What is ‘cortisol face’? How to tell if your facial swelling is a sign of a bigger health problem

If you've been on social media recently, chances are you've heard about "cortisol face," a term to describe facial swelling or puffiness, allegedly caused by high levels of the stress hormone cortisol.

On TikTok, videos about #cortisolface have racked up tens of millions of views. "You're not ugly, you just have cortisol face," has become a popular tagline. Influencers claim that stress triggers high cortisol levels, which cause their face to appear visibly rounder, fuller and puffier.

Many allege that managing their cortisol levels by reducing stress changed their facial appearance, posting dramatic before-and-after comparisons of their "glow up" to a slimmer, more chiseled face.

Others promote lifestyle changes and remedies that they claim can lower cortisol and transform facial features — from supplements to diet regimens and self-care.

Is cortisol face real? Can high levels of the hormone in response to stress actually cause the face to change shape? Experts explain what cortisol is, what causes high levels of cortisol in the body, and what many creators are missing about hormones and facial swelling.

What is cortisol face?

“While cortisol face is not a medical term, it has gained popularity on social media to describe puffiness of the face thought to be due to high levels of cortisol,” Dr. Priya Jaisinghani, endocrinologist in the Holman Division of Endocrinology, Diabetes & Metabolism at NYU Langone Health, tells TODAY.com.

It’s unclear exactly how or where the term originated, however, experts emphasize that "cortisol face" is not a real condition and should not be confused with hormonal disorders.

A person's face shape, including its roundness or fullness, are influenced by a variety of factors, Dr. Shari Lipner, dermatologist at Weill Cornell Medicine, tells TODAY.com. “I don’t think we should blame cortisol.”

These factors include genetics, bone anatomy, weight, and the volume and position of fat pads in the face, TODAY.com previously reported.

While it's true that stress can negatively impact the skin and very high cortisol levels can cause physical symptoms, the way cortisol affects the face is generally being misrepresented on social media, the experts note.

In rare cases, chronic high cortisol caused by certain conditions or medications can affect fat deposits in face — but this is not what most influencers are referring to in the cortisol face discourse.

What does cortisol do in the body and what causes high levels?

What is cortisol?

Cortisol is a steroid hormone produced by the adrenal glands, which sit on top of the kidneys.

Commonly called the "stress hormone," which may have a negative ring to it, cortisol plays a number of important roles in the body and we need it to function, Lipner notes.

“Cortisol affects metabolism, blood pressure, and stress response,” says Jaisinghani. In response to emotional or physical stress, the body releases cortisol to help keep us alert, per the Cleveland Clinic.

The hormone also helps suppress inflammation, control the sleep-wake cycle, regular blood sugar levels and more, Lipner adds.

What causes high cortisol levels?

Cortisol levels fluctuate naturally throughout the day. "Normally our levels of cortisol go up in the morning, and then they go down and (reach) their lowest levels in the middle of the night," says Lipner.

Stress does raise cortisol levels, the experts note. Many other things can affect cortisol levels, including a diet high in salt or sugar, exercise, alcohol, pregnancy and more.

In most cases, high cortisol is temporary and not a sign of a serious health problem, the experts note. The body is good at regulating cortisol levels, and they will return to normal, Lipner says.

Rarely, "high cortisol levels can result from abnormal growths in the pituitary glands, which stimulate cortisol production, or adrenal gland disorders that cause excess cortisol release," says Jaisinghani. Certain medications, such as the corticosteroid prednisone, can also cause prolonged high cortisol levels.

Having too much cortisol in the body can cause Cushing Syndrome, a hormonal disorder.

“If we get stressed, cortisol levels can go up, but they’re not going up to such a level as if you had a tumor on the adrenal gland or Cushing’s, for example," says Lipner.

High cortisol levels are determined through blood or urine tests, which measure the amount of the hormone in the body.

Can high cortisol affect the face?

Chronic high levels of cortisol due to underlying conditions or medications can increase fat deposits in the face, the experts note.

"Fat accumulation in specific areas, like the cheeks and sides of the head, creates a round, full appearance commonly known as a 'moon face,'" Jaisinghani says.

"Moon face" is a medical condition and should not be confused with the term "cortisol face" currently going viral online, Lipner notes.

In cases of moon face, the body is exposed to very high cortisol levels over a long period of time, says Lipner, which also causes other symptoms. These include weight gain, obesity primarily in the abdomen, a hump at the back of the neck, Type 2 diabetes, high blood pressure, muscle weakness, and more, the experts note.

“Fluctuations in your cortisol levels with stress does not cause a moon face," says Lipner. "Even someone with Cushing's syndrome, if it is caught early, they may not develop those facial features. It really has to be a large amount of cortisol that is is sustained."

Why is my face so puffy?

Facial puffiness and swelling can range from mild to severe.

Some mild facial swelling normally isn't a sign of a serious health problem. For example, it's not uncommon to have a puffier face in the morning due to normal overnight fluid retention while sleeping, according to the Cleveland Clinic.

A puffy face can be attributed to a variety of other common causes, says Jaisinghani. These include poor sleep, drinking alcohol, an imbalanced diet, excess salt or sugar, and more.

In many cases, it’s not only stress causing a slightly puffier face but also the way stress impacts our habits, such as sleeping or eating. Mild facial swelling usually will go away on its own.

On the other hand, more serious facial swelling (not including the real medical condition moon face) may be caused by hypothyroidism, allergic reactions, side effects of medications, tooth or sinus infections, and fluid retention due to heart failure can also cause facial swelling, Jaisinghani adds.

Often, the facial swelling will go away on its own or when the underlying cause is treated.

How to lower cortisol levels

Cortisol face is not be a real condition, and lowering your stress levels probably won’t change your face shape or appearance, the experts emphasize. That said, reducing stress does have other benefits for your health.

"I think in general, it’s a pretty well known fact that stress can wreak havoc on our bodies and our skin," says Lipner.

Stress can affect the skin in many ways, says Jaisinghani, including increased inflammation, slower wound healing, premature aging and it can trigger other skin conditions like psoriasis and eczema.

According to the experts, people can take various steps to reduce stress. These include:

• Eating a healthy, balanced diet

• Getting enough quality sleep

• Exercising regularly

• Practicing meditation and mindfulness

When to see a doctor for 'cortisol face'

Face swelling combined with shortness of breath or lip swelling can be a sign of a life-threatening allergic reaction called anaphylaxis, which is a medical emergency, Lipner says. In these cases, go to the emergency room immediately.

People with sudden and severe or painful facial swelling should also seek medical attention.

"If you're experiencing gradual facial swelling, especially if you're having other symptoms, it's best to see a a doctor who can diagnose your condition and give you the right treatment," says Lipner.

The experts caution people to be wary of medical advice on social media and to avoid self-diagnosing. "Along with reliable information, there is also misinformation, disinformation and personal experiences on these platforms," Jaisinghani adds.

It's not uncommon for the internet to medicalize natural body differences — from hip dips to buccal fat — and cause people to obsess over their appearance or seek unnecessary treatments.

There's nothing wrong with a naturally fuller, rounder face. In fact, facial fullness is often associated with a more youthful appearance — over time, as fat pads in the face lose volume and sag, this contributes to visible aging.

What's more, the transformations people post on social media are not always what they seem, the experts caution. Anyone can use editing tools, filters, lighting and angles to change the way their face looks in a photo or video.

If you have concerns about a medical diagnosis or information on seen social media, talk to your doctor.

This article was originally published on TODAY.com