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Have you ever, especially after a particularly stressful time, looked in the mirror and barely recognized your puffy face? TikTok claims chronic stress leads to ‚Cortisol or Moon Face,‘ making facial features appear round and puffy.

 

 

But what exactly is Moon Face? How does Cortisol work in the body and should you really be worried?

Let’s take a closer look – from a medical perspective!

 

 

What is Cortisol Face according to Social Media?

Cortisol Face, often also called Moon Face, describes a previously more defined face becoming puffier and rounder. In recent months there have been more and more people on various social media channels that showed impressive before and afters of their face looking more defined after they “tackled their elevated cortisol”. Their explanation is that their chronic stress caused the previous puffiness because of chronically elevated Cortisol levels, hence the term Cortisol Face.

And it is true, very high levels of Cortisol over a prolonged period of time can cause fat pads to develop in the face leading to a very characteristic round face shape. But… this is probably not what you experience.

 

 

What is Cortisol and how does it affect the body?

Let’s look at the role Cortisol plays in the body first. While it’s commonly called the stress hormone, Cortisol actually plays many crucial roles in the body beyond stress response.

Cortisol is produced in the adrenal cortex both following a circadian rhythm – it rises in the early morning to help you get out of bed for example – and due to different triggers, for example perceived threats or illness. That means everyone has, at each moment in their life, a certain amount of Cortisol present in their blood stream. How much changes throughout the day.

If you encounter a stressful situation, for example you undergo surgery or you fear for your life, your body immediately releases Adrenaline and, if the stressor doesn’t instantly go away, Cortisol. This elevated Cortisol production goes away when the stressor has gone away. If you spotted a saber-toothed tiger, your body would release adrenaline to heighten alertness, followed by Cortisol to provide quick energy for escape. Once you did outrun the tiger, the Cortisol levels will drop again and your body functions will get back to normal.

Being too low on Cortisol is called Hypocortisolism and can occur due to different factors, for eample due to Morbus Addison, a disease where the adrenal cortex can’t produce enough Cortisol to meet basic demands. That leads to weakness, gastrointestinal symptoms, hypoglycemia and can, in severe cases, be deadly.

So you see, Cortisol is actually quite important.

 

 

How does Cortisol affect the face?

While a short term elevation of Cortisol will have no noticeable effect on your face, chronically elevated Cortisol levels might. It can lead to an increase in inflammation and oxidative stress, which might lead to faster breakdown of collagen, worsening of acne and other inflammatory skin diseases and slower wound healing with a higher risk of scarring or hyperpigmentation. (More info: The different types of hyperpigmentation explained)

If the levels are very high, like they are if you experience Cushing Syndrome, it can also lead to fat deposits in the face.

 

 

What is Cushing Syndrom?

But what is Cushing Syndrome? There are two different forms, endogenous and exogenous Cushing Syndrome, and both describe a condition where Cortisol is very, very high. Much higher than it will ever get if you experience stress.

That is either caused by a tumor in your adrenal cortex made up of cells that autonomously produce Cortisol without reacting to the body’s own control mechanisms – that is endogenous Cushing, with endogenous meaning “coming from within”.

Or it is caused by ingesting or injecting Cortisol in very high doses, usually as part of your medication for treating other diseases like autoimmune diseases or after organ transplant – this is the exogenous Cushing, exogenous meaning coming from the outside.

People suffering from Cushing Syndrome do develop a very round face, but the also show various other signs of Hypercortisolism. They have fat deposits in the face, the neck and around the middle part, leading to a characteristic hump between the shoulder blades often referred to as Buffalo Hump. At the same time they lose muscle mass, meaning they have thin arms and legs with a very round belly.

There is often flushing of the cheeks, so the face is not only round, but also quite red and increased hair growth on face and body with increased hair shedding on the head. The skin starts to thin, leading to increased chance of bruising with slower wound healing and the appearance of purple and quite broad stretch marks especially around belly and chest.

Not visible, but very important are an increased risk of diabetes, hypertonus, osteoporosis and infections.

 

 

So do you suffer from Cortisol Face?

It is highly unlikely that the puffiness you notice when you look in the mirror is caused by elevated Cortisol unless you experience other symptoms that are associated with Cushing Syndrome. If you, however, suspect that it is indeed Cushing you have, you should go see a doctor immediately.

Yes, chronic stress can lead to chronically elevated Cortisol levels. But they will not reach the heights you get from corticosteroid medication or when you have a tumor in your adrenal glands, and that is what would be needed to trigger the true “Moon Face”.

 

 

But why does your face look more puffy when you are stressed?

That doesn’t mean that the chronic stress won’t show on your face. Maybe due to the Cortisol – when an inflammatory skin condition you have gets slightly worse for example, or you feel breakouts or bruises take longer to heal than they usually do.

Or, and that is much more likely, due to lifestyle changes, because all the things you know you should do, like prioritize sleep, eat a balanced diet and get regular exercise, are the first things to fly out of the window when things get rough. Eating more processed foods, especially comfort food like crisps, often is associated with a higher salt intake which in turn promotes puffiness. The same goes for interrupted or too little sleep – puffiness all over.

You see, chronic stress will affect the way you look. But not because you get Cortisol Face.

 

 

Ways to mitigate stressful times

So, what can you do to be less stressed? That is the Million Dollar Question I guess.

First of all: Not everyone that experiences stress daily is chronically stressed. Many people do have stressful jobs, but manage to decompress so efficiently that their stress markers aren’t elevated over prolonged periods of time.

And while what works best is different for everyone, your best bet are the things both free and incredibly boring: Sleep, food, exercise and mindfulness.

• Prioritize your sleep so your body and mind can recover.
• Eat a balanced diet with nutrient rich foods so your body has the right fuel.
• Get regular exercise, as especially endurance training lowers Cortisol in the long run
• And practice mindfulness through meditation, breath work or whatever else you prefer. (More info: The benefits of meditation for well aging)

No, there is no supplement I recommend to lower your Cortisol. There truly is no short cut here, no magic pill you can pop to cut the line.

As annoying as it is, you know what you need to do – go on that stupid mental health walk and get to bed early.

 

TL;DR

Are you worried that elevated Cortisol levels are the cause of your facial puffiness? Do you think you see what TikTok catchingly calls Moon Face when looking in the mirror?

You don’t.

While high levels of Cortisol can lead to fat deposits in the face, true Hypercortisolism, also known as Cushing Syndrom, comes with more telltale signs than just a round face. You’d experience a sudden onset of stretch marks, muscle weakness, elevated blood sugar, weight gain around your midsection and other symptoms on top. If that is true, go see a doctor immediately. If you just feel stressed and your face is more puffy, it is much rather stress related changes in your lifestyle that are to blame than your Cortisol.

 

 

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