What is “cortisol face” and why is TikTok obsessed with it? | Well, actually

DDoes your face sometimes feel swollen? Do you occasionally experience the feeling of “stress”? According to some of the world’s leading medical thinkers (TikTok influencers), these are not simply inevitable consequences of existence; These are signs that you may have what is known as “cortisol face.”

Cortisol is the body’s most important stress hormone. According to hundreds of clips on social media, excessive stress—and therefore excess cortisol—leads to a round, puffy face. “You’re not ugly, you just have cortisol on your face,” is a popular refrain in these videos. In posts, users share before and after pictures of themselves going from a round, full face to a slim face – all prominent cheekbones and sharp jawline.

“The reason you get a double chin, puffy eyelids and sagging cheeks is because your high cortisol levels are silently changing the look of your face,” one video says.

Aside from the explicit fat-shaming in these messages, the science doesn’t quite hold up. “‘Cortisol face’ is not a recognized medical term,” explains Dr. Priya Jaisinghani, an endocrinologist at New York University Langone Health.

Sustained high cortisol levels can have detrimental health effects. Over time, excess cortisol can lead to Cushing’s syndrome, a condition that can lead to high blood pressure, bone loss and occasionally type 2 diabetes. But Cushing’s syndrome is relatively rare, experts say.

We asked experts about the truth behind this new wellness term.

What is cortisol and what effects does it have on our health?

“Cortisol is a steroid hormone produced by the adrenal glands,” says Dr. Adam Friedman, professor and chair of dermatology at the George Washington University School of Medicine and Health Sciences. He explains that it plays an essential role in a number of bodily functions, including regulating metabolism, controlling our immune and stress responses, and maintaining blood pressure.

“Without the right amount of cortisol, we can’t survive,” says Friedman. But too much of it “is a bad thing.”

Doctors can determine your cortisol levels by testing your blood, urine, or saliva.

What is Cushing’s Syndrome?

There are two types of Cushing’s syndrome, says Dr. Maria Fleseriu, Director of the Pituitary Center at Oregon Health & Science University: exogenous (the result of a factor outside the body) and endogenous (the result of a factor inside the body).

Exogenous Cushing’s syndrome is typically the result of steroid treatments, particularly glucocorticoid medications such as cortisone and prednisone. These can increase cortisol levels in the body.

This is far more common than endogenous Cushing’s syndrome, which can be caused by a pituitary tumor or an adrenal gland disorder.

While everyday stress can contribute to weight gain, Friedman says, it’s unlikely to happen “to the extent that it does with medical syndromes like Cushing’s syndrome.”

“Cushing’s syndrome is rare,” says Fleseriu, who estimates that there are four to five cases of endogenous Cushing’s syndrome per million people per year worldwide.

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Is facial cortisol real?

Sort of, but not in the way that is generally discussed on TikTok. As Jaisinghani says, it is not a medical term.

Weight gain in the face and neck is a common symptom of Cushing’s syndrome, but that alone is not enough for a diagnosis, says Fleseriu. “The clinical diagnosis of Cushing’s is a major challenge,” she explains. When determining whether a patient has the disease or not, Fleseriu says she looks for “more than one symptom.”

Other symptoms of Cushing’s syndrome include pink and purple stretch marks on the stomach, high blood pressure, thin skin that bruises easily, a lump of fat between the shoulders, and weight gain on the face and trunk while limbs and extremities remain thin.

How do you regulate your cortisol levels?

The risk of developing Cushing’s syndrome is relatively low. However, Jaisinghani says people can manage their stress and cortisol levels by taking care of their overall health. She suggests “maintaining a nutrient-dense diet, ensuring adequate, quality sleep, staying hydrated, and incorporating stress reduction strategies.”

If one is diagnosed with Cushing’s syndrome, treatment options vary. If it is exogenous, Fleseriu warns that it is important not to stop or reduce the intake of glucocorticoid medications without medical supervision. “Immediately stopping steroids could lead to an adrenal crisis,” she explains.

In the case of endogenous Cushing’s syndrome, patients may take medication or undergo surgery or radiation to remove any tumors. Generally, these treatments are successful. “We can currently induce remission in almost everyone,” says Fleseriu.

If you think your cortisol levels are high, don’t turn to TikTok for answers. “If you are concerned about your cortisol levels, it is important to consult your doctor,” says Jaisinghani.