficiency is thought to contribute to poor wound healing as there is a significant difference in recovery time between pre and postmenopausal women.

Night sweats, flushing & rosacea.
This affects around 50% of women going through perimenopause and up to 80% after menopause. The blushing generally occurs on the face, neck, chest, palms and soles. Oestrogen deficiency is linked with a decrease in the skin’s microcirculation, leading to flushing. This can also lead to rosacea.

Decrease in body hair and increase in facial hair.
As if all the symptoms discussed above are not menacing enough, menopause can also lead to a thinning of the hair in the body and scalp but an increase in facial hair. Once again, this is thought to happen due to hormonal imbalances.

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What are the key product ingredients to help with symptoms, and how does each ingredient affect the skin?

Getting the balance right between hydration and moisturisation is important. It may come down to adding product more regularly rather than more types of products and this is something you can make a call on.

Increasing oils.

Smoothness, softness and moisture help with increased sensitivity. Increased sensitivity happens as we age and the natural lipids in our skin diminish. Studies show that, after the age of 50, the pH level of our skin gets higher. There’s a certain level (5.4) where the pH of our skin allows for optimal operation of our microflora and defensive cells. As the pH level climbs, those cells are less able to help defend the skin and we’re more prone to rashes, sensitivity, and dermatitis. It becomes important to repair the skin’s moisture barrier with good, plant oils and butters.


These will also stimulate collagen production and boost skin’s elasticity, which is important as skin becomes thinner and starts to sag.

A really good, rich serum/moisturizer.

Something with hyaluronic acid or glycerine will be particularly helpful at easing the dryness.

Gentle exfoliation.

Depending on your skin once or twice a week to remove dead skin cells, brighten and allow products to more easily penetrate the skin.


Wear sunscreen every single day, including during the wintertime.


There are so many available but, when starting, go lightly. I love using pro Vitamin A oils – Rosehip and Kahai for example are loaded with pre cursors and will really help, especially in perimenopause and the beginning of menopause.

How should you change your skincare routine in the perimenopausal years?

If you are not already doing it, facial massage. I think this is such an incredible tool. It ensures you take five minutes to look after yourself, to release the stress of the day and to breathe deeply and reset.

Conscious breathing techniques really help to engage the Parasympathetic Nervous System, and begin rest mode. I find integrating this into my skincare rituals increases the performance of the products as the scents are blended to work at the root cause of the manifestations I see on my skin.

A few minutes at the beginning of your routine can set you up for a good night’s sleep as you are turning off your cortisol. Beginning to understand your skin and what it needs can make a huge difference: You are feeding your skin and not just putting more and more expensive products on your skin and not seeing results.

Last but not least, what are your favourite products that you recommend to perimenopausal women?

I would always have them begin with Restorative Cleansing balm, £62. It is bursting with oils, butters and adaptogens to nourish and repair the skin barrier. It’s incredibly nourishing and balancing.

I love First Fix Stress Response Serum, £130, for hydration and calming the skin. The Skin Recovery Blend, £95, is for compromised skin for moisturising, repair and balancing, mixed with Dewy Facial Mist, £52.

I look at what is keeping a woman awake before choosing a sleep product: Soothe, £40, for the more anxious person or Anchor, £42 for the restless, to settle and help go to sleep.

Altitude Oil, £30, is literally for everyone, to help breathe, ground and protect.

For more information on Annee and her clinic, go to

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