TikTok claims the stress hormone cortisol gives you a puffy face, but is it true, or is there more at play? Our experts weigh in.

With 111.1 million posts at the time of writing, it’s fair to say #cortisolface is TikTok’s latest obsession. If you’ve found your face looking unusually puffy in photos, you may even have worried it’s affecting you.

The good news is that most of the time, cortisol face is nothing serious and can be cleared up with a quick visit to your doctor. Underlying stress, however, is a different matter entirely, as our experts explain.

What do we mean by ‘cortisol face’?

Put simply, ‘cortisol face’ or 'moon face' – that puffiness or swelling around the face that might be captured in unfortunate social media pics – is down to higher than usual levels of the stress hormone, cortisol.

“Cortisol is our stress hormone which our body uses to reduce inflammation so when you have chronically raised cortisol you’re in an inflammatory state,” explains Dr Paul Banwell, skin cancer, sun safety and body confidence expert.

The reason your face swells up is because excess cortisol can lead to increased fat deposits in the cheeks and increased inflammation throughout the body.

“Symptoms include a puffy, red face, increased fat lumps around your neck and shoulders and skin that bruises easily,” Banwell adds.

Another cause of cortisol face in both women and men can be the long term use of steroid medications which can cause excess levels of cortisol production. “Some medications, such as Prednisone, prescribed to manage asthma, rheumatoid arthritis or given after organ transplant might be to blame,” says Reema Pillai, a nutritionist at Dietitian Fit.

“Other steroids such as hydrocortisone can also cause cortisol face.” If you suspect your medication is the cause, the solution is simple: speak to your doctor about taking a break from the medication, or coming off it entirely.

As far as life stress causing cortisol face, Banwell isn’t convinced. “The key point is that everyday stress (despite what TikTok is saying) does not really raise cortisol levels to sufficient levels or for long enough to cause significant swelling to the face.”

So, while cortisol face might be caused by an excess of the stress hormone, it isn’t typically caused by stress – or at least not stress alone.

Is it serious?

Apart from changing how you look in online pictures, do you need to worry about cortisol face?

Banwell points out that ongoing high levels of cortisol, in addition to a puffy face, can lead to a build up of fat around the chest and stomach, back of the neck and shoulders as well as acne, muscle weakness and mood disorders such as difficulty sleeping, anxiety and depression.

But it’s important to distinguish high cortisol levels caused by medication from actually anomalies in our bodies. These days, where biological terms like ‘endorphins’, ‘serotonin’ and ‘cortisol’ have entered into common usage online, we can think it’s easy to categorise the first two ‘happy hormones’ as good, and stress hormones like cortisol as bad.

Like most things on social media, this is a bit reductive.

In fact, as Pillai points out, we all experience raises in cortisol from time to time. It’s normal – our bodies wouldn’t have the ability to produce cortisol unless we needed it in some capacity.

The trouble comes when our bodies have unregulated production of cortisol on their own, which might even lead to Cushing’s syndrome – something entirely different to ‘cortisol face.’

“Cushing’s syndrome, although rare, is a condition where there is too much cortisol being produced in the body, which can cause several health issues and might even be caused by a tumour in the adrenal glands,” Pillai explains, adding that while usually non-cancerous, these tumours are most common in young women but can also occur in males.

“There are treatment options, including taking steroids, or surgery to remove the tumour, so cortisol face as a result of Cushing’s syndrome should not be permanent,” Pillai adds.

How does cortisol benefit us?

As mentioned, our stress hormones can be beneficial, if used in the right circumstances. If you’re trying to beat a running PB, your body is likely to feel pretty stressed, if only for a while. And, if you’re working on perfecting that presentation, a degree of stress can help narrow our focus so we’re better able to get the job done.

In other words, don’t write cortisol off entirely.

“In fact, a study published in 2005 discussed how cortisol supports blood glucose maintenance, especially during times of stress, to promote brain function,” Pillai explains.

Another study showed how those treated with cortisol had less negative effects after stress exposure, compared to a placebo group. Again, think of that stressful work presentation or your annual review with your boss – a little stress can help us manage these situations more effectively.

And, while too much cortisol causes our body to hold onto weight because we think resources are scarce – as in the case of cortisol face – a little bit is actually can help us stay at a healthy weight.

“Cortisol regulates your metabolism by helping control how your body uses fats, proteins and carbohydrates for energy,” Banwell explains. “When cortisol is released, it signals to your body to use stored glucose as an energy source, as well as converting fats, proteins and carbohydrates into usable energy. This means you have a burst of energy to combat whatever stressor has caused the fight or flight response.”

And, while cortisol can cause inflammation if it remains too high for a long period of time, in short periods, cortisol can boost your immunity by limiting inflammation through preventing tissue and nerve damage associated with inflammation.

“Finally, when it comes to our sleep cycle, it is believed that cortisol plays a role by lowering in the evening so you feel more tired and peaking in the morning so you feel more awake,” Banwell explains. “When your cortisol levels are too high, this sleep-wake cycle can become unbalanced.”

How can we safely lower our cortisol levels?

Whether you’re looking to combat cortisol face for the ‘gram, or taking a more holistic approach to balancing your metabolism, inflammation and sleep, reducing high cortisol levels is always beneficial.

While stress doesn’t cause cortisol face, we do know that high levels of stress are linked to everything from depression to heart disease and your risk of stroke and cancer.

Banwell recommends you get your stress under control by increasing exercise, mindfulness and sleep.

“When we are stressed over a long period of time, cortisol levels are constantly elevated,” he says. “By increasing exercise, you are lowering your stress levels and increasing your dopamine and serotonin levels, making you feel happier and less stressed overall. Low-intensity activities like yoga, meditation or walking can help.”

Getting enough sleep can also help, while Pillai points to diets rich in omega 3 fatty acids like oily fish and nuts to support a reduction in cortisol levels.

“Studies have shown that a diet high in saturated fats and added sugars can cause higher levels of cortisol,” adds Banwell. “A diet high in protein, healthy fats and fibre helps to keep blood sugar and cortisol regulated.”

As with any problem, opening up to a partner can help – as can taking your stress into the bedroom: one study from 2008 showed that intimacy between couples was significantly associated with reduced salivary cortisol levels.

In summary, cortisol face might be an online phenomenon right now, but instead of looking to social media for quick fixes, focus on booking in a consultation with your doctor if you're worried about the issue.

And remember, unchecked regular high stress can impact more than just your selfies. Luckily, as outlined above, there are plenty of relatively easy and simple lifestyle swaps to help you banish stress, improving mood and self image in the process.

Words: Tom Ward