Is ‘cortisol face’ actually a thing?

Has someone on the internet warned you that high stress was giving you a round, puffy, “cortisol face”? Did they then try to sell you a supplement to cure it? 

You’re not alone. 

We found countless testimonials from social media influencers describing how their faces swelled from high levels of the stress hormone cortisol — levels they alleviated through diet, de-stressing or taking over-the-counter supplements like magnesium or ashwagandha. 

But is “cortisol face” a real thing? Not in the way these online influencers would have you believe. 

What is cortisol? 

Cortisol is a hormone produced by the adrenal glands above your kidneys. Cortisol spikes when you experience stress, and it has other jobs as well. It regulates metabolism and blood pressure, lowers inflammation and regulates your sleep-wake cycle. 

The body naturally keeps cortisol levels in check, but certain medical conditions or medications can disrupt that balance. 

High cortisol from medical conditions — not day-to-day stress — can cause face roundness

Persistently high levels of cortisol, or hypercortisolism, is a medical condition called Cushing’s syndrome. And although this condition can lead to facial roundness, it’s not something that can effectively be addressed with simple diet changes or herbal supplements. It comes from serious dysfunction in the body, one requiring medical evaluation and treatment.

Cushing’s can be brought on by long-term use of steroids such as prednisone, dexamethasone, budesonide and hydrocortisone. It can also result from tumors often found in the pituitary or adrenal glands causing the overproduction of the hormone.

Such high cortisol production can lead to fat accumulation in the face, tissue swelling, and thinning of the skin that can all lead to a round, swollen appearance. 

The spikes of cortisol from day to day stressors — the ones that people are talking about online — are very unlikely to raise cortisol levels high and long enough to cause this change to facial features.

If someone is experiencing persistently high levels of cortisol, there will likely be other symptoms like weight gain, easy bruising, weakened muscles, purple stretch marks on the abdomen, or a fatty hump between the shoulders.

Other health conditions can also increase cortisol and cause symptoms similar to Cushing’s syndrome, but have a separate underlying cause that must be treated. Examples include chronic alcohol abuse, eating disorders, severe depression or anxiety or poorly controlled diabetes. 

If you are worried about high cortisol levels, or an unusually rounded face, speak with your doctor about your concerns. 

But don’t use the term “cortisol face,” it’s an internet term, not a medical term. 

A swollen, puffy face could have many other causes

There are many reasons, aside from cortisol overproduction, that could cause a person to appear swollen or puffy. 

A high salt diet can cause the body to hold on to extra fluid. Allergies, reactions to medications, or acne may also cause a swollen face.

Any other health issues that impact how the body retains fluid like thyroid or kidney issues may also cause facial swelling.

Stress might be playing a role — but not just through cortisol production. Stress can contribute to weight gain, poor sleep, and increased inflammation that can all lead to changes in facial appearance.

Reducing stress in your life is never a bad idea, so if you are really concerned about your health, talk to a professional.