What Doctors Want You to Know About Cortisol Face
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People on TikTok are talking about “cortisol face.”
People on social media say that the condition is reportedly caused by higher levels of stress.
Doctors say that this isn’t a medical condition.
TikTok is packed with commentary on beauty and health, and sometimes the two subjects collide. Case in point: cortisol face. A slew of people on social media are warning about the so-called “cortisol face” and “moon face,” which links a round, puffy face to high levels of the stress hormone cortisol.
Cortisol is a steroid hormone that your adrenal glands produce and release, according to the Cleveland Clinic. Cortisol influences nearly every organ and tissue in your body and can do a range of things, including regulating your body’s stress response, controlling your body’s metabolism, suppressing inflammation, and controlling your sleep-wake cycle.
In one video that’s gone viral, Mandana Zarghami simply says, “You’re not ugly. You just have cortisol face.”
Meet the experts: Cindy Wassef, M.D., an associate professor at the Rutgers Robert Wood Johnson Medical School; Ife J. Rodney, M.D., founding director of Eternal Dermatology + Aesthetics; Luma Ghalib, M.D., an endocrinologist and associate professor at The Ohio State University Wexner Medical Center and College of Medicine; Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School; Gary Goldenberg, M.D., a board-certified dermatologist practicing in New York City
But for all of the chatter surrounding cortisol face—is it legit? Doctors break it down and explain if high stress levels can change your appearance.
What is cortisol face?
Since it is not a diagnosis, there is no clear definition for what, exactly, cortisol face is. However, the general consensus is that cortisol face happens when you have higher levels of cortisol swirling around your body. Still, “cortisol face is not a real medical condition,” says Cindy Wassef, M.D., an associate professor at the Rutgers Robert Wood Johnson Medical School.
Cortisol is released in your body when you experience stress, including acute and chronic stress, says Ife J. Rodney, M.D., founding director of Eternal Dermatology + Aesthetics.
What many people claim on social media is that when you’re dealing with higher levels of stress, or chronic stress, it can cause your face to look puffier.
What causes cortisol face?
Several people claim that higher levels of cortisol in your body from stress will cause cortisol face, but that’s not entirely true.
Cushing’s syndrome
There is a rare medical condition called Cushing syndrome that’s linked with excessive circulating cortisol, points out Luma Ghalib, M.D., an endocrinologist and associate professor at The Ohio State University Wexner Medical Center and College of Medicine. In people with Cushing syndrome, “too much cortisol leads to a more rounded face, pinkish red cheeks, thinner skin with easy bruises, a puffy neck, and a worsening upper back hump,” Dr. Ghalib says.
But Dr. Buettner points out that Cushing syndrome is rare and is highly unlikely to just cause a rounded face. “To claim that an isolated round face without these other symptoms is caused by Cushing disease is wrong,” he says.
“Stress doesn’t just manifest as high cortisol,” says Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “Stress also raises other hormones [in the body].”
But, the following things may affect your facial appearance:
Certain medications
Just being stressed out is unlikely to change the shape of your face, Dr. Rodney says. However, taking high levels of corticosteroids—i.e. medication—can lead to a phenomenon called “moon face,” where someone will develop a rounder-than-usual face, points out Gary Goldenberg, M.D., a board-certified dermatologist practicing in New York City.
“You can get that from extremely high corticosteroid levels from taking steroids for a medical condition,” Dr. Rodney says. “But having very high general stress levels is different.”
Dr. Wassef agrees. “While emotional or life stress may cause an increase in cortisol, it would not be high enough to see these effects,” she says.
Diet changes
If someone is stressed, they may eat more than usual—and that could also lead to a rounder face, Dr. Buettner says. “Is this then due to the cortisol because you’re stressed? No, it’s because you ate too much and you were stressed,” he says.
Sodium and water retention
This varies from person to person, but research has found that people will pass more sodium in their pee when they’re stressed, while other people will hold onto more sodium when they feel frazzled. If you couple that with a high-sodium diet, there's a chance you could look a little puffier than usual, Dr. Rodney says—it's just not a given.
Signs of cortisol face
Cortisol face, according to TikTok, means having a puffy, rounded face. But doctors say that it’s possible that being perpetually stressed can also impact your face.
“Stress hormones have also been shown to make the skin look older, and to decrease levels of collagen and elastin that can create a more youthful appearance,” Dr. Goldenberg says.
Stressful situations can also lead to other behavioral changes that can impact the appearance of your face, including disrupted sleep, which can raise the risk of developing under-eye circles and facial puffiness, Dr. Wassef says.
Cortisol face treatments
Again, cortisol face isn’t a medical term. With that, there are no clearly defined treatments.
However, if you find that you’re dealing with a puffy face and it’s a new and persistent thing for you, Dr. Buettner recommends contacting your primary care physician for an evaluation. It could be due to something easily fixable, like having a lot of salt in your diet, or it could be a sign of something more serious, like Cushing syndrome (although, again, it's more likely that you'll have other symptoms along with a rounder face).
If your doctor suspects that you have Cushing syndrome, they can order a range of testing, including a 24-hour urine collection test, a saliva test, and a blood test, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). From there, they can get a good idea of what’s happening with cortisol levels in your body, along with other hormones.
Still, doctors say that you shouldn’t jump to conclusions with this. “There are a bunch of things that can lead to puffiness in your skin,” Dr. Rodney says. “I just wouldn’t pin it on stress.”
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