Could stress give you a round face? Unpacking myths, facts behind TikTok’s cortisol face trend
Cortisol often gets a bad rap for its association with stress…
Is your face puffy and swollen after you experience stress? If yes, you might just get diagnosed with ‘cortisol face’, as per TikTok. The popular tagline doing the rounds is ‘You aren’t ugly. You just have cortisol face’.
Recently, influencers have attributed a round, bloated appearance to elevated cortisol levels, claiming that stress is the culprit. Many have sworn they’ve transformed their looks simply by ‘managing’ stress, sharing before-and-after photos to showcase their leaner faces versus their ‘stress-induced cortisol’ faces. The chatter does not end there: People are even selling products and programs, claiming the reduction in cortisol and lead to a slimmed-down appearance.
“The reason you’re getting a double chin, you have puffy eyelids, and your cheeks are sagging is because your high cortisol is silently changing the way your face looks,” one video dramatically declares.
To quote one confused user who commented on one such video, “The science is just not scienc-ing.”
So, what is cortisol really, and does it really lead to a ‘round face’?
What is cortisol?
Cortisol often gets a bad rap for its association with stress, but it’s essential for our survival. Explaining what exactly cortisol is, Layla Shariffm a Dubai-based clinical psychologist says, “It’s a steroid hormone, produced by adrenal glands, which are small triangular glands right above the kidney. It is called the stress hormone, however it does far more than just respond to stress. It’s crucial for the functioning of various internal organ systems, such as maintaining blood pressure, blood sugar levels, and also controls how our body uses carbohydrate fats and proteins for energy, which reduces.”
On digital platforms, people have cited cortisol as the main reason for fatigue, dull skin and a puffy face. Trying to separate the facts from misinformation, Shariff stresses that while stress can affect our health and skin — causing acne or eczema flare-ups — these facial effects are not simply instantaneous. In other words, just because you’re stressed, your face doesn’t swell up immediately as if you’ve just suffered an allergy. “It takes years of brutal stress for such effects to show,” says Shariff. As she maintains, ‘cortisol face’ is not a medical term. And neither should it be confused with Cushing syndrome, which is an uncommon endocrine disorder.
Cushing Syndrome
According to Shahistha Joshi, a Dubai-based endocrinologist, the symptoms of Cushing Syndrome is the accumulation of facial fat and a symptom called ‘moon face’. These are caused by prolonged, sustained exposure to cortisol as opposed to intermittent, temporary spikes, which is what most people experience when they’re stressed out. She explains, “Even if people are really stressed out, they will not experience the high levels of cortisol as seen with those suffering from Cushing Syndrome.”
There are many such reasons for Cushing Syndrome. It can also result from long-term use of corticosteroid medication, like prednisone, or it can be caused by the body itself producing excess cortisol. This overproduction can occur due to:
• A tumor in the pituitary gland (called Cushing disease) that signals the adrenal glands to make more cortisol.
• Tumors in the adrenal glands that directly produce excess cortisol.
• Tumors in other parts of the body (such as the lungs) that produce a hormone called ACTH, which stimulates cortisol production.
As a result, there will be weight gain especially around the mid-section and upper back, a ‘round full face’, dubbed as ‘moon face’, fat accumulation between the shoulders, and thin, fragile skin that bruises easily, accompanied by high blood pressure and muscle weakness. As Joshi adds, medically elevated cortisol levels differ from mildly increased levels and require diagnosis through blood tests.
So what can really cause a puffy face?
There can be an entire constellation of factors that cause a puffy face, including water retention, allergies or inflammation, explains Joshi. “The facial puffiness can be linked to the lymphatic or circulatory systems, an allergic reaction, a sinus infection, or even lying down or sleeping for extended periods, which can cause fluid to accumulate around the face,” she says. What people on TikTok are describing can be medically explained by a combination of factors, rather than being attributed solely to cortisol.
There is a deep, complex relationship between stress and our health, adds Shariff. For instance, here’s a scenario: If someone is anxious, they don’t have the energy to cook. They’ll order some fast food, which might have higher levels of sodium. They aren’t sleeping well either: They’re staying up at night, pondering about work and personal troubles. A few days later, they notice that they have a puffy face. The possible reason behind this could be lack of sleep, dehydration and increased salt in their diet.
Cortisol face: An oversimplification of stress
It’s not always that straightforward, and ‘cortisol face’ is an oversimplification of stress, adds Shariff. Joshi elaborates, “Cortisol is just one hormone involved in the body’s stress response. Other hormones, like adrenaline and aldosterone, also fluctuate during stress and impact water retention, weight gain, and inflammation, all of which could contribute to facial changes.”
Moreover, people have different reactions to stress. “While some may experience weight gain or puffiness, others might lose weight or show no visible physical changes at all. The effects of stress manifest in a range of ways, depending on genetics, lifestyle, and overall health,” adds Joshi. For instance, some people are genetically predisposed to release higher levels of cortisol under stress, which can lead to increased fat storage, particularly around the face and abdomen. Others may have a different hormonal response, showing less of a physical effect despite experiencing the same level of stress. Similarly, there are individual variations in metabolism, the efficiency of the lymphatic system, and even the way the body processes sodium and water retention are all influenced by genetics, meaning that not everyone will experience puffiness or bloating.
Chronic stress and high cortisol levels can accelerate premature ageing as it fastens collagen breakdown, which can lead to wrinkles and sagging. High cortisol can exacerbate skin conditions like acne, eczema by increasing inflammation....
Your lifestyle also reflects on your body, explains Joshi. “Diet, sleep, and exercise routines influence how stress impacts the body. Someone who turns to comfort eating, particularly sugary or salty foods, in times of stress is more likely to gain weight and experience bloating or facial puffiness due to increased water retention. Meanwhile, someone who loses their appetite or eats less when stressed may lose weight.”
The way stress affects each person is shaped by a complex blend of biology, habits, and health, explain the specialists. Lakshmi Saranya, a clinical psychologist explains, "Chronic stress and high cortisol levels can accelerate premature ageing as it fastens collagen breakdown, which can lead to wrinkles and sagging. High cortisol can exacerbate skin conditions like acne, eczema by increasing inflammation." Some people may easily notice visible signs like a puffy face, while others may process stress internally without obvious physical changes. Understanding the complexity behind stress reactions helps explain why everyone does not experience ‘cortisol face’ or other visible signs of stress in the same way. So, while understanding how stress impacts the skin, it’s important to take steps to reduce stress, and realising it’s not as simple as social media makes it sound.
How do you keep your cortisol levels under control?
What you can do is focus on your health and well-being, explain the specialists. This would involve sleeping for a good 7 to 9 hours, else a poor night’s rest can lead to higher levels of cortisol. “You can also work on physical exercise, such as walking, swimming, or cycling helps reduce cortisol levels. Intense, prolonged exercise can sometimes spike cortisol, so aim for balance,” warns Shariff.
Finally, eat a balanced, nutrient-rich diet and cut out the snacks. Focus on anti-inflammatory fruits, vegetables, whole grains, and healthy fats, such as Omega-3s from fish or flaxseed. These help combat inflammation that stress and cortisol can cause. “Reduce sugary foods as they contribute to cortisol imbalances and lead to blood spikes,” adds Shariff. And, don’t forget to stay hydrated.