Cortisol face: Can stress cause a puffy face?

Cortisol face, a condition that can make your face look round and puffy, is still on TikTok. Many users of the platform say that it is a prominent effect of having high levels of cortisol or the stress hormone in the body. To prove their point, TikTok users show their “cortisol” face along with an “after” photo of a non-suffering face. When it comes to our body, cortisol has many functions. Intervening in the stress response is one of its most important functions. But is daily stress to blame for facial swelling or is it just a misconception?

What is the face of cortisol?

The real meaning of the term “moon face” or “cortisol face” is the appearance of puffiness or rounding of facial features, shares dermatologist Dr Neha Khuraana. There is no medical test called “cortisol face”. Instead, it’s just a sign of physical changes in the face due to certain health problems such as Cushing’s syndrome. It can cause heaviness in the face.

Can daily stress lead to cortisol levels?

Placing the face of cortisol on stress levels is a slightly more accurate statement. The main cause of such a facial expression is Cushing’s Syndrome, in which the body produces too much of the hormone cortisol, says psychiatrist Dr Ashish Bansal.

Cushing’s syndrome is caused by long-term exposure to high levels of cortisol, according to a study published in StatPearls in 2023. But this disease is rare, since its annual incidence is between 1.8 and 3.2 per million inhabitants, according to research published in Best Practice. Practice and Research in Clinical Endocrinology and Metabolism in 2021.

There is no doubt that daily stress raises cortisol levels in the body, but these are temporary and may not cause a cortisol spike, says Dr Bansal. If cortisol levels are high, it can cause water and sodium retention in facial tissues, and lead to a puffy face. But these physical changes will not be obvious.

As for Cushing’s syndrome, it is caused by other factors as well –

• Pituitary adenomas: The growth of benign pituitary tumor cells leads to the production of high levels of ACTH (adrenocorticotropic hormone), which causes the body to produce more cortisol hormone.
• Adrenal tumors: The growth of a Benign tumor in one or both adrenal glands puts the body at high risk of excessive production of cortisol, says Dr Bansal.
• Ectopic ACTH syndrome: Any tumor growth outside the pituitary gland may be in the lung, which produces more adrenocorticotropic hormone that causes the production of cortisol.
• Corticosteroid drugs: 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 often prescribed for autoimmune diseases such as asthma, rheumatoid arthritis or lupus.

How to get rid of puffy face?

The main task is to find the cause of swelling in the face.

1. Cushing’s syndrome

Treatment options available for treating Cushing’s disease include surgery, radiation therapy or medications to lower cortisol levels in the blood, says Dr. Bansal. For the growth of tumor cells in the pituitary gland, nose surgery is called transsphenoidal surgery. For the growth of cancer cells in one or both adrenal glands, the affected part is removed by adrenalectomy. If due to certain circumstances, especially if the tumor is large, surgery is not an option, radiation is given in order to detect and kill the tumor cells. Other drugs such as ketoconazole, metyrapone, and mifepristone may be prescribed by your doctor. They stop the production of the hormone cortisol in the body or block its action.

2. Lifestyle changes

Eat a balanced diet that includes whole grains, fruits, vegetables and protein, says Dr Khuraana. Reduce sodium intake, which can lead to water retention and increased facial appearance. Also, high cortisol levels are caused by being overweight, so exercise regularly to control your weight.

3. Avoid drinking alcohol

Drink alcohol in moderation so you don’t end up with a puffy face. Women who drink heavily (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 very little food

Inflammation can cause swelling, and therefore, can make the face look puffy. Limit your intake of foods that can cause inflammation in the body. This list includes processed foods, sugary drinks, and refined carbohydrates.

5. Sleep well

Poor sleep can have a negative impact on your health. It can make you feel irritated, and it also causes a puffy face. Try to get 7 to 8 hours of sleep a night, suggests Dr Bansal.

Being stressed every day won’t give you a “cortisol face”, but the stress hormone may play a role in your puffy face. It can be caused by Cushing’s syndrome, which is rare.