Cortisol face: Can stress cause inflammation in the face?

Cortisol face, a condition that can make your face rounder and puffier, has been trending on TikTok. Many users of the platform claim that it is a noticeable side effect of having high levels of cortisol or stress hormone in the body. To prove their point, TikTok users show their “cortisol face” along with an “after” photo of a less bloated face. When it comes to our bodies, cortisol has many functions. Mediation of the stress response is one of its key functions. But is daily stress to blame for facial puffiness or is it just a misunderstanding?

What is cortisol face?

The literal meaning of the term ‘moon face’ or ‘cortisol face’ is the appearance of puffy or round facial features, says dermatologist Dr Neha Khuraana. There is no medical diagnosis called “cortisol face”. Rather, it is just a symptom that involves physical changes to the face due to certain underlying health problems such as Cushing’s syndrome. It can cause weight gain in the face.

Can everyday stress lead to a cortisol face?

Attributing cortisol to stress levels is partially true. The main cause of such facial appearance is Cushing’s syndrome, where the body produces more cortisol hormone, says psychiatrist Dr Ashish Bansal.

Cushing’s syndrome is caused by chronic exposure to high levels of cortisol, according to a study published in StatPearls in 2023. But this syndrome is rare, with an annual incidence of between 1.8 and 3.2 cases per million population, according to a study which was published in Best Practice and Research in Clinical Endocrinology and Metabolism in 2021.

Daily stress undoubtedly raises the body’s cortisol levels, but these are short-lived and do not cause a cortisol face, says Dr Bansal. If cortisol levels are high, they can cause fluid and sodium retention in the facial tissue and lead to facial swelling. But these physical changes will not be noticeable.

You might also enjoy

As for Cushing’s syndrome, it is also attributed to other causes –

• Pituitary hemangioma: The growth of benign pituitary tumor cells leads to the production of large amounts of ACTH (adrenocorticotropic hormone), which causes the body to produce more cortisol hormone.
• Adrenal tumors: A benign tumor growth in one or both adrenal glands puts the body at high risk of excessive cortisol production, says Dr Bansal.
• Ectopic ACTH syndrome: Any tumor growth outside the pituitary gland can be in the lungs, which in turn produces more adrenocortical hormone which triggers cortisol production.
• Corticosteroids: When corticosteroids such as prednisone or dexamethasone are used for a long time, they lead to high levels of cortisol in the blood. Such drugs are usually prescribed for autoimmune diseases such as asthma, rheumatoid arthritis or lupus.

How to get rid of a puffy face?

The main task is to find the cause of facial swelling.

1. Cushing’s syndrome

The treatment options available to deal with Cushing’s syndrome include surgery, radiation therapy or drugs to lower blood cortisol levels, says Dr Bansal. For the growth of pituitary tumor cells, a surgery through the nose is performed called transsphenoidal surgery. For cancer cell growth in one or both adrenal glands, the affected part or gland is removed with an adrenalectomy. If due to certain conditions there is mainly widespread tumor growth, surgery is not an option, rays are given to detect and kill the tumor cells. Your doctor may prescribe certain medications such as ketoconazole, metyrapone, and mifepristone. They either stop the production of cortisol hormone in the body or block its activity.

2. Lifestyle changes

Have a healthy diet that includes whole grains, fruits, vegetables and protein, says Dr Khuraana. Limit sodium intake, which can lead to fluid retention and a puffy face. Also, high cortisol levels are linked to being overweight, so exercise regularly to manage your body weight.

3. Avoid drinking alcohol

Use moderate consumption of alcohol so you don’t end up with a puffy face. Women who indulge in heavy drinking (more than eight alcoholic drinks per week) are more likely to have puffy faces than others, according to a study published in the Journal of Clinical and Aesthetic Dermatology in 2019.

4. Eat less inflammatory foods

Inflammation can lead to swelling and can therefore contribute to the face looking bloated. Reduce the consumption of foods that can cause inflammation in the body. The list includes ultra-processed foods, sugary drinks and refined carbohydrates.

5. Sleep well

Poor sleep can have a negative impact on your health. It can cause irritation and also cause swelling of the face. Try to get 7 to 8 hours of good sleep a night, suggests Dr Bansal.

Everyday stress can’t give you “cortisol face,” but the stress hormone can play a role in your face being puffy. It may be due to Cushing’s syndrome, which is rare.