If you’ve spent any time at all on TikTok in the past year, chances are, you’ll have come across the term “cortisol face.” And, if you’ve spent even a minute swiping through the endless videos related to the topic, you’d have seen the pool of beauty influencers trying to explain the body terminology. Many of them would claim that they’ve transformed their appearance by managing their stress levels, sharing before-and-after photos that contrast their once fuller faces with a lean one—all jutting cheekbones and new jawlines. But besides the explicit fat-shaming in these messages, the science doesn’t quite hold up.
@itsbrookeelle I literally dont even recognize myself WHAT 🫠 #cortisolface #cortisol #cortisollevels #cortisolimbalance #glowup #howtoglowup #faceglowup #faceslimming #facetransformation #lensbuddy ♬ original sound – Brooke Elle
“Cortisol face is a term coined by people on social media. It refers to people suffering from puffy face or facial swelling due to chronic levels of stress,” explains Dr Xu Xiao Ye, a family physician at Raffles Medical Group. “However, it seems to be exaggerated with little medical evidence to support it.”
In that regard, Dr Xu breaks down everything you need to know about cortisol.
What is cortisol?
“Cortisol is a hormone produced by the adrenal glands in response to stress,” says Dr Xu. “It plays a crucial role in regulating various bodily functions including metabolism, the immune response, and blood sugar levels.” Admittedly, its association with chronic stress has earned cortisol a bad reputation. Yet, as Dr Xu explains, the “stress hormone” has a number of different impacts beyond rounding out your body.
What causes cortisol levels to rise?
While it’s true that high cortisol levels can affect your appearance, such cases are rare and occur only if you have chronically high cortisol levels. According to Dr Xu, “High levels of cortisol in your body is a condition known as Cushing’s syndrome.” She explains that Cushing’s syndrome is usually the result of taking steroid medication for another condition, or an effect of tumours in the pituitary gland near the brain that stimulates the production of cortisol—so certainly not your day-to-day stress, as claimed by influencers.
Effects of high cortisol levels
“When cortisol levels remain chronically elevated (a condition known as hypercortisolism), it can have significant impacts on both [your] physical and facial appearance,” says Dr Xu. Such outward changes include facial swelling (moon face), thinning of your skin, fat accumulation over the back of your neck and abdomen, and an increase in facial hair and acne formation. In some cases, high cortisol levels can lead to high blood pressure, type 2 diabetes, and even reduced bone density.
So, do you have a “cortisol face”?
Probably not. If you’ve been feeling stressed lately, your elevated cortisol levels might leave you feeling a bit puffy and bloated. But the “cortisol face” is a result of sustained, chronically high cortisol levels that last through weeks and months.
To spot the difference between a puffy face that is caused by everyday stressors versus high cortisol levels, Dr Xu says the former typically results in a more temporary and localised swelling around the eyes, jawline, or lower face, while high cortisol levels lead to a persistent and uniform puffiness that rounds out the whole, entire face.
How do you treat a puffy face in general, then?
Facial puffiness that is related to everyday factors or diet is usually temporary. A quick fix would be to, “reduce salt intake and alcohol consumption, improve your sleep quality, drink adequate amounts of water, or apply a cold compress,” among others, says Dr Xu.
What to do if you think it’s something more serious?
Short answer: Visit a doctor. “If you are noticing persistent or unexplained swelling, especially if accompanied by other symptoms like weight gain, skin changes, fatigue, or mood swings, it’s important to consult a healthcare provider to rule out conditions like Cushing’s syndrome or other hormonal imbalances,” recommends Dr Xu. A blood or urine test can confirm if high cortisol levels are the reason behind your facial swelling, she adds.
