You are not overweight, you just have a “cortisol face” (“moon face”). Women on TikTok believe they have found the solution to facial puffiness. They claim the cause is cortisol levels, the body’s natural stress hormone. Influencers showcase a series of “before” and “after” videos, persuading users that the solution lies in lifestyle changes. These include reducing morning caffeine, high-intensity workouts, taking supplements, and even avoiding scrolling through social media feeds.
Their theory suggests that by eliminating stressful habits, we can reduce cortisol release and achieve a slimmer face. Is this really true? Let’s explore.
How does cortisol work in the body?
Cortisol is a steroid hormone produced by the adrenal glands. Scientists describe it as the body’s “alarm clock,” a vital component that regulates metabolism, reduces inflammation, and aids in memory formation.
Cortisol is similar to adrenaline, another “fight or flight” hormone produced by the body. But while adrenaline is a quick response to stress—helpful if you see a tiger and need to run—cortisol has a slower mechanism, useful for getting us to move. Humans have daily peaks of cortisol production—it is higher in the morning and decreases in the afternoon and towards bedtime. Under normal functioning, the body continues to produce cortisol as needed, and we don’t even notice it. But if too much is produced, problems can arise.
“Our stress response is 10,000 years old. The cortisol mechanism was designed by evolution to get us moving, releasing glucose into the bloodstream so we could run from danger or kill to feed our family. But the stress response hasn’t changed, and we no longer need to run from danger, so this is a fundamental problem,” says Jane Ollis, a medical biochemist and founder of Mindspire.
It is equivalent, she says, to “a relentless fire alarm.” Just as constant alarms disrupt your peace, chronic activation of the hormonal system leads to continuous cortisol secretion, disrupting body functions. And while stress itself is not considered a disease, it underlies physical conditions such as IBS, depression, and weight gain.
“Whether stress is caused by poor sleep, psychological stress, disruption of biological clocks from shift work, excessive physical activity, or financial problems—your body doesn’t differentiate,” says Dr. Nicky Keay, Senior Lecturer at UCL and author of Hormones, Health and Human Potential.
Experts say that too much stress can lead to elevated levels of pro-inflammatory cytokines (proteins), increasing the risk of cardiovascular and autoimmune diseases, as well as diabetes. Cortisol affects glucose metabolism. These elevated levels can cause blood sugar spikes and contribute to insulin resistance, exacerbating inflammation.
What is “cortisol face” and how common is this problem?
Given the term’s popularity on social media, you might think it’s widespread, but it’s not. In fact, “cortisol face” isn’t even an official diagnosis. Some symptoms associated with this term are also characteristic of Cushing’s syndrome. This condition occurs when the body produces excessive cortisol. However, Cushing’s syndrome is very rare and provokes many other noticeable symptoms.
“While chronically high cortisol levels can lead to puffiness, this is usually seen in more severe endocrine disorders, not the everyday stress most people experience,” says Dr. Vijay Murthy, co-founder of Murthy Health.
He also believes that in most cases, everyday stress does not elevate cortisol to the level necessary for such significant physical changes. Most people’s bodies can cope and adapt to daily stress without causing significant, sustained cortisol increases.
“Look at the portraits of Henry VIII at the end of his life: there’s a theory that he had Cushing’s syndrome, so you could say the king might have had a ‘cortisol face.’ However, it’s unlikely that enthusiastic TikTokers have such a serious condition. Cushing’s disease is diagnosed by a blood test, and anyone should get a blood test to rule it out,” says Nicky Keay.
However, the expert believes that there are many other things that can cause a swollen face: for example, fluid retention if you’ve just gotten off a plane. The luteal phase of your menstrual cycle can also cause facial puffiness—or perhaps some of these women in TikTok videos just gained weight and now simply lost it because they got rid of bad habits.
“Blaming cortisol for facial puffiness is like blaming the last piece of pizza for your entire diet,” says Ollis. “It oversimplifies the problem and ignores other important factors.”
Facial puffiness can be caused by a range of conditions, such as thyroid problems, allergies, or sinusitis, so it’s always good to check for them. Several studies have also shown that taking magnesium supplements at a dose of 200–400 mg a day can help balance sodium levels, reduce inflammation, and puffiness in people who retain a lot of water.
Ollis adds that the extra glucose produced by relentless cortisol production can lead to weight gain. We convert glucose back into fat deposits, but they tend to turn into belly fat or other parts of the body. Your face is generally not the first place where you gain weight.
“I think we should be more concerned about the effects of chronic stress on our heart, blood pressure, and emotional health than whether it makes our face puffy or not,” adds the expert.
How to deal with facial puffiness?
If you’ve noticed that your face looks more bloated and puffy than usual, it’s important to understand what factors contributed to this.
According to Murthy, these include:
- Diet: High salt intake can lead to water retention and swelling.
- Allergies: Allergic reactions can cause facial swelling.
- Medications: Some drugs, such as steroids, can cause fluid retention and bloating.
- Medical Conditions: Conditions like hypothyroidism or kidney disease can also cause facial swelling.
- Lack of Sleep: Sleep deficiency can also lead to water retention and a puffy appearance.
Murthy believes that reducing salt intake and getting good rest can help reduce facial puffiness. Also recommended applying a cold compress to reduce swelling and doing lymphatic drainage massage to stimulate fluid outflow. However, if facial puffiness frequently bothers you, you should consult a healthcare professional to identify the underlying cause and get the correct diagnosis.
